Health care is front and center on the Oregon ballot.
Three measures up for a vote would change how the court handles and treats low-level drug offenders, raise the tax on tobacco and vaping products and make Oregon the first state to start regulating hallucinogenic drugs for therapy.
As part of the drug measure, voters will decide if Oregon should get rid of criminal charges for low-level drug possession cases and put part of the existing marijuana tax revenues toward substance abuse treatment programs. The tobacco tax measure would put a new tax in place for nicotine vaping products to raise money for Medicaid and programs to prevent and stop smoking and vaping.
And the third ballot measure would allow Oregon patients to receive hallucinogenic drugs as a treatment therapy for mental health problems.
Supporters of the ballot measures made a pitch to voters on Tuesday at a virtual event organized by the Oregon Health Forum, a partner of The Lund Report. The event drew nearly 180 attendees.
Here’s a look at the ballot measures:
What It Does: Measure 108 would raise the tax on cigarettes another $2 a pack, making the total state tax $3.33. Oregon’s $1.33-per-pack cigarette tax is the lowest on the West Coast.
The measure also would raise to $1 the 50-cent cap on the tax for each cigar.
The measure would levy a 65% wholesale tax on nicotine vaping products and e-cigarettes. Those products are not taxed now.
The tax money would go toward Medicaid and programs to prevent and stop smoking and vaping, including among youth.
Who Supports/Opposes It: Supporters include public health groups like the American Heart Association and the Oregon Association of Hospitals & Health Care Systems, hospitals and health care providers throughout the state.
Christina Bodamer, Oregon government relations director for the American Heart Association, said at the online forum that the ballot measure is aimed at reducing smoking and vaping rates. The measure would put the Oregon Health Authority in charge of distributing the program money to communities and organizations such as tribal health providers and regional and local public health programs. The measure allows the authority to take into account the local needs of communities and groups that seek funding, including smoking rates.
“This is a very dynamic work that needs to have some flexibility,” Bodamer said.
A “Vote No on Measure 108” group has formed in opposition, with backing from the vaping industry. Opponents argue that the tax is regressive and disproportionately harms low-income people. But supporters say the measure helps low-income people who rely on Medicaid for health care and benefit from programs to stop smoking.
The health care industry is the driving force behind the campaign’s funding, with hospitals donating about $7 million to support the measure.
The tobacco industry so far has held off on opposition spending. In 2007, the industry spent millions to successfully defeat Measure 50, a nearly 85-cent-a-pack increase to raise money for children’s health insurance coverage.
How Much It Will Cost: The state estimates the new taxes would pull in $331 million in the 2021-2023 biennium. Under the proposal, 90% of the money would go toward Medicaid and the remaining 10% would go to smoking and vaping cessation and prevention programs.
What It Does: Measure 109 would eventually allow the regulated manufacture and administration of psychedelic mushrooms in clinical settings to treat conditions like depression and post-traumatic stress. It would make Oregon the first state to regulate psilocybin for therapeutic purposes.
Who Supports/Opposes It: The measure stems from a campaign by Portland-area therapists Tom and Sherri Eckert. Other supporters include one of Oregon’s U.S. representatives, Democrat Earl Blumenauer, and Oregon Sen. Elizabeth Steiner Hayward, D-Portland, and a family physician. Supporters say that psilocybin could help Oregon’s mental health crisis in new ways, providing a new treatment option in a state population with a high prevalence of behavioral health. Oregon ranked the worst in a national study that analyzed the rate of adult mental health problems. An estimated one in five adult Oregonians suffer from a mental health condition.
They also point to research showing it can be effective for some patients.
The measure would give the Oregon Health Authority two years to establish a regulatory framework and system before psilocybin is available to adults 21 and older.
“Sessions will occur only in licensed facilities, not in residential neighborhoods,” Tom Eckhert said during the forum, stressing the focus on planning and safety in a tightly controlled environment.
The Oregon Psychiatric Physician Association and the American Psychiatric Association oppose the ballot measure, citing concerns about safety and the effectiveness of the product. Those groups say more research is needed before psilocybin can go on the market for a wide variety of conditions. The U.S. Food and Drug Administration has given “breakthrough therapy” status to psilocybin, which allows more research for treatment of major depressive disorder.
How Much It Will Cost: The state estimates it will cost about $5.4 million for the two-year period when the Oregon Health Authority develops a plan to regulate and license psilocybin. The money would come out of the state general fund. The ballot measure would establish an advisory body of experts and professionals to provide guidance to the authority during this process.
After the program is put in place, the state expects that the annual $3.1 million cost of regulating psilocybin would come out of taxes and fees directly linked to the program. There would be a 15% tax on retail psilocybin sales.
What It Does: Measure 110 would change low-level drug possession cases from misdemeanors or felonies to a citation with a $100 fine. Violators could avoid paying the fine if they get a health assessment at an addiction recovery center.
The measure would fund addiction recovery centers throughout Oregon with existing marijuana tax revenues and savings from reduced incarceration, arrests and supervision of people in the criminal justice system on non-commercial drug possession charges. The measure ensures that an addiction recovery center would be in each coordinated care region in Oregon and provide 24-hour services.
Who Supports/Opposes It: Measure 110 has a deep bench of support and opposition. Groups in favor include ACLU of Oregon, the Oregon Academy of Family Physicians, the Oregon School Social Worker Association and the Oregon Nurses Association. Supporters say the measure would destigmatize addiction and encourage people to get treated without facing the long-term burden of a criminal record.
“I’ve really seen the devastating consequences that our current systems are allowing to continue,” said Haven Wheelock, chief petitioner for Measure 110 and a harm reduction specialist at Outside In, a nonprofit that provides health care and safety net services in Portland. “‘I have watched hundreds of people that I know die because of lack of care.”
The measure has a variety of opponents, including advocates for treatment, such as Mental Health Association of Portland and Oregon Recovers. Others include Sheriffs of Oregon and district attorneys throughout the state. They have a range of concerns. For example, they say the measure does not raise any new funding, takes funding away from existing local city and county programs and diminishes the role that the criminal justice system can play in spurring people with addictions to get treatment, for example through drug court programs.
Supporters say the measure is narrowly crafted to only focus on low-level drug possession charges and does not eliminate drug court programs.
How Much It Will Cost: The financing of the measure is complex. The measure does not raise taxes, but it does pull money from marijuana tax revenues that go toward other government functions. The ballot measure would allow state lawmakers to appropriate the first $45 million annually in marijuana tax revenues toward unrelated purposes, like school funding and roads. All marijauana tax revenues that exceed the $45 million mark would go toward addiction recovery centers and substance use disorder services, including programs like housing and peer support services.
This would force other government programs to lose millions that they would otherwise receive from marijuana tax revenues. Public schools would lose the most money. For example, public schools would receive $73 million in the 2021-2023 biennium without the ballot measure passing, based on revenue projections and the current distribution plan for marijuana revenues. If the measure passes, public schools would not receive that funding.
So while the measure would not directly raise taxes, it may force lawmakers to look for other ways to fund programs due to the redistribution of marijuana revenues.
There could also be savings. The measure would save the criminal justice system an estimated $24.5 million in the 2021-2023 biennium because of fewer arrests and incarcerations. This savings would go toward the addiction recovery centers.
You can reach Ben Botkin at [email protected] or via Twitter @BenBotkin1.