Voters Give Whopping Support to Medicaid. Next Referral? Healthcare as Human Right
House Democrat Mitch Greenlick of Portland did not mince words in his response to the 62-38 passage of Measure 101, which will keep the Oregon Health Plan funded for the next two years.
“I think it was a fool’s errand by Rep. Parrish and Rep. Hayden and a total waste of time and money,” said Greenlick, the chairman of the House Health Committee. “I think the citizens got to know what a stupid idea repealing that [funding package] would be.”
He said he was not surprised at the overwhelming support voters gave to Measure 101, which could raise $320 million from hospitals and insurers to provide the state’s share of funding for the Medicaid expansion and other healthcare needs, bringing in an additional $1 billion in matching funds from the federal government.
The referendum was necessary after Rep. Cedric Hayden, R-Cottage Grove, and Rep. Julie Parrish, R-West Linn, opposed the deal and gathered enough signatures to put a vote before the people.
The Medicaid expansion has helped lower Oregon’s uninsured rate to just 5 percent and the Oregon Health Plan covers roughly one million residents, or a quarter of the state’s population.
Feeling bullish, Greenlick had predicted it would win 2-to-1.
Like the Martian invasion of Earth in Kurt Vonnegut’s “Sirens of Titan,” the attack on the funding stream for the state’s Medicaid plan was enough to bring together the warring players of the Oregon healthcare system, from hospitals to unions to Medicaid insurers, to fight together, against an opponent that was easily obliterated.
Yes for Healthcare raised $2.9 million to run a statewide campaign. After pushing the tax package onto the ballot with a tumult of fire and fury, the opposition ran a meager campaign, failing to attract more than token opposition from the business community, which will pay modestly higher insurance premiums to stabilize the market for individual policyholders and ensure coverage for poor Oregonians and children.
The Stop Healthcare Taxes campaign raised only $70,000. Hayden said the lopsided funding between the two camps was a cry for campaign finance reform -- particularly because among the leading funders of the Yes for Healthcare campaign were Medicaid providers, ultimately using taxpayer dollars for political purposes. Oregon is one of the few states that has no limits on campaign spending.
Hayden said he was unable to win much support from the business community because large corporations like Nike or Intel self-insure their employees’ healthcare plans and were not directly affected by the tax plan. He said small businesses could not compete with the millions spent by the healthcare industry. “Money talks and if somebody’s able to out-raise their opponents 35 to 1, we can’t compete,” he said.
Measure 101 passed in all but four counties in Western Oregon, including some surprises such as conservative-leaning Curry, Polk and Yamhill counties. At the same time, Coos County continued its rightward drift and voted down the funding package. And in the sparsely populated and deeply conservative eastern half of the state, Measure 101 passed in just three counties.
The Democratic Party of Oregon quickly pivoted to latch Gov. Kate Brown’s most likely opponent in the fall election, Rep. Knute Buehler, R-Bend, to the unpopular opposition campaign, as well as President Trump, a foil the Yes for Healthcare campaign used in its online ads.
“The overwhelming passage of Measure 101 by Oregon voters tonight shows the rough road ahead for Knute Buehler and Oregon Republicans heading into this fall’s general election,” said party spokeswoman Molly Woon. “As a progressive Blue Wave continues to sweep the nation, the decisive victory of Measure 101 should be seen as a clear warning to Republicans like Buehler who ignore voters’ priorities on healthcare and instead side with President Trump in advocating reduced access to healthcare.”
Buehler had signed onto the opposition campaign early, and emphasized that bad governance at the Oregon Health Authority mandated that the Legislature take a closer look at the agency’s accounts before approving funding.
He reiterated that line of reasoning in his Twitter response to the passage: “With Measure 101 now resolved, the Legislature should turn its attention to bipartisan reforms to secure repayment of $74 million+ in provider overpayments, correct OHA mismanagement and advance CCOs.”
Buehler has introduced legislation for 2018 that would force the Medicaid coordinated care organizations to repay the state for overpayments made in past years -- the state has already recouped money from 2017. His other bill would require more transparency for the CCOs and require them to spend on upstream health improvements in social determinants of health.
Not all Republicans opposed Measure 101, and the statement from Senate Minority Leader Jackie Winters, R-Salem, underlined the lonely position Buehler took with Hayden and Parrish:
"The voters have approved Measure 101, voting to protect health care for over 300,000 Oregonians,” Winters said. “This is a short-term fix, and we will need to work to find a bipartisan long-term solution. I am hopeful that we will move forward with this bipartisan spirit into the 2018 short session."
Greenlick was excited about what the support for Measure 101 might mean for his own ballot referral in November, which asks voters to amend the state constitution to add healthcare as an intrinsic right for every Oregonian. If that passes, its popular support could open the door to improvements to healthcare financing to provide more affordable, universal healthcare access.
He found 40 co-sponsors for House Joint Resolution 203, including the House Democratic leadership and more moderate Democrats such as Sen. Laurie Monnes Anderson of Gresham and Sen. Lee Beyer of Springfield.
“I think it does indicate there’s a fair amount of support for the healthcare system,” Greenlick said.
Reach Chris Gray at [email protected].