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Free Health Clinic Opens At Clackamas Community College

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Clackamas Volunteers in Medicine is relocating to the college campus to expand services for low-income, uninsured and underinsured patients.

What might TrumpCare look like?

Oregon has plenty to lose when it comes to President-elect Donald Trump’s vow to change the nation’s health care system.

His surprise victory threatens state officials’ hope of plugging a looming budget hole with $1.25 billion in federal health care reform payments, and his vow to immediately repeal Obamacare creates uncertainty for more than 470,000 Oregonians who received coverage or subsidies under the law.

However, Trump already has signaled a willingness to reconsider aspects of the federal Patient Protection and Affordable Care Act, and observers believe nobody’s coverage is in immediate danger. Any changes could take until 2018 to filter down.

Here’s what Oregonians should know as Trump prepares to take office in January.

Oregon Health Plan

About 1 million Oregonians are enrolled in the state’s version of Medicaid, the government low-income health care program.

Of those, 378,607 adults qualified under Obamacare’s expansion of Medicaid, which in Oregon boosted the maximum income to qualify from 100 percent of the federal poverty level to 133 percent. Instead of having to earn $20,160 or less to qualify, a family of three could make a little more than $26,800 under the new cap.

But while Trump has vowed to repeal and replace Obamacare, it’s unclear how that might affect Medicaid expansion.

Jeff Heatherington, CEO of Portland-based Family Care, one of 16 organizations around the state providing for Oregon Health Plan members, echoes other health care officials in saying it’s unlikely Republicans will strip millions of Americans of their health care.

“I think it would be a crazy disaster,” he says. "Hospitals and the pharmaceutical companies would argue against doing that because they’re making too much money.”

Trump has proposed turning Medicaid into a program that gives states block grants rather than placing restrictions on the spending. Republicans in Congress, meanwhile, have long sought to add conditions to the program such as premiums or work requirements.

Oregon could be shielded from changes under an application for a five-year waiver from standard Medicaid rules. President Barack Obama could approve the plan before leaving office.

Gov. Kate Brown’s office released the following statement: “There will be a lot of speculation in the next couple of months, but we have to work with the facts we have, which is that Oregon has a successful coordinated care model that is improving the quality of care while holding down costs.”

State budget hole

Oregon faces a nearly $1.4 billion budget hole over the next two years.

The state’s waiver application includes a request for $1.2 billion over the next five years from the federal government, which could to help plug that hole. A similar request by Gov. John Kitzhaber in 2012 yielded $1.9 billion.

But even if the state’s Medicaid waiver request is approved by Obama, any funding that goes with it could be cut off by the Trump administration at any time, officials say. “I think that could be at risk,” said Health Share of Oregon CEO Janet Meyer.

Any resulting budget pressures could affect how the state administers the Oregon Health Plan.

Obamacare private insurance

More than 220,000 Oregonians not covered by employers or Medicare buy their own insurance policies in a market that has undergone a radical makeover under the Patient Protection and Affordable Care Act.

Obamacare bans insurers from discriminating against people with pre-existing medical conditions and levies a tax penalty against many of those who don’t have health coverage, while offering subsidies to those with incomes of 400 percent of federal poverty level or less.

About 130,000 Oregonians signed up through the federal website HealthCare.Gov, and of those 95,000 qualified tax credits to offset their premiums, averaging $250 a month.

Premiums for the 130,000 Oregonians who don’t receive subsidies have skyrocketed, however.

Since winning the election, Trump has said he favors preserving Obamacare’s guarantee that sick people can’t be denied coverage — triggering speculation that the changes to Obamacare may not be as widespread as advocates of the law feared.

What might the future hold? “We can’t answer that right now — it’s too early to tell what changes may be made,” said Lisa Morawski, a state spokeswoman.

Morawski says people should keep enrolling for 2017 private health insurance. Those who do are guaranteed no changes in terms for the coming year.


More than 750,000 Oregonians receive benefits under Medicare, the health insurance program for people 65 and older.

Trump has vowed to preserve and modernize Medicare, but congressional Republican leaders want to and turn it over to private insurers.

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Measure 97 breaks fundraising record

Measure 97 has shattered the state’s record for the most money contributed to a battle over a ballot measure.

The campaign to defeat the corporate sales tax measure has reached $22.5 million in contributions, more than double what proponents of the corporate sale tax have raised, according to campaign finance records. The Yes on 97 campaign has raised $10.9 million.

The record previously resided with the fight over GMO labeling in 2014, when opponents and proponents raised a combined $29 million.

In the past several days, three major grocery chains have contributed a combined $2.7 million in a final push against Measure 97, as voters received ballots in the mail this week. Costco, Albertsons/Safeway and Kroger/Fred Meyer each donated $900,000 to the campaign.

The Yes on 97 campaign also continued to receive donations, largely from public employee unions.

The measure would levy a 2.5 percent tax on the Oregon sales of “C” corporations exceeding $25 million, while “S” corporations — some with similar business structures and sales — would pay no additional tax.

Unlike S corporations, there are no limitations on the number of shareholders in a C corporation, and C corporations generally pay a corporate tax on the company’s income, while shareholders also have to pay taxes on any income or dividends they receive from the company.

The tax would yield about $6 billion per biennium in additional revenue for the state and provide a stable funding stream for state services such as education, health care and senior services. The budget gap for the coming biennium is estimated at just under $1.4 billion.

The tax directly targets big corporations such as Costco, Safeway, Kroger and Walmart, but some homegrown Oregon businesses also would have to pay the tax. In addition, many smaller businesses and chambers of commerce are opposing the tax because it would increase their cost of doing business due to higher prices for supplies and utilities.

The nonpartisan Legislative Revenue Office has estimated that the tax would likely cost the typical household about $600 more per year in the form of higher prices and slowed job growth.

By Paris Achen
Portland Tribune Capital Bureau Reporter
email: [email protected]
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Marijuana measures go before metro voters

Local pot tax, retail sales ban appear on many Nov. 8 ballots

Although legalizing marijuana is not on Oregon’s statewide ballot for the first time in four election cycles, many metro area voters will decide the fate of 29 marijuana-related measures in the Nov. 8 general election.

Marijuana measures go before metro voters

Local pot tax, retail sales ban appear on many Nov. 8 ballots

Although legalizing marijuana is not on Oregon’s statewide ballot for the first time in four election cycles, many metro area voters will decide the fate of 29 marijuana-related measures in the Nov. 8 general election.

Some voters, particularly in Portland and Clackamas County, will decide whether to impose a 3 percent local tax on top of the statewide tax on retail sales of marijuana for recreational use.

Some voters will decide whether to keep current city bans on retail sales and related facilities.

Voters in five cities — Canby, Gladstone, Oregon City, Sandy and Sherwood — will decide both types of measures. If voters uphold the bans on retail sales, the added local tax would not take effect even if voters approve.

All of these local measures stem from Oregon’s 2014 ballot measure that legalized marijuana for recreational use and follow-up action by the Oregon Legislature to carry out the new law.

Political observer Jim Moore says voters probably have not seen the last of marijuana on the ballot.

“The reason why all these measures are out there is that there are a lot of pockets in this state that just disagree with the (2014) statewide vote,” says Moore, who teaches politics at Pacific University.

“The measures are a reaction by their city councils and county commissioners to that approval. The people who oppose a statewide measure say they want local measures to prevent their sale.

“I think that shakeout will continue for at least one more election cycle — unless the Legislature puts its foot down and says there can be no local exceptions.”

A 25 percent state tax was imposed on medical marijuana dispensaries selling cannabis for recreational use — cannabis for medical use remains untaxed — but the state rate will drop to 17 percent on Jan. 1. Cities and counties have the option of adding 3 percent with voter approval.

Nineteen of the metro-area measures fall into this category.

Cities and counties also will share part of the proceeds from the state tax, unless they choose to bar retail sales, in which case they get nothing. Under state law, 10 percent of state proceeds will go to counties and 10 percent to cities, all for law enforcement.

The other 10 measures on metro-area ballots ask voters whether they want to uphold current bans on retail sales of marijuana and related facilities, such as growing and processing.

State law allows that option for cities and counties, but required many of them to put the question to voters in the Nov. 8 general election. Although majorities of voters in several counties opposed the 2014 legalization in the form of Measure 91, majorities in Multnomah, Washington and Clackamas counties voted for it.

According to the Oregon Liquor Control Commission, which regulates recreational-use marijuana, bans are in effect in a total of 85 of Oregon’s 240 cities and 18 of 36 counties. Forty-five cities and five counties have referred their bans to voters Nov. 8.

In Canby, the ballot question asks voters whether they want to remove the ban; in all other cities, the question is whether they want to uphold the ban. So a “yes” vote in Canby would be the opposite of a “yes” vote in the other cities.

Cities with a ban cannot share in the state tax or levy their own tax.

The city bans do not affect the provision of the 2014 law that allows each household to grow up to four plants, more for medical-marijuana cardholders and caregivers.

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