Delaying health care tax risks care for a million Oregonians (Guest opinion)


Medicaid, the federal-state partnership program that provides health coverage and long-term care services for one-in-five Americans, turned 52 on July 29. One of Medicaid’s creators, Hubert Humphrey, said: “the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life, the sick, the needy, and [people with disabilities].”

When it comes to Medicaid funding, we are facing a moral test of government at both the state and federal levels.

The Oregon Health Plan (OHP) is our state’s version of Medicaid, and it serves about one million Oregonians. The OHP — especially since the advent of coordinated care organizations in 2012 — is widely regarded as among the nation’s most innovative and cost-effective Medicaid programs.

Last December, I wrote about the need for Oregon to strengthen its commitment to the Oregon Health Plan in the face of a $1 billion budget gap.

Oregon legislators answered that call and passed House Bill 2391, a funding package that will sustain the plan’s services for the next two years. Together with significant budget cuts, the revenue raised by the bill was a collaborative solution supported by nearly every coordinated care organization, health insurer and hospital in the state.

The package generates more than $600 million from assessments on those health care entities and brings in more than $2 billion in federal matching funds for OHP.

As the chief executive of Health Share of Oregon, a coordinated care organization, I supported this bill that will protect our most vulnerable citizens. Specifically, it will protect coverage for more than 215,000 Health Share members, 76,000 of whom qualify for coverage under the Affordable Care Act.

However, opponents are already campaigning to derail efforts to protect health coverage by gathering signatures to refer HB 2391 to voters. This would put a hold on collecting tax revenue until January, which would put the entire Medicaid system (and thousands of lives) in danger.

These are scary times, with the looming threat of the federal government passing deep cuts to Medicaid through attempts to repeal the ACA. That would eliminate health care coverage for millions and take OHP many steps backward. While our instincts might tell us to retreat, it’s more important than ever that Oregon remains a leader now, when the stakes are highest.

Oregon’s health system transformation is already showing tremendous results, but it’s far from complete. We must continue improving the system if we are to impact the cycle of poverty, reducing health care costs and improving health in the long term.

Critics of HB 2391 claim the 1.5 percent tax on some commercial insurance plans will hurt the customers of those plans. However, the rise in premiums for those customers — if insurers choose to pass on the tax — is minimal: between $6 and $7.50 per month on average. The alternative is to eliminate health coverage for more than 400,000 Oregonians.

If the right to health care isn’t persuasive enough, the economic benefits of investing in health are beyond dispute. An Oregon Health Authority report shows that increased spending on evidence-based public health interventions offers the best chance to “reduce substantial costs to society and the public insurance system.”

Before you sign a petition for this voter referendum, please recognize their campaign for what it is: an effort to roll back Oregon’s successful Medicaid expansion at the expense of proper coverage for all Oregonians and a stable health care market. The health of our communities and Oregon’s economy is too important to ignore.

Janet L. Meyer is the chief executive of Health Share of Oregon.


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