A group tasked with forging Oregon’s path to universal, state-run health care coverage will delay its report to the state by several weeks, after its members acknowledged in a vote Thursday they had not made as much progress as hoped
Whereas before, the special report was set to be delivered on Sept. 15, it is now set to arrive by Dec. 1. The delay means lawmakers will have less time to review the recommendations before the long legislative session kicks off early next year. Backers have said they hope state lawmakers would refer it to voters on the 2028 ballot, but now that timeline looks even more ambitious—and, to critics, preposterously unrealistic
State lawmakers created the Universal Health Plan Governance Board in 2023, asking it to take the baton from a previous group that had mapped out a framework for a centrally administered universal health care system in Oregon—like the Oregon Health Plan or certain aspects of Medicare, but for all. In the emerging vision, the system would be run by an Oregon public corporation created for the mighty task
The board is made of health system stakeholders and experts. Its mandate was to put more meat and specifics into the vision, specifically around finances and administration. This September, it was supposed to deliver lawmakers material that would be the grist for concrete legislation
The delay in that report reflects concerns the board has not yet accomplished this task. As The Lund Reportdocumented this past spring, the group’s finance committee had substantial disagreements over how much the plan would cost and how it would be funded. And, months later, these concerns linger. The Oregon Capital Chronicle was first to report the news of the board’s vote to delay its final report, which occurred in a special meeting Thursday
Seven board members voted to delay the report: They were Chunhuei Chi—see his interview with WW from this past spring—Amy Fellows, Michelle Glass, Bruce Goldberg, Cherryl Ramirez, Mary Lou Hennrich and Michael Leahy
Opposing the delay were board chair Helen Bellanca and Judy Richardson
The delay is a setback for Oregonians who hope to see the state do what no other could. The concept would in much of the developed world appear unremarkable, but in the U.S.’s sprawling, tangled, expensive and administratively opaque system would prove nothing short of radical: a centralized, government-run system that administers and funds Oregonians’ health care—fueled by a mix of federal dollars and larger employer and income taxes for some within the state
Some Oregonians would pay far more, others would pay less. Health insurance premiums would go away entirely. Even as some argue the model would, in its final form, reduce overall health system spending, there is no doubt the plan would incur a gargantuan overall sticker cost—many tens of billions of dollars per year (one committee estimate is between $70 billion and $80 billion)
The question is precisely how much. And how this compares to the status quo. And how much new tax revenue would need to be raised. And how much simplifying the system to have just one major payer would reduce overall administrative burden
The board has been working on these questions. Another question: how to communicate the vision to the public
No matter its final form, the proposal, if it did make it to the ballot, would face profound political resistance. It’s common for health care actors of all stripes to express some level of disgust with the U.S. health care system, but the fact is many are deeply invested in the status quo—particularly in a state like Oregon, where health care is the largest employer and a source of many very-high-paying jobs. And as the Oregon Journalism Project reported last month, state spending on health care and other social services has already well outpaced inflation and population growth over the past decade, draining the general fund of money that could go to other core services like education.
The measure would also face resistance from those wary of a greater tax bill, not to mention industry forces, like private health insurance companies, for whom the measure would constitute an existential threat. (An industry campaign helped convince Oregonians to soundly reject a similar idea in 2002.)
Against this backdrop, the delay of the report until after the coming November election offers something of a political break to Oregon Gov. Tina Kotek, who, if the report were released in September might well have been thrust into the unennians while fending off attacks from her GOP challenger, state Sen. Christine Drazan (R-Canby)
Still, the state health care system is flashing very ugly signs, and it’s apparent something must change, and quickly. Hospitals aregobbling up heaving sums of cash. Premiums swirl upward. Taxpayers pump ever more money into the system as it is
“I think we have a healthy skepticism right now,” Hospital Association of Oregon chief executive Becky Hultberg told WW last month when asked about the universal health plan vision. “But we do want to engage in longer-term conversations about the future of the health care system. And we agree that the current system is broken and needs to change.”
