Voters weigh tax to fund rising Medicaid cost
PORTLAND, Ore. — Oregon aggressively expanded its Medicaid rolls under the Affordable Care Act, adding enough people to leave only 5 percent of its population uninsured — one of America’s lowest rates.
Now, with the reduction of a federal match that covered those enrollees, the state is calling on voters to decide how to pay for its ballooning Medicaid costs.
A special election on Tuesday asks Oregonians whether they approve of a tax on hospitals, health insurers and managed care companies that would leave Medicaid, as it is now, untouched. More than 1 in 4 residents here rely on it.
Maine voters were in the national spotlight when they recently approved Medicaid expansion. But experts say Oregon’s election is the only instance of voters — not lawmakers — getting the final say on the complicated question of how to fund rising Medicaid costs.
The outcome could have significant consequences for the state’s health care spending.
“If it’s not supported, you have a huge hole, and where do you go from there?” said Stacey Mazer, senior staff associate with the National Association of State Budget Officers. “I followed these issues starting in the fall, and this was the biggie.”
Measure 101 would impose a 0.7 percent tax on some hospitals and a 1.5 percent tax on the gross health insurance premiums collected by insurers and on managed care organizations, raising anywhere from $210 million to $320 million over the next two years.
Proponents call the tax an “assessment” and say money raised could cover the more than 350,000 low-income Oregonians who were added to the plan since 2014 while state lawmakers work out a long-term solution.
The loss of that revenue could jeopardize an additional $630 million to $960 million in federal Medicaid matching funds that flow to the poorest in the state, according to the nonpartisan voter pamphlet. That possibility prompted the very hospitals and health insurers who would be taxed to come out as the measure’s biggest backers. They say the cost of the taxes would be less than that of uninsured emergency-room visits.
The ballot measure arose from a grassroots campaign to put parts of a bipartisan legislative funding solution passed last year before voters.
More than 175 organizations have backed the pro-Measure 101 campaign, including former Gov. John Kitzhaber, an emergency room doctor.
People who support Measure 101 have raised $2.8 million. Opponents have raised $353,000.
Portland resident Kelly Burke has volunteered at a pro-Measure 101 phone bank. She briefly lost her insurance years ago when she was pregnant with her second child. She now has an auto-immune disease and is thankful she has insurance through her partner’s employer.
“What people don’t understand is that people are working, but they still can’t afford health care,” she said.
Medicaid is a federalstate collaboration originally meant for poor families and severely disabled people. Over the years, it’s grown to become the largest government health insurance program, now covering 1 in 5 Americans.