Voters can be forgiven if they think Measure 101 is complex. They’re right. The arguments for and against have been mind-numbingly confusing.
In short, they are being asked to weigh in on a temporary 0.7 percent tax on hospitals for two years that was approved by the state Legislature in the last session, as well as taxes on insurers, the Public Employees Benefits Board and coordinated care organizations. A “yes” vote keeps the taxes; a “no” vote repeals them.
Proponents arguing “yes” say the money is needed to avoid up to 350,000 low-income residents potentially losing health care.
The state would lose from $210 million up to $330 million in revenue, according to projections, plus $630 million to $960 million or more in federal Medicaid matching funds.
There’s a real risk that low-income patients could be dropped from Medicaid coverage if Oregon voters scrap the taxes. The assumption of opponents is that the Legislature would scramble to plug the hole in the upcoming session that begins in February. But that is by no means assured.
In 2003, to help close a budget gap, Oregon — along with other states — eliminated its “medically needy” Medicaid program. Tens of thousands of people lost medical and prescription drug benefits. The state saw a sharp increase in visits to hospital emergency rooms by uninsured patients, according to the Center on Budget and Policy Priorities.
We do not want to revisit that bit of history. We live in a country where, in most cases, sick people aren’t turned away from hospitals for inability to pay. We can’t imagine living in a society that denies medical care. Those emergency room visits are the most expensive services hospitals offer, and the costs are passed along to the rest of us.
In 2013, the expansion of Medicaid under the Affordable Care Act resulted in 385,000 more Oregonians gaining health care coverage.
About a quarter of Clatsop County’s residents rely on Medicaid for their health care, according to the Oregon Health Authority. Local advocates say that includes 4,900 children 18 and under.
Many new patients in the county who had never received regular medical care are now able to pick up a phone and make an appointment with a doctor. The ability to see a doctor on a regular basis has made a big difference in people’s lives.
Those new patients include kids with serious conditions, like asthma. Many are homeless.
“Every child deserves health care, just as every child deserves education,” Debbie Morrow, a member of the Warrenton-Hammond School Board, told The Daily Astorian’s editorial board.
Columbia Memorial Hospital CEO Erik Thorsen said the 2013 Medicaid expansion reduced the hospital’s need for charity care writeoffs dramatically, by 50 percent.
That savings has been used to expand medical services for everyone in the county.
“It’s great for the patients, and it’s a huge benefit to us,” Thorsen said.
Those urging us to vote “no” on Measure 101 have a point, in that the tax isn’t fair. Not everyone in the state pays. People covered by self-insured medical plans through their employer (The Daily Astorian is self-insured) and unions are exempt, among others. Small businesses, school districts, nonprofits and college students aren’t. Shouldn’t everyone bear the burden of supporting the neediest in our society?
Fiscal conservatives are also justified in feeling that the Legislature is holding the state’s most vulnerable residents hostage in its thirst for ever-increasing taxes. Who is going to argue against medical coverage for sick kids? Why weren’t deeper cuts made in other programs to offset this expense?
That’s the pattern of the Legislature. As long as powerful interests — such as the public sector employee unions — carve out their pieces of the pie, solutions to complex problems such as health care will continue to be unevenly applied. That doesn’t make it right, but it’s the state we live in.
Forty-eight other states and the District of Columbia levy tax assessments against health care providers to fund care for low-income patients. The strategy is popular because it generates matching federal dollars. In this case, Oregon health care providers agreed to tax themselves, and insurers may not raise rates more than 1.5 percent to cover the assessment.
An impressive list of more than 160 organizations in Oregon have endorsed the plan, including the medical and education communities.
Given that groundswell of support, both statewide and locally, we urge you to vote “yes” on Measure 101.