An Apple A Day

[June 11th, 2008]

In Portland—where voters supported a 2007 state tobacco tax increase to cover children’s health insurance—you might think children’s advocates would unite behind a new proposal for uninsured students to get health coverage.

But the proposal by Hillsdale physician Gregg Coodley to cover an estimated 9,000 uninsured public-school students in Portland is raising concerns from City Commissioner Dan Saltzman and Multnomah County Commissioner Jeff Cogen.

When Cogen was Saltzman’s chief of staff in 2002, the pair successfully advocated for Portland voters to approve a $50 million initiative for children’s programs.

Their initiative is up for renewal this year. And they say Coodley’s initiative is an unnecessary distraction to that renewal, flawed because it ultimately would dump an unfunded mandate on school districts, and might not even pass legal muster.

“I’m not interested in seeing [the Coodley measure] on the ballot,” Saltzman says. “As presently worded, it would be an unfunded mandate.”

He and Cogen aren’t alone in their worries. Stand for Children, a nonprofit children’s advocacy group, also will probably oppose Coodley’s initiative.

“When school districts are not able to cover the basics, we just think adding health insurance to the mission is bad policy making,” says Rachel Langford, director of Stand for Children’s Portland chapter.

Coodley got the idea for a local plan after 57 percent of Multnomah County voters last year supported Measure 50, a state tobacco tax increase of 84.5 cents per pack to pay for kids’ health insurance. The measure failed statewide.

He raised $93,000—including $50,000 from himself and his Fanno Creek Clinic along with donations of $2,500 from Legacy and $5,000 from Providence—to hire paid petitioners. And he got endorsements from former Portland Mayor Bud Clark and Portland Democratic state legislators Mitch Greenlick, Mary Nolan and Ginny Burdick.

Coodley is waiting to hear this month from the city auditor if his measure collected enough signatures to get on the Portland ballot this November.

The proposal would require the city to seek bids from private insurers for a policy covering all uninsured public school students in Portland, for no more per month than $50 per student. Coodley estimates covering 9,000 uninsured children in the six school districts entirely or partly within Portland—or about one in six students—would cost $4 million a year.

His proposal calls for the city to pay fully for the program’s first two years and then school districts would pick up two-thirds of the cost.

But $50 a month wouldn’t buy much coverage. The measure lacks a dental or vision benefit, and parents would have to cover the first $7,500 of drugs, diagnostic and hospital expenses before insurance.

“I’m not saying this is the greatest plan,” Coodley said. “But it seems to me rather than coming up with a perfect plan that doesn’t pass, it’s better to come up with something.”

Coodley says he went the initiative route because he wasn’t taken seriously by city commissioners and school-district leaders. He remains optimistic that more recent meetings with Cogen as well as city Commissioners Randy Leonard and Sam Adams can produce a plan perhaps without a ballot measure.

Coodley says his plan would pay for itself, because insurance would draw more kids to the city’s public schools. And increased enrollment would draw more per-student funding from the state, giving the districts money they could use for the insurance.

Even if barebones insurance could lure lower-income parents to Portland, Coodley doesn’t account for new students’ extra classroom expense, observers say.

“Every kid that comes we’re going to have to provide teachers for,” said Portland Public Schools spokesman Matt Shelby.