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Early this month, the board tasked with shepherding a universal health care measure to the Oregon Legislature voted to delay its final report to December. It looked like a setback. But Valdez Bravo of Health Care for All Oregon says backers shouldn’t fret.
“We’re happy for this extension,” he says, echoing the widely held view that the Universal Health Plan Governance Board needs more time to nail down the finances of a sweeping proposal to swap Oregonians’ insurance premiums for taxes to support a state-run, single payer health care system for all.
Questions abound, and many note the uncommonly rough budget climate Oregon faces as, among other things, federal funding for its Medicaid program is poised to plummet. To steel lawmakers and members of the public who might support a single-payer dream in theory but feel now is not the time for such a major health system overhaul—which, though not uncommon globally, no U.S. state has ever achieved—Valdez proposes a metaphor. “Instead of figuring out how to ferry people across the river for the next six years,” he says in a text message, “let’s figure that out for the next two years WHILE building a bridge that will let everyone cross effortlessly a few years from now.”
Money is the first thing everyone asks about—and here we are talking tens of billions of dollars atop baseline state health care spending. The board is tasked with hammering out key details here, but has not made as much progress as hoped—with some wondering if its advanced much at all.
Some say its a matter of time. “They’ve been trying to find this Goldilocks solution, a progressive financing structure that’s equitable, fair, but also somewhat easy to understand if you’re explaining it to voters,” Valdez says.
Others say the board’s problems run deeper. “The revenues are overstated, the expenses are understated,” Jeff Gudman, a former finance committee member, told the board, referring to its working estimates.
Gudman was among the finance committee members who wrote a “minority report” arguing the committee’s work was not complete when the Universal Health Plan Governance Board shut it down as it raced to meet what was then a September deadline to deliver a final report to the Legislature.
It remains unclear whether the group, even by December, can get lawmakers a detailed plan that can be directly plugged into a bill. “That’s what I thought I voted for,” House Health Committee Chair Rob Nosse (D-Southeast Portland), tells WW, referencing the creation of the board years ago. But he adds the delay does not greatly perturb him.
“The delay is not the big challenge in my mind,” he says. “The challenge is, if it’s referred to the voters by a ballot measure, can we run a campaign that can pass it?”
