July 1, 2013 — The House passed a universal healthcare study bill 37-23, clearing the way for private money to fund a comprehensive study into what advocates consider the most equitable and cost-effective means of financing healthcare for all Oregonians.
“We need to take a better look at financing different healthcare systems in this state,” Rep. Michael Dembrow, D-Portland, told his House colleagues Friday.
House Bill 3260 calls upon the Oregon Health Authority to administer the study, which will look at several different healthcare models. The $200,000 to $600,000 required could be a combination of federal grants, individual contributions and foundation donations, according to Dembrow.
That revenue would likely flow through a nonprofit entity such as the Northwest Health Foundation which would pass those dollars onto the Oregon Health Authority. It would contract directly with an entity skilled in healthcare research, such as Oregon State University, and have the final say about such a contract.
“The Oregon Health Authority will act as the firewall to ensure that there is no connection between the donors and the research,” Dembrow said.
Although Dembrow is optimistic the Medicaid expansion and the insurance exchange will help more people gain access to healthcare, he said, Oregon could make great use of an objective academic study to review shortcomings in the system, such as the 170,000 Oregonians who'll be left without insurance and the continued high cost of healthcare for those who have coverage.
“Anyone who doesn’t know the healthcare system isn’t sick or hasn’t been to a doctor lately,” said Rep. David Gomberg, D-Lincoln City. He told his colleagues that his wife paid $400 for X-rays and a shoulder injury in a foreign country, but had a retina tear to her eye in the United States and had to spend $20,000 out-of-pocket, even with insurance.
The Affordable Care Act should mitigate much of that out-of-pocket expense next year, but Gomberg said he's still faced with having to spend a considerable amount of money on health insurance for the employees in his kite manufacturing business.
Five Republicans supported HB 3260 when it reached the House, including Rep. Jim Thompson of Dallas, the vice-chairman of the Health Committee. Earlier, the measure received a unanimous vote in that committee, but Thompson was the only Republican on the panel who stuck with the bill.
“The more I thought about it, the more I realized we’re conducting a study with the outcome already determined,” Rep. Bill Kennemer, R-Oregon City, told The Lund Report. “It’s an investigation into a single-payer system.”
“Only if he thinks that’s the best and most effective system,” Dembrow told The Lund Report after he heard Kennemer’s rationale for switching his vote while he had supported it in the Health Committee.
Vermont conducted a similar study, Dembrow said, and anticipated the outcome would lead to a single-payer health system. Instead, people in Vermont adopted a hybrid model that's creating a state-run system similar to Medicare paid for with tax dollars, while exempting self-insured companies such as IBM. Although that decision upset some single-payer activists, Dembrow believes in the scholarly objectives laid out in the study and said he would support the results.
Because of restrictions in the Affordable Care Act, Vermont’s system must wait until 2017 to be implemented.
Oregon’s study, meanwhile, must be completed by November 2014, in time for the start of the 2015 legislative session. At that point, the Legislature will decide what to do with the information, if anything.
Also, single-payer supporters have announced they intend to put their preferred system before voters in the 2016 general election.
The study called for in HB 3260 will look at four systems – single-payer; a full roll out of the Affordable Care Act with the Cover Oregon exchange, a Basic Health Plan option for low-income families ineligible for Medicaid; with a public option sold on the exchange; and a system offering families a private insurance plan with just the essential health benefits.
Families and individuals eligible for federal subsidies on the exchange would get care without cost-sharing, while those above that income level would be required to make co-payments and pay deductibles, under the last scenario, which was pitched by former Sen. Frank Morse, R-Albany.
Two Democrats opposed the bill, Rep. Caddy McKeown of Coos Bay and Rep. Brent Barton of Gladstone.
Barton told The Lund Report that he was uncomfortable funding the study with private money that could influence the outcome, sharing an argument taken up by conservative Republican Rep. Tim Freeman of Roseburg who cited that example on the House floor.
“I absolutely support the idea behind it,” Barton said. “If it were government-funded, I would have voted for it.”
Earlier in the session, the legislative budget chairmen told Dembrow they would not agree to spend any tax dollars for a universal healthcare study. And, it's highly unlikely that Republicans who are opposed to universal healthcare would have wanted such a scenario.
HB 3260 must now go before the Senate, where it's co-sponsored by Democratic Sens. Laurie Monnes Anderson of Gresham and Chip Shields of Portland.