PORTLAND — Supporters and opponents of Ballot Measure 101, which could repeal part of Oregon’s Medicaid funding plan, faced off Wednesday in a debate at the Multnomah Athletic Club.
Medicaid is a health care coverage program jointly funded by the state and federal government serving about 1 million Oregonians through the Oregon Health Plan.
A special election Jan. 23 concerns parts of a 2017 funding law. Particularly at issue are provisions in the law to increase federal Medicaid matching funding by collecting assessments from the state’s hospitals, insurers and coordinated care organizations — the regional networks of providers serving Medicaid patients.
A trio of Republican state representatives successfully petitioned to refer portions of the law, including those provisions, to the ballot.
Measure 101 will ask voters to either vote “yes,” to keep all the provisions of the bill; or “no,” to cut some of them out.
Republican State Reps. Julie Parrish, of Tualatin/West Linn, and Cedric Hayden, of Roseburg, who referred the issue to the ballot, spoke in favor of repealing parts of the law Wednesday.
Speaking on the opposite side was Felisa Hagins, political director of the Service Employees International Union Local 49, and Jessica Adamson, director of government affairs for Providence Health and Services, are advocating to keep all of the assessments.
Some takeaways from Wednesday’s forum:
• Neither side wants to cut people from Medicaid: Both sides of the issue said they didn’t want people on Medicaid to lose health care. Parrish and Hagins say they grew up covered by Medicaid, and Hayden, a dentist, serves patients on the Oregon Health Plan.
Hayden and Parrish largely disagree with the Measure 101 supporters, though, on how it ought to be paid for — and argue the state could find other sources of funding.
Supporters of the measure say that it took the last legislative session to get insurers and Medicaid providers to agree on a funding plan. They argue the legislation’s mechanisms are approved ways to collect federal matching funds, which pay the vast majority of Medicaid costs.
• Where could the money from the taxes go? The two sides disagree on whether the funds generated by portions of the legislation at issue can be reverted to the state’s general fund to pay for other things.
Parrish claims a legislative counsel opinion from June indicates that a .7 percent assessment on net hospital revenues could get swept to the state’s general fund and used for purposes other than health care.
The “yes” side disagrees, saying that the money collected from the assessment would only go to health care, and that a “sweep” to the general fund requires separate legislation — which is not an unprecedented move.
• The insurance market: The cost of insurance for those not on Medicaid, which could also be affected by the ballot measure, came up during Wednesday’s debate as well.
The law’s 1.5 percent tax on gross premiums, or premium equivalents for public employee health care plans, on insurers is intended to fund a reinsurance program that insulates insurers from high-risk claims that can drive up premiums.
Proponents say it’s already working, reducing 2018 premiums by an average of 6 percent.
However, petitioners want to stop the tax on insurers, because the law allows the to increase premiums by up to 1.5 percent to absorb the cost of the tax.
They also argue that the state could have preempted the need for a reinsurance market by enrolling the state’s public employees in coordinated care organizations or having the state buy employees’ insurance on the exchange — either of those moves, they argue, would dramatically increase the risk pool and bring down premiums.
Hagins, the SEIU panelist, said that the Public Employee Benefits Board — which oversees health care benefits for public employees — did a pilot project that enrolled employees in a coordinated care organization.
But, Hagins said, the CCO was unable to contain rates to the agreed level.