Lawmakers nibble around edges trying to fix health care
Medium-sized steps
were what labor
was able to achieve
this year in Salem
About 650,000 Oregonians have no
health insurance. Three million other
Oregonians have access to health in-
surance, but at a greater and greater
cost, to someone — employers, gov-
ernment, or themselves — every year.
What did Oregon lawmakers do
this year about this institutional crisis?
More than the U.S. Congress, which is
where the national problem could be
solved. But less than they could have.
Many health system reform pro-
posals backed by Oregon labor organi-
zations fell victim to opposition from
the hospital, insurance and pharma-
ceutical industries.
“The profiteers in the health care
industry have a hammer lock on the
whole system,” said Arthur Towers,
political director of Service Employ-
ees International Union (SEIU) Local
503. “So it feels like a huge victory
even when we take a medium-sized
step.”
On health care at least, medium-
sized steps were what labor was able
to achieve this year in Salem.
The most comprehensive was Sen-
ate Bill 329, a bill closely tracked by
the labor-backed health-care-voter
group Oregonians for Health Security
that was signed into law June 28. If it
fulfills the hopes of its authors, Sena-
tors Ben Westlund and Alan Bates, all
Oregonians will be insured in a few
years time.
SB 329, the product of a year’s
work by a Senate task force, sets up a
health insurance purchasing pool that
any individual or group in Oregon can
join and that uninsured individuals
would have to join or face a tax
penalty. The idea is to get a better rate
from insurance companies by combin-
ing hundreds of thousands or millions
of Oregonians into one giant pur-
chaser. The insurance product they
purchase would be closely regulated
to guarantee certain minimum bene-
fits, including preventive care, which
would be fully covered with no co-pay
or deductible.
Employers and labor-management
health trusts could still offer their cur-
rent insurance, or they could join the
pool and pay the premiums for em-
ployees. Bates, the bill’s co-sponsor,
says he thinks it will cost around $350
a month per person, but most of those
who are currently uninsured will pay
only part of that. The program would
stretch federal Medicaid dollars so
that everyone earning up to four times
the federal poverty line would get
some subsidy.
The bill passed handily in the
House and Senate, with just 13 “no”
votes among the two chambers’ 90
members. If it’s supposed to save
money by cutting into insurance com-
pany profit margins, why didn’t the in-
surance industry oppose it? Because,
Bates explains, they’ll make up for it
in volume — right now the uninsured
are a lost market opportunity.
None of this will happen immedi-
ately. SB 329 sets up a seven-person
panel, with staff support, to work out
details of how the program would op-
erate. They’ll give a progress report to
the Legislature in its special session
next February, and then present the fi-
nal program for approval in the 2009
legislative session. That’s when the
tough vote will take place.
Another health care reform to pass
this session was the governor’s
Healthy Kids Plan, which would raise
the cigarette tax by 85 cents a pack to
pay for insurance coverage for all
117,000 of Oregon’s uninsured chil-
dren. Lawmakers couldn’t get the
three-fifths majority needed to pass
the tax increase, and instead referred
to voters on the November 2007 bal-
lot. Medicare covers all those 65 and
over. So if Oregon covers all kids 18
and younger, that leaves just 19-64 —
46 years — to worry about. It’s incre-
mental.
Even more incremental is Ore-
gon’s prescription drug bulk purchas-
ing program (OPDP). It expanded this
year without a peep of opposition
from the pharmaceutical lobby, which
fought its founding in 2003 and its ex-
pansion in 2005 and 2006. Now any
individual or group can join Oregon’s
pool and get a discount on prescrip-
tion drugs. That’s what backers had
started out proposing in 2003, but the
pharmaceutical lobby was able to
limit the pool to individuals over 54.
After backers failed to expand the
program in the 2005 session, they
took it to voters in 2006 and got it
broadened to local governments and
E
E
FR
uninsured individuals. Pharma must
have given up: the proposal to expand
the program to private businesses and
health plans passed 58-0 in the
House. It was easy to support some-
thing when it had no opposition, a Re-
publican lawmaker told Oregonians
for Health Security Director Maribeth
Healey.
Another pooling proposal finally
saw the light of day — combining the
state’s 198 school districts to bargain
better rates on health insurance cover-
age for 85,000 education employees
and their families. While past Repub-
lican-led sessions had stopped the
bill, early this year, Democrats over-
came objections from the Oregon
School Boards Association, which
had profited by acting as an insurance
broker.
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PAGE 10
Housing
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