Oregon to Vote on Medicaid Funding 01/22 06:13

Oregon to Vote on Medicaid Funding     01/22 06:13

   PORTLAND, Ore. (AP) -- Oregon aggressively expanded its Medicaid rolls under 
the Affordable Care Act, adding enough people to leave only 5 percent of its 
population uninsured --- one of America's lowest rates.

   Now, with the reduction of a federal match that covered those enrollees, the 
state is calling on voters to decide how to pay for its ballooning Medicaid 
costs.

   A special election on Tuesday asks Oregonians whether they approve of a tax 
on hospitals, health insurers and managed care companies that would leave 
Medicaid, as it is now, untouched. More than 1 in 4 residents here rely on it.

   Maine voters were in the national spotlight when they recently approved 
Medicaid expansion. But experts say Oregon's election is the only instance of 
voters --- not lawmakers --- getting the final say on the complicated question 
of how to fund rising Medicaid costs.

   The outcome could have significant consequences for the state's health care 
spending.

   "If it's not supported, you have a huge hole, and where do you go from 
there?" said Stacey Mazer, senior staff associate with the National Association 
of State Budget Officers. "I followed these issues starting in the fall, and 
this was the biggie."

   Measure 101 would impose a 0.7 percent tax on some hospitals and a 1.5 
percent tax on the gross health insurance premiums collected by insurers and on 
managed care organizations, raising anywhere from $210 million to $320 million 
over the next two years.

   Proponents call the tax an "assessment" and say money raised could cover the 
more than 350,000 low-income Oregonians who were added to the plan since 2014 
while state lawmakers work out a long-term solution.

   The loss of that revenue could jeopardize an additional $630 million to $960 
million in federal Medicaid matching funds that flow to the poorest in the 
state, according to the nonpartisan voter pamphlet. That possibility prompted 
the very hospitals and health insurers who would be taxed to come out as the 
measure's biggest backers. They say the cost of the taxes would be less than 
that of uninsured emergency-room visits.

   The ballot measure arose from a grassroots campaign to put parts of a 
bipartisan legislative funding solution passed last year before voters. 
Republican Rep. Julie Parrish and several colleagues were angered by portions 
of the bill that exempt large, self-insured corporations like Nike from 
Medicaid taxes but not Oregonians who buy insurance on health care exchanges.

   They also believe hospitals and insurers will pass the cost to consumers, 
despite language that limits premium rate increases to 1.5 percent.

   Parrish, who represents a Portland suburb, spearheaded the drive to collect 
more than 84,000 signatures to get the measure on the ballot. Her cellphone 
number appears in the official voter's guide with a note urging voters to call 
her with questions.

   People who support Measure 101 have raised $2.8 million. Parrish and her 
allies have raised $353,000.

   "This is not a 'We hate Medicaid' referendum," Parrish said. "This is about 
the fact that our colleagues put forward some pieces of the funding package 
that we believed to be unfair, unequitable and unsustainable."

   Portland resident Kelly Burke disagrees. She briefly lost her insurance when 
she was pregnant with her second child years ago. She now has a serious 
auto-immune disease and is thankful she has insurance through her partner's 
employer.

   "What people don't understand is that people are working, but they still 
can't afford health care," she said.

   Medicaid is a federal-state collaboration originally meant for poor families 
and severely disabled people. Over the years, it's grown to become the largest 
government health insurance program, now covering 1 in 5 Americans.

   In 2014, Oregon was one of 32 states and the District of Columbia to allow 
people making 138 percent of the federal poverty line to qualify for Medicaid 
under the Affordable Care Act. That's $34,600 for a family of four. Before, 
they had to make less to qualify.

   The changes brought Oregon's slew of new enrollees. For the first two years, 
the federal government covered the full cost for them --- and for those in 
other states.

   In 2017, the match dropped to 95 percent, adding $136 million in costs in 
Oregon. It will drop to 90 percent in 2020.

   At the same time, the federal government asked Oregon to pay more for its 
other Medicaid recipients because of its strong economy. And state lawmakers 
voted to provide Medicaid coverage for children living in the country illegally 
starting Jan. 1, adding another $27 million in costs.

   Parrish says she has a backup funding plan if Measure 101 fails. Lawmakers 
reconvene for a short, six-week session next month.


(KA)

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