COOS COUNTY — January ballots have been sent to voters with only one issue: Measure 101.
The measure is asking voters whether or not they support taxes to support Medicaid expansion funding. Measure 101 is being put in front of voters after House Bill 2391 was approved by the state legislature and signed into law by Gov. Kate Brown, but portions of the bill were challenged through a referendum.
Now voters are being asked to weigh in.
A “yes” vote means approving the language of five sections of House Bill 2391, which was a result from expanding Medicaid under the Affordable Care Act in 2014. Voting “yes” on those five sections ensures healthcare coverage for those with disabilities, children, and the elderly.
A “no” vote repeals those five sections.
“If it fails, it’s an avalanche of catastrophic issues that will fall on our community,” said Phil Greenhill, executive director of WOAH.
Greenhill explained that the largest impact, if the measure is voted down, would be in approximately 350,000 Oregonians losing their Medicaid coverage.
“If it failed, we could get back into the legislature quick enough in the short session next month and come up with a solution, but we’d be handcuffed by limitations of the ballot measure,” he said. “It would take away some of the options that we had, first of all being the $3 million in general fund money we use to draw down close to $1 billion federal funds. It would basically gut House Bill 2391.”
However, there is a Catch 22 if it passes. In fact, the editorial board with The Oregonian recommends that the measure be voted down. The board demands that the legislature delivers a better solution for its people, citing that “The sheer inequity of asking college students, K-12 school districts and small businesses to shoulder the cost of an essential program while exempting others is one of the biggest reasons.”
In addition, Bay Area Hospital would see an impact by being slapped with what some are calling a “true tax.”
“A true tax is not something we supported in the legislature from a managing care position, the hospital association and commercial insurance level, none of us supported a true tax,” Greenhill said. “We supported the 5.3 assessment that we had around for years that was for the DRG hospitals.”
That 5.3 assessment brought in a federal match to Oregon and then the money was returned to the hospitals. Greenhill had wanted to see that increased from 5.3 percent to 6.0 percent. That 6 percent assessment on the hospital would have pulled down more money from the federal government for healthcare while the hospital lost zero money.
“It wasn’t a tax because it wasn’t kept,” Greenhill said. “State leadership in the legislature wanted a true 0.7 percent tax and many of us still disagree with it. The taxes were unnecessary because that tax goes into the general fund and could be used for any purpose and could be increased at any time.
“We think it’s unfair to tax the revenue of hospitals when so many struggle anyhow. Some make $200,000 to $2 million in profit. That cost somewhere is going to be passed to the consumer.”
Consumers will not only be hit harder when going to hospital but also in paying insurance premiums. Though commercial insurance companies would be given a limit of 1.5 when raising premiums to compensate the tax, it is still an extra cost to consumers.
On the other hand, Greenhill pointed out that if the measure doesn’t pass and 6,000 Coos County residents lose coverage, premiums on the insured will go up anyway.
“It will go up because those who lose their insurance will then go to the ER, are indebted, can’t pay the bill, the hospital has to write off that bill and that will lose them another $6 million in bad debt and those admitted to the hospital have no coverage so they become charity care,” he said. “Now we have to pay providers more money to take care of these people because they don’t have insurance.
“It’s horrifying and completely unnecessary,” he said. “We could have solved it in the legislature but leadership wanted to go after the hospitals because they thought there was a lot of trapped equity in big systems like Providence and Legacy. There probably are, but that’s not true in our community. We have a hospital struggling to stay open, as are the majority of the 42 hospitals in Oregon.”
In an email to the employees at Samaritan Health Services in Corvallis, President Doug Boysen wrote:
"Although we at Samaritan remain very concerned about the impact of this additional tax on our financial position over the next two years, with the support of our Board of Directors we are joining Oregon's other hospitals in supporting a 'yes' vote on Measure 101."
Boysen states the reason behind this decision is to ensure that 95 percent of all Oregonians have health coverage.
"If Measure 101 is voted down, we fear the results could be catastrophic," he wrote.
That being said, Greenhill hopes that the legislature will correct the 0.7 tax on hospitals and instead make it a 6 percent assessment where the money is returned after the federal match.
“We’ve worked so hard to be able to ensure 99 percent of our children and over 95 percent of the adults and almost full insurance across the state,” he said. “Voting yes on Measure 101 ensures that 6,000 of our own most vulnerable community members retain coverage. Going without the Medicaid coverage they have now, at the end of the day, will cost all of us.”
As for the hospital tax, Greenhill encourages voters to call local delegates to make the change.
The World spoke with Bay Area Hospital but no official statement is being released at this time.