Among the budget-balancing efforts approved by the 2017 Oregon Legislature and signed by the governor is House Bill 2391, which raises some $605 million to keep the Oregon Health Plan (Medicaid) whole while balancing the state budget.
The law, nearly universally panned by the Legislature's Republicans, closes the health care financial gap by raising taxes. Thus, most hospitals will pay a 0.7 percent tax on revenues, coordinated care organizations must cut their cost of doing business by 1.5 percent, and some people's premiums will be charged a 1.5 percent tax.
At least that's what the law says. In reality, hospital bills almost certainly will rise, as will health insurance premiums, as insurers and hospitals raise rates to cover the increased cost of doing business.
Three Republican lawmakers — Rep. Julie Parrish, West Linn; Rep. Cedric Hayden, Roseburg; and Rep. Sal Esquivel, Medford — hope to refer sections of the new law to voters, and the Legislature's Democrats have said that if they do, the referendum must be in January.
In some ways, the early vote date is a blessing. If sections of the law are overturned, it will happen relatively early in the biennium. That, in turn, should give lawmakers time to come up with a more acceptable Plan B.
Whether you favor the proposed changes or believe lawmakers should find a better way, the discussion is worth having. Among the questions are these:
Does it make sense to tax revenues without considering the cost of creating them? Some Oregon hospitals, including those in the St. Charles system, have revenues that come dangerously close to being outstripped by expenses.
Is a tax on health insurance premiums, which are expensive and likely to get more so, the best way to finance health care? And what about CCOs? They are required to hold individual cost increases to a figure below the rate of medical inflation, according to testimony on HB 2391; this will reduce that increase further.
If you believe it's time to talk about Oregon's health care system and the way it is financed, the proposed referendum gives you the chance. All you have to do is sign a petition to put the law on the ballot.