SALEM — Pending final verification of about 84,000 petition signatures by state elections officials, Oregon voters will have a chance to weigh in on parts of the state’s Medicaid funding plan Jan. 23.
Medicaid provides health care coverage to the poor and other qualifying groups, and is jointly funded by the state and the federal government. About 1.1 million people — a quarter of the state’s population — are on Oregon’s Medicaid program.
Health care advocates, unions and many Democratic legislators argue that as many as 350,000 may see reduced benefits, or may be cut from the program altogether if voters reject the parts of the funding plan that got a step closer to the ballot Thursday.
The Legislature passed a bill this session 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 group of Republican lawmakers — State Rep. Julie Parrish, R-Tualatin/West Linn, Rep. Cedric Hayden, R-Roseburg, and Rep. Sal Esquivel, R-Medford — want voters to weigh in on parts of that plan, referred to as the “provider tax.”
According to financial impact estimates approved for the ballot last month, state revenues could decline anywhere between $210 million and $320 million if voters reject parts of the legislation in question.
Since the state uses those revenues to get federal matching funds, the total effect on the state budget could be upwards of $840 million.
The Affordable Care Act allowed states to extend eligibility for Medicaid to people making up to 138 percent of the federal poverty level. That’s about $16,642 for a single person and $33,948 for a family of four.
That group would likely face cuts in part because the federal government requires states to cover pregnant women and people with disabilities, but not people who, but for the Affordable Care Act, would not qualify for Medicaid, said state Sen. Richard Devlin D-Tualatin. And the state must cover all or none of those people.
Devlin said that it’s unlikely that health care funding lost by a partial repeal could come from another part of the budget.
For example, it took months for legislators to approve an $8.2 billion funding package for education, an amount many on both sides of the aisle argued should be higher.
“We don’t have that much in dollars sitting on the side that we could use,” Devlin, who chairs the Legislature’s budget committee, said. “It would be beyond the current resources that we have.”
The petitioners say that they don’t want to cut people from the Oregon Health Plan — Hayden is a dentist who sees Medicaid patients, and Parrish says she grew up receiving Medicaid and other government programs — but they want to force a conversation at the legislature about how the state pays for the system.
In a press conference Thursday afternoon, Parrish and Hayden maintained that the money could come from elsewhere in the budget. Parrish argues a proposal to move public employees onto plans in the exchange, for example, could save the state money.
“Budgeting is about choices,” she said.
But other alternatives proposed by Hayden during the session were criticized as “part logic and part fantasy” in August by the Democratic chair of the House Committee on Healthcare, Rep. Mitch Greenlick, of Portland.
The petitioners have labeled the legislation — which allows the state to collect payments from insurers, CCOs and the Public Employees Benefits Board as well as the state’s hospitals — as a “sales tax on health care.”
A coalition of more than 50 organizations is campaigning to keep the law in place and prevent cuts in the Oregon Health Plan that would likely result from a repeal, said Meg Niemi, president of SEIU Local 49. The union is a member of the Coalition of Community Health Clinics.
The coalition held a press conference in downtown Portland Thursday to highlight what is at stake if the referendum makes it on the ballot.
“Together, we’re going to fight to protect health care for families for kids and for the most vulnerable people in Oregon,” Niemi said.
The law reduces health insurance premiums for those who purchase their own insurance but could mean increases for others of about $5 per month in 2018, said Patty Wentz, a coalition spokesperson.
“We need people to vote yes on Referendum 301 because it will protect health care coverage for a million people who are on Oregon Health Plan and lower premiums for hundreds of thousands more,” Wentz said.