As of Tuesday, January 9, 2018
I’m a physician in Hood River. My business and passion is taking care of my patients — all ages, all incomes, large and small medical needs, acute and chronic, physical and mental, from preventive to end-of-life. I don’t have the chops or inclination to be a journalist, but those same patients and neighbors often need policy advocacy to ensure even basic access to medical care. So, on their behalf, let me explain why I, and the vast majority of Oregon’s medical community, want to make sure Measure 101 gets passed this month.
My patient Anna has had a lifelong struggle with asthma. For many years, she didn’t have access to health insurance. She worked multiple minimum wage jobs in order to make ends meet for her family, but because of this she was always just above the cut-off to be covered by OHP (Oregon’s Medicaid). She often couldn’t afford the prescription medications to manage her asthma. So when Anna’s asthma would kick up, she would often try to wait it out, hoping it would resolve on its own, and then would have to go to the emergency room, and on occasion, be admitted to the hospital.
When the ACA expanded the Medicaid program, meaning that the income-based cut-off was increased, she was able to qualify for Medicaid coverage. Now her preventive medications are covered, so she doesn’t have to decide between her medications and food or rent. She has fewer asthma flare-ups, misses fewer days from work, and in general feels healthier. When she does feel an asthma attack coming on, she calls the clinic promptly instead of waiting until she is in dire straits. The medications and early care limit the attack’s severity and make it resolve much more quickly, without a trip to the hospital.
With the Medicaid expansion, Anna feels more secure and is able to function better — personally, as a parent, as an employee, and as an active part of the community. She also saves money for the system by avoiding the ER and hospital as much as possible. Passing M101 will ensure that these benefits to both Anna and the medical system will continue.
M101 is intended to protect health insurance coverage for the one in four Oregonians who use Medicaid. Insurance companies, hospitals and managed care organizations (not individuals) will pay new fees to the State of Oregon, generating $210-$320 million. This revenue will fund:
n Oregon’s 6 percent “match” funds to qualify for the Feds’ 94 percent Medicaid matching funds (i.e., $630 million to $960 million of federal funding that would come to Oregon, according to the Secretary of State’s website).
n A state “reinsurance” program that partially reimburses insurance companies for extremely expensive care, such as neonatal ICU, cancer treatment, and catastrophic accidents, allowing stabilization of rates and premiums in the individual health insurance market.
This funding mechanism is temporary, designed to meet the State’s 6 percent Medicaid funding requirement in the face of a current state budget shortfall. It was already passed by the 2017 Oregon legislature as HB 2391, and signed by the governor, but a campaign led by several state legislators garnered enough signatures to get the measure on a Special Election ballot. An OPB publication suggested there was a racist/anti-immigrant sentiment behind the effort, noting that Rep. Sal Esquivel (R-Medford) chose to fight the bill because it would fund healthcare for undocumented children. Now, voters are being asked whether to approve the funding as originally passed.
Opponents argue against M101 as a new and unfair tax, but it is telling that virtually all of the entities being taxed are in favor of it, including Providence, MCMC, Kaiser, Legacy, PeaceHealth, the Oregon Association of Hospitals and Health Systems, GOBHI, Oregon Medical Association, and over 160 other Oregon insurers and healthcare-related organizations (yesforhealthcare.org/supporters).
So why would they WANT to be taxed? Because the alternative would be economically devastating for them and for our communities. High numbers of uninsured patients using the ER for primary care will force hospitals back in the red, and many will likely close. Rural hospitals, serving their more elderly and indigent populations, will be especially hard hit.
Voting in favor of M101 will allow continued medical coverage for 300,000 Oregonians like my patient Anna, stabilize premium costs for our neighbors on individual health insurance, and keep our rural hospitals afloat and serving their communities — a trifecta of benefits well worth supporting.