Oregon Public Broadcasting

20 years ago, Oregon bolstered its reputation as a pioneer with the Oregon Health Plan.

The groundbreaking program was aimed at bringing medical coverage to the working poor.  Over the years, though, economic conditions forced lawmakers to chip away at the number of people receiving state funded health care.  

This year, that could change. Even in the face of a budget shortfall, the Oregon Legislature is developing a proposal to dramatically increase the number of people who are insured.  Salem correspondent Chris Lehman reports.

Regular patients at the Virginia Garcia Memorial Health Center in McMinnville know that the receptionist starts answering the phone at precisely 8:15 each morning.

Receptionist:  “Good morning, Virginia Garcia.  Can you hold please?  Thank you. Good morning, Virginia Garcia.  Can you hold please? 

If you want an appointment, you have to have quick fingers.

Receptionist:  “Thank you. Good morning, Virginia Garcia.  Can you hold please?  Thank you.  Thank you for holding, how can I help you?”

The reason appointments are so coveted is that Virginia Garcia is a so-called safety net clinic.  Nearly all of the patients here are on Medicaid or have no insurance coverage at all.  So for those who do manage to snag an appointment, the health center is a potential lifesaver.  

That’s how Linda Solano feels.  She brings her husband here for diabetes treatments.

Linda Solano:  “Without this clinic I don’t know what we would have done.”

Solano lost her insurance when she was laid off several years ago.  Her husband’s employer doesn’t offer any health plan.  At Virginia Garcia the Solanos can pay on a sliding scale.  They’d rather have insurance coverage, but....

Linda Solano:  “We can’t afford the premiums.  So we’re lost.  We can’t get any assistance, because we’re just in the middle.”

Oregon lawmakers are working on a plan that might help people like the Solanos.  The bill would extend insurance coverage to a third of the roughly 600,000 people without health insurance in Oregon.  

How would lawmakers pay for that?  By raising a tax on hospitals and health insurance companies.  Supporters have dubbed it a provider tax and say the money would be used to leverage matching federal funds.  

Democratic Representative Mitch Greenlick chairs the House Health Care Committee.

Rep. Mitch Greenlick:  “We’re estimating that a hospital tax and a health plan tax would raise about $600 million, and that would bring an extra billion dollars of federal money.  That’s money with our name on it sitting in Washington D.C. right now, that if we don’t claim it goes to some other state.”

Not so fast, says Republican Representative Ron Maurer.  He’s the leading House Republican on health care issues and voted against the provider tax in committee.  He says it’s misleading to say that there’s a billion dollars of federal money just sitting around for Oregon to claim.

Ron Maurer: "That money hasn’t been created yet.  The federal government will go borrow a billion dollars of which is my tax money that my children are ultimately are going to have to pay for.  So it’s not, quote, free money. It’s still my tax money.”

Republicans aren’t the only ones raising concerns.

The Oregon Association of Hospitals is trying to convince lawmakers to scale back the amount of the provider tax.

A lobbyist for the group shied away from speaking on tape, citing the sensitive nature of current negotiations.  But the group has said publicly that Oregon hospitals are struggling financially and can’t afford higher taxes.

Supporters of the bill, such as Representative Greenlick, say hospitals will benefit from the influx of new federal cash.

Mitch Greenlick:  “The tax on hospitals essentially would be returned to hospitals dollar for dollar in the form of higher hospital reimbursement.  And the federal match on that would be used to bring more people into the health care system.”

It’s not clear when or if an agreement will be reached.  Negotiations are so sensitive that a recent hearing on the bill was cancelled.

Funding isn’t the only thorny health care issue this session.

A separate bill would completely restructure Oregon’s largest state agency.  The Department of Human Services would split in two.  One division would be aimed solely at health care and another at addressing other human service needs.

Supporters say such a dramatic overhaul would make Oregon’s health care system more efficient.

Online:

Oregon House Bill 2116 , which raises taxes on hospitals and health insurance companies.

Oregon House Bill 2009, which creates the Oregon Health Authority, an agency that would oversee all state-related health care functions.