Voters have passed a measure amending the Oregon Constitution to create a new fundamental right for everyone living here: access to affordable health care.
For much of last week, the outcome was too close to call, but as more ballots were counted, the yes votes took a narrow lead, passing 50.7% to 49.3% in unofficial returns.
Measure 111 makes Oregon the first state in the nation with a constitutional obligation to provide access to affordable health care to all its residents, similar to the constitutional guarantee of a public K-12 education.
The measure is a win for Democrats in the Legislature, who referred it to the voters over opposition from their Republican colleagues.
The language of the measure states: “It is the obligation of the state to ensure that every resident of Oregon has access to cost-effective, clinically appropriate and affordable health care as a fundamental right.”
But Measure 111 does not spell out what the state must do to meet its new constitutional obligation, or define what access to affordable health care means. It will be up to the Legislature to shape what health care access for all looks like and how to pay for it. The Legislature will be back in session starting in January.
Sen. Elizabeth Steiner Hayward, who carried the bill in the Senate, said in a pre-election interview with OPB that Measure 111 does not set Oregon up for a single-payer system.
“It does not implement any new taxes, it does not say how we’re supposed to do this. It just says this is a value,” she said.
Legal experts agree the amendment opens the door for Oregonians who don’t have access to affordable health care to try to sue the state. But the measure also says that state funding for health care must be balanced against funding for public schools and other essential public services.
While there’s no guarantee as to how Oregon courts will interpret it, that language gives courts a path to defer to the legislature on questions of how to implement and fund health care access.
In a year where Oregon Democrats generally outperformed expectations, Measure 111 was remarkably close to defeat.
John Horvick, an independent pollster with the firm DHM Research, points to a few factors that made Measure 111 a close call. Voters are more skeptical of constitutional amendments and cautious about changing “the rules we play by.”
Measure 111 also wasn’t able to garner national attention, or major out-of-state dollars.
The Right to Health Care PAC brought in just under $100,000. Compare that to Measure 114, the gun control measure that passed by a similar margin. They raised more than $2 million on the strength of large contributions from out-of-state donors and got support from national gun safety activists for their campaign.
The measure also wasn’t a top priority for state Democrats, who faced their most serious challenges in 40 years in the governor’s race and in two close congressional districts.
“It’s not where they put their time, energy, and money,” Horvick said.
It passed anyway, but barely.
A constitutional right to health care was the lifelong project of Mitch Greenlick, who served in the state legislature and tried at least eight times in 16 years to send a proposal for it to the voters. Greenlick died in 2020, and his Democratic colleagues in the legislature referred the measure to voters in honor of his work.