Oregon voters have until 8 p.m. Tuesday, Jan. 23, to cast ballots in the special election over Measure 101. Here's a quick user guide:
What Would Measure 101 Do?
The federal government is reducing payments for Medicaid. This effectively forces Oregon to either find a new way to pay to cover people who received insurance when President Obama expanded the program under the Affordable Care Act, or make some poorer Oregonians find health insurance elsewhere.
Last summer, the Oregon Legislature passed a package of tax and fee increases to cover the gap in funding. A yes vote on Measure 101 would maintain those taxes and fees. A “no” vote on Measure 101 would eliminate two parts of that: a 0.7 percent increase to an existing tax on hospitals and a 1.5 percent tax on health insurance contracts.
If the measure fails, legislators will have to get together in February to develop a new way to pay for expanded Medicaid.
Will Measure 101 Increase My Health Costs?
It’s complicated. The two new taxes will likely be passed on to consumers. But Measure 101 also pays for a program that pools risk among insurers, saving consumers an estimated $300 a year.
Who Opposes Measure 101?
Measure 101 opposition is being driven by a small group of Republican legislators. Their "Stop Healthcare Taxes Committee" collected enough signatures to put the issue on the Jan. 23 ballot.
They say the tax package is unfair because it doesn't apply to unions and big corporations. Instead, they say, the burden is being placed on small businesses and individuals who have to buy their own insurance.
Measure 101 opponents say they also worry the taxes could be used for purposes other than Medicaid expansion. And they don't trust the Oregon Health Authority. They point out that the OHA lost millions on Medicaid over-payments and CoverOregon, the state's trouble-plagued health care exchange website.
Who Supports Measure 101?
A bipartisan group of Democratic and Republican lawmakers created the tax package that led to Measure 101. Just about every healthcare organization in the state wants Measure 101 to pass.
They believe it's cheaper to treat people who have health insurance than when they turn up sick in emergency rooms without insurance.
At last count, the "Yes On Measure 101" campaign had 160 endorsements, including from hospitals, insurers, unions, churches, schools, firefighters, housing advocates and climate activists.
Measure 101 supporters say 48 states use these kinds of assessments to pay for health care for poorer people. And they say hospitals and insurance companies are not going to let the new taxes be spent on anything other than Medicaid expansion.
Supporters also say numerous legal decisions have blocked governments from levying taxes on health insurance programs at large companies such as Nike or Intel.
What Happens If Measure 101 Passes?
Little changes if Measure 101 passes. The Medicaid expansion tax package will continue for the next couple of years. After that, more money will be needed as the federal government is scheduled to further reduce Medicaid contributions.
What Happens If Measure 101 Fails?
If Measure 101 fails, the February short session of the legislature will be dominated by efforts to find a new way to pay for Medicaid expansion.
The chief opponents of Measure 101, Reps. Cedric Hayden and Julie Parrish, have proposed a Plan B in the form of House Bill 4146. It would use a combination of tobacco taxes and higher hospital taxes to fill the budget hole. But it’s not clear the bill would generate enough money to ensure Medicaid coverage at its current level or attract enough votes to pass.
If replacement money cannot be found, many of the hundreds of thousands of people who secured insurance under Medicaid expansion could lose coverage.