Oregon to Look at Single-Payer Bill Next Session

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While the details of the proposed bill haven’t been ironed out, the tenets are strong. There would be a dedicated tax based on ability to pay, universal access, and a shared risk pool to increase purchasing power and reduce administrative costs.

“The basic principle is equity,” Shapiro said. “Everybody should have the same access to treatment regardless of how much risk they are or how much money they have in the bank.”

The group will soon begin working with a consultant on the costs of such a plan and the barriers, including ERISA that governs employee benefits, that could be overcome with federal waivers.

The Oregon State Public Interest Research Group is also pushing state healthcare leaders to do more with what’s already allowed in the federal law passed earlier this year. OSPIRG’s efforts, however, have focused on strengthening the health insurance exchange and creating a strong state-based public health insurance option, not a single-payer plan.

Laura Etherton, OSPIRG’s healthcare lobbyist, is pleased Oregon is among the first states to get out of the blocks to establish an exchange where individuals and small groups can purchase insurance that’s highly regulated and possibly subsidized. But, thus far, the draft plan which was released on Aug 14 falls short, Etherton said.

“Just an exchange by itself is not going to solve all the problems in healthcare,” she said. “But it’s a great tool to help us drive solutions.”

Etherton said the draft plan doesn’t allow the exchange to negotiate premiums on behalf of its members. It could include small businesses with more than 50 employees earlier. It needs stronger public accountability. And it lacks adequate protections to prevent the insurance industry from undermining the exchange’s stability, she said.

According to OSPIRG, the exchange as currently drafted would “let insurers cherry-pick only the healthiest people, and enroll them in plans only available outside the exchange. This would leave older, relatively less-healthy people inside the exchange.”

“The details matter,” Etherton wrote in comments to the draft plan on OSPIRG’s website. “Done right, the exchange will pool the buying power of hundreds of thousands of Oregonians, so all of us can get a better deal on healthcare. But done wrong, the exchange will just be a nifty website with the same expensive plans and spotty coverage.”

Single-payer advocates hope the state goes a whole lot further.

“There are a lot of people who want to see the conversation about single payer still happen,” Dembrow said. “I hope the federal plan will work. I’d like to see the state really seize the moment.”