Update on Oregon Single-Payer Health Care

by Alan F. Zundel

Charlie Swanson of the Health Care for All Oregon (HCAO) board has written to correct some of my speculations about SB 1046, the bill for single-payer health care currently in the Oregon legislature.

I guessed that the plan to refer single-payer health care to the ballot was a way for state legislators to “pass the buck” to voters so they would not antagonize powerful interests such as the insurance industry.

According to Charlie, SB 1046 was introduced as a way to move discussions forward and build support in the legislature. It was not expected to get out of the Senate Health Care Committee, and it had only a courtesy hearing there.

He writes, “We knew before the session started that we were not going to try to convince the health care committee to move the bill forward, though at that time we were hoping for a courtesy hearing in both the house and senate health care committees.”

The bill was not regarded, even by HCAO, as ready for action. There are still many considerations about the best way to shift costs for health insurance from the private sector (for example, premiums, co-pays and deductibles paid by employers or individuals) to public insurance. The amount needed is also uncertain and subject to various factors.

Funding considerations are a major aspect of a single-payer plan, and still need more discussion, research and reflection to create a sound plan.

In any event, a single-payer bill will entail provisions for raising revenue, which in Oregon requires a 60% super majority in both legislative chambers, not a simple majority. Even if all Democrats backed it, it would still need Republican support, unless there is a large shift in party representation in the legislature.

(As an aside, State Senator James Manning recently claimed at a meeting of Our Revolution Lane County that if Democrats could gain “six seats” in the 2018 election, they would pass a single-payer bill. They are currently one seat short of 60% of the seats in each chamber.)

But even if a bill did pass the legislature, it is virtually certain someone would institute a referendum on the bill, placing it on the ballot to give the voters a chance to approve or disapprove of it. As it will end up in the voters’ hands anyway, it would be much easier to move it forward in the legislature by asking them to refer it to the ballot in the first place.