Affordable Healthcare in Oregon? Maybe . . .
Oregon becomes the first state to make Affordable Healthcare a fundamental right.
May 2021, the Oregon Legislature referred the proposed amendment to the voters. Known then as Senate Joint Resolution 12, it passed on a near-party-line vote. Democrats supported it. Republicans opposed it (what-a-surprise). Then-Democrat Betsy Johnson, who was running for governor as an unaffiliated candidate, joining the opposition.
Voters were deciding whether to amend the state’s constitution creating a new fundamental right for every Oregon resident to have, “access to affordable health care.”
The language of Measure 111 was simple, stating:
“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.”
Measure 111 did not define the key words of “cost-effective, clinically appropriate and affordable.” Neither did the Measure say who would foot the bill. It passed with 50.6% supporting it and 49.4% against it. Oregon is now the first state (redundant alert) in the nation with a right to health care in its constitution.
Legal experts say the closest parallel is the right to affordable healthcare is the right to a K-12 education. This also guaranteed by state constitutions.
Charles Gaba at ACA Signups has more information on it’s passage.
“Oregon appears to have just baked healthcare as a right into the state constitution,” ACA Signups, Charles Gaba
As the dust settles on the 2022 Midterm Election, there was an interesting proposal on the ballot in Oregon which (just barely) won last week:
Measure 111: Enshrine the Right to Health Care in the State Constitution
- Yes: 50.6%
- No: 49.4%
>95% of votes in
Not withstanding the slim possibility of it ultimately being defeated (Yes is up by around 20,000 votes as of this morning), it’s important to understand that Measure 111 doesn’t actually enact a specific healthcare coverage program. Here’s an explainer of what it does do from More Perfect Union (published prior to it passing):
The ballot initiative would put health care roughly on par with the right to public education, which is in every state constitution. Like with the right to education, the proposed language making health care a right in the state constitution is intentionally vague, giving the legislature the freedom to interpret and implement policy changes.
…Should the measure pass, Steiner Hayward says that she will push for a waiver that would keep people under 200 percent of the federal poverty level insured. She does not believe Measure 111 would change how people get their health insurance, nor does she think it would lead to a single-payer system, like the one in Canada, where one public agency pays for health care.
I think the “< 200% FPL coverage waiver” comment refers to Oregon’s pending Basic Health Plan waiver, which indeed would create a special healthcare program for Oregon residents earning between 138 – 200% FPL similar to programs in New York and Minnesota, but she might be referring to something else
However, there would be one immediate change for residents. Oregonians would be able to sue the state if it “fails to satisfactorily implement each resident of Oregon’s fundamental right to access cost-effective, clinically appropriate and affordable health care,” according to Lorey Freeman, a member of the legislative council, in a committee meeting document.
In other words, while the proposal doesn’t force the legislature to pass any particular healthcare expansion policies in & of itself. It basically sets things up for the state court system to force them to do so going forward. Interesting.
The real question is what the courts can/will/should do if the legislature whiffs. There’s a long debate about the enforceability of “constitutional welfare rights”. My vague understanding is that the courts have been at least somewhat effective at redistributing resources to poorer school districts. But that’s an easier lift for the courts than ensuring universal, affordable health care, if only because there is universal free public schooling. Equalizing school spending is way simpler than running a health care system.
More generally, although I support universal access to affordable health care, I’m not a big fan of judicial policy making. It will be interesting to see how this plays out.
Betsy Johnson is/always was a DINO, who campaigned for governor as a Republican spoiler. Oregon Republicans have a long history of running clowns ~ basketball players (Brett Kavanagh’s college roomie, Globetrotter’s foil), medical doctors too busy saving children’s lives to campaign, a New York Times columnist who hadn’t set foot in Oregon for fifty years, and a complete loon ~ for governor, she’s just another. I stopped taking her seriously before she ran for anything.
Good news on the ACA though, though I wonder if there will be a lottery like there was for the Oregon Health Plan …
Hawaii Prepaid Health Care (PHC) Act (PHCA) is a state law (Hawaii Revised Statutes Chapter 393) enacted June 12, 1974 in the State of Hawaii to improve health care coverage by employer mandate. The Hawaii Prepaid Health Care Act set a minimum standards of health care benefits for workers. Upon its adoption in 1974, Hawaii became the first U.S. state to require minimum standards of health care benefits by law. … (Wikipedia)
In 2009, Hawaii passed a bill into law, HRS 322H, creating the Hawaii Health Authority (HHA), charged with overall health policy for Hawaii and with designing a universal health care system covering all residents of Hawaii. However, neither of the past two Democratic administrations has chosen to implement the law and empower the HHA to fulfill its statutory mission. …
One-payer states: Hawaii
Who’s gonna pay for it? Aye, there’s the rub.