The health policy implications of Oregon’s elections

After record spending in what many had rated a “toss-up” horse race for Governor, Gov. Kate Brown cruised to a six-point victory over State Rep. Knute Buehler, a moderate Republican who ran a policy focused, disciplined campaign.

By the numbers, the Metro Portland area – urban Multnomah County (Portland) and suburban Washington County – on which Buehler focused his campaign proved to be his undoing. He garnered only 22% of the vote in Multnomah Co. and 39% in Washington Co. – well behind every GOP nominee of the 21st Century.

Gov. Brown, for her part, disqualified Buehler with an extraordinarily negative campaign. Very little of her paid advertising was devoted to either her first-term record or second-term agenda.

Democrats won big in Legislative races. No GOP challenger got within 5 points, and three GOP incumbents lost.

Most notably: Rep. Julie Parrish, who became a high-priority target after organizing a ballot referral of a new health insurance premium tax last January (M101). Parrish was outspent more than 2:1, nearly $850,000 vs. Parrish’s $365,000. Surviving Republicans will take note.

What happened?

Two things: Superb execution, especially of “ballot-chase” voter turnout operations by the Democrats’ coalition, and President Donald Trump. The Donald’s disapproval ratings in the crucial Portland metro area were upward of 70% going into Election Day, a gale-force headwind for Republicans.

The House will be 38D/22R after picking up three seats. The Senate will be 18D/12R. The significance of those numbers is that a new tax or a tax rate increase requires a 3/5 vote. Democrats’ will have it, if they don’t over-reach.

What’s this all mean for 2019 Session issues?

  • Medicaid “CCO 2.0” moves forward without potentially disruptive key state leadership staff changes.
  • Revenue measures to close Medicaid and education budget holes will have no difficulty clearing the House, and, if not extreme, also will cruise through the Senate. Look for removal of the premium tax sunset, or even a long-rumored claims tax.
  • Significant new regulatory requirements on businesses (including health care) are very likely, as Democrats will have ample margin to continue enacting labor’s workplace priorities.
  • Bipartisan moves against prescription drug costs are likely.
  • PERS reform, like Generalissimo Francisco Franco, is still dead. The state likely will lean on a combination of new revenue, creative borrowing and higher risk PERS fund investments to ease PERS pressures on schools and local governments.