Oregon Task Force on Universal Care chair discusses single-payer plan elements with Senate Interim Committee on Health Care

The chair of a task force designing a universal health care plan for Oregonians discussed details of the plan with lawmakers on Thursday.

 

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The Task Force on Universal Care was established following the passage of Senate Bill 770 in 2019. Following some delays due to the COVID-19 pandemic, the task force will be required to submit final recommendations for the health care plan to lawmakers by September. Task force Chair Dr. Bruce Goldberg discussed plan elements with the Senate Interim Committee on Health Care.

If the plan is enacted, all Oregonians will be eligible for coverage through a simple enrollment process, Goldberg said. Out-of-state residentsand their dependentswho work for Oregon-based employers would also be eligible. Medicare-eligible Oregonians would be covered to the extent permitted by federal law.

Plan benefits would be comparable to those offered by the Oregon Public Employees’ Benefit Board (PEBB), Goldberg said. It would provide primary, preventive, and specialty care, as well as prescription and hospital service benefits. Oral health benefits would also be similar to those offered by the PEBB.

Enrollees would not pay any deductibles or co-pay fees, Goldberg said. There will be a behavioral health benefit, but benefit details have not been determined yet. Long-term care services will continue to be funded by Medicaid and private plans.

“Participating providers in the plan will not be allowed to give preferential treatment to private-pay patients, or to charge more for their care,” Goldberg said. “A single state entity will reimburse providers directly. Methods and rates of reimbursement will be regionally based.” 

Private insurance will have a limited role in the new system, Goldberg said. Insurers will be able to offer complimentary insurance for benefits not offered by the universal health plan. The plan will not cover plastic surgery services, or every drug. Some services will have coverage limits. 

Program funding will come from existing state and federal health care revenue, which will be pooled into a state trust. Additional revenue needs will be generated by a payroll tax, Goldberg said.

“Employers will pay a payroll tax to help fund the cost of health care for all residents,” Goldberg said. “Employers will no longer need to provide health benefits, though they will have the option to continue to offer ERISA plans.”

The preliminary cost estimate to implement the plan in 2026 is $57.13 billion, Goldberg said. The cost to fund Oregon’s current system in 2026 would be $58.12 billion, according to research done by Optumas. That represents a savings of $990 million. 

“It would be about $1 billion cheaper and provide most people with better benefits,” he said. “We will see increased use of health care under the plan. Uninsured people will now have access to care; that will increase costs. Those were offset by a single-payer system that would save us money. And there would be tremendous administrative savings, with decreased fraud, waste, and abuse.”

Sen. Lee Beyer (D-Springfield) asked if there was any concern about health care professionals fleeing the state in favor of areas they believe they could make more money, should the single-payer system be implemented.

“Part of this is about how the single-payer would set reimbursement rates,” Goldberg said. “If rates are set too low, physicians would flee and there would be access problems. When you look at reimbursement from the standpoint of there being less administrative [fees], and other savings, we won’t have physicians leaving. There are some providers who don’t want a single-payer to set their rate. And there are others who are saying, ‘I’m going to get a rate that’s fair, and I can concentrate on my patients.’”

Beyer also asked whether wait times might increase for non-emergency services. But Sen. James Manning (D-Eugene) said wait times are already an issue with the state’s current health care system.

“When we first started the task force, I heard the same argument about wait times,” Manning said. “Right now, we’re experiencing wait times without this new model. I had an appointment for back surgery, and it took me six months to get it. I think the cost savings will attract more practitioners here, simply with the reduction of administrative overhead costs, which are a huge part of why our health care system is suffering.”

Lawmakers will review the task force’s finalized plan in September, and eventually decide whether to implement it.