A bill sponsored by Sen. James Manning (D-Eugene) would bring Oregon one step closer to becoming the first state in the nation to implement a single-payer healthcare system.
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Members of the Senate Committee on Health Care discussed Senate Bill 704 on Monday. The bill would establish the Universal Health Care Governance Board in the Oregon Department of Administrative Services. The board would design an administrative structure for a universal health plan to assess the readiness of public institutions and infrastructure to implement a single-payer program.
“The intent and vision of this bill is that if you live here, in our great state of Oregon, you should have and will be entitled to receive equitable healthcare,” Manning said. “We’re talking no out-of-pocket expenses, no copays, dental, vision, hearing, the basic rights that fall under Measure 111.”
Voters passed Measure 111 last year, which amended Oregon’s constitution to require the state to ensure that every resident has access to cost-effective, clinically appropriate and affordable healthcare as a fundamental right.
“Oregonians have spoken out loud and proclaimed that healthcare is a human right here,” Manning said. “This plan will cover everyone. This is an important step towards the realization that healthcare is a human right.”
SB 704 would further Oregon’s efforts to eventually implement a universal healthcare system. Legislators created the Joint Task Force on Universal Health Care through Senate Bill 770 in 2019. The task force was charged with designing a single-payer healthcare financing system that would be available to all residents.
The task force developed a blueprint for the type of universal healthcare system envisioned in SB 770. SB 704 would build off of that work. Task force member Dr. John Santa said the work the group did proves that a single-payer plan is feasible, either at the state level or the federal level.
“Health delivery systems would be able to predict resources available, eliminate wasteful administrative processes, and pursue regional strategies that are advised by the communities they are part of,” Santa said. “The governance board would create a plan that would not depend on employment, allowing businesses to be far more efficient by focusing on their business. Both employers and employees would have more options, flexibility, and portability as their needs evolve.”
Tom Holt represented the Oregon Association of Health Underwriters (OAHU) in testifying in opposition to SB 704. He said OAHU examined the task force’s report.
“There’s just heroic assumptions,” Holt said. “There is still a lot of [administrative work] with Medicare, which is a single-payer system for seniors in this nation. It is not as simple as many of us would like it to be. This seems like a project ultimately destined to crash and burn. And we would recommend that efforts be placed more on the incremental improvements we can all make together in the system, with the state and the private sector working together, as we have on many projects in recent years.”
Rep. Travis Nelson (D-Portland) testified in support of SB 704.
“It is well past time that we got corporate profit and private insurance out of Oregonians’ healthcare,” Nelson said. “What providers and treatments are available to us shouldn’t be determined by commercial bottom lines. The US is a world leader in more ways than we can count. But being one of the largest countries in the world that does not offer universal healthcare shouldn’t be one of those reasons.”
Nelson is a registered nurse, and said many families have to spend an exorbitant amount of their monthly paycheck just to cover the monthly premium for a healthcare plan.
“And that’s not including the copays, the prescription costs, the deductibles, and other out-of-pocket expenses that factor into one urgent care visit,” he said.
Silverton Mayor Jason Freilinger noted that the city passed Measure 17-15 in March 2017, which urged the state legislature to create a comprehensive healthcare system to serve all Oregonians.
Prior to becoming mayor, Freilinger was a small business owner in Silverton for seven years. Prior to that, he worked for T-Mobile. He said universal healthcare would be beneficial for small businesses.
“One of the things that was astronomically amazing to me was the extreme difference in cost for me as a small employer to be able to employ my small staff in comparison to what my corporate entities used to have to do,” Freilinger said. “When I left T-Mobile, I was paying $400 a month for all my staff to get insurance per person. And when I tried to open a small retail outlet, it was $850. I’m not a small business owner anymore, partially because of healthcare.”
Salem City Councilor Dr. Trevor Phillips, who is an emergency room doctor, also testified in support of SB 704.
“I routinely care for patients who ration their care, and avoid taking potentially life-saving medications, or delay medical procedures due to cost concerns,” Phillips said. “It feels like we are living through an unraveling of past healthcare models and coverage.”
Phillips voiced concerns over the challenges hospitals are currently facing in trying to care for an overwhelmingly growing patient population.
“Across this nation, seeing patients in emergency room hallway beds has become normalized,” he said. “All too frequently, critical resources like inpatient beds are completely utilized, and there are wait lists that become closed. This impacts all of us by delaying care for everyone. We need significant improvements like SB 704 to meet this moment in our history.”
Under SB 704, the governance board would have nine seats with members appointed by the governor. Members would serve four-year terms, and would be paid as full-time public employees. The board would present a comprehensive plan for the implementation of a universal health plan that would begin in 2027 to the legislature by Sept. 15th, 2025.
No action was taken on SB 704 on Monday. Sen. Deb Patterson (D-Salem), committee chair, said she would reopen the hearing on Wednesday in order to hear more testimony on the bill. She said 50 people had signed up to testify.
“There’s so much more to hear, and so many more people to hear from,” Patterson said. “The balance of those who have signed up are all testifying in support of this bill.”