(St@teside Published November 30, 2006)

Oregon:

Oregon has begun to lay the conceptual framework for an overhaul of its health care system that would ensure basic, universal coverage for every resident. With the reelection of Democratic Governor Ted Kulongoski and both a democratic Senate and a newly democratic House, efforts to advance a universal coverage plan appear to be coalescing. If implemented, such a plan would make Oregon the first state in the nation to offer universal health care to its citizens.

With a tentative launch as early as January 2009, the program would provide all Oregonians with a health card to buy essential medical services, meeting the health care needs of more than 600,000 Oregonians who lack health insurance. Managed by a public board or commission, the plan would pool federal and state Medicaid funds with contributions from employers and employees.

Under the plan, health insurers would compete for enrollees and would be required to sign up any resident with a card. All of the essential benefits covered by the plan have not been defined but mental health care would be included. Employers and employees could supplement the basic health care coverage package by buying more comprehensive coverage. Prior to enrolling, Oregonians would have to sign an advanced directive describing the level of care they wish for at the end of life. Preliminary estimates indicate that the plan would cost about $350 per person per month.

A state Senate commission has taken the lead in preparing the universal coverage plan and has begun drafting legislation for consideration when the legislature returns in January. In addition to the Senate commission's plan, the Oregon Health Policy Commission and former Democratic Governor John Kitzhaber have also developed universal coverage proposals. The Legislature will likely consider a legislative package that includes features from each of these proposals.

In the meantime, Oregon is pursuing implementation of a Healthy Kids Plan targeted at the 117,000 Oregon children who lack health insurance. The Healthy Kids program would maximize the use of federal and state dollars, and would also rely on funding from a proposed increase in the state's tobacco tax. With an ambitious launch date of January 2008, the Healthy Kids Plan would build on existing children's programs and expand coverage to all uninsured Oregon children up to age 19.