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The Oregon State Capitol in Salem. 

Mark Ylen

Two weeks remain until the Jan. 23 election on Measure 101, which asks voters to pass judgment on a pair of health care taxes (and, yes, they are taxes) designed to provide temporary funding for the state's Medicaid programs.

If you haven't returned your ballot yet, we understand: It's a complicated bit of business, and deciding how to vote on the measure is a tough call. The Democrat-Herald reluctantly recommends a "yes" vote on the measure, but allow us to make some points that could help with your own decision.

First, this background: The 2017 Legislature was facing a big budget hole, in part because of an expansion of Medicaid services in Oregon. (In this state, we call Medicaid the Oregon Health Plan; in general, the expansion has allowed people who make between 100 percent and 138 percent of the federal poverty level to sign up. As a result, more Oregonians are able to access health care, and that's a good thing.)

This particular budget gap shouldn't have come as a surprise to state officials, who knew as early as 2014 that Oregon would have to pay a bigger share of this Medicaid expansion beginning in 2017. Yet they did nothing until their hand was forced in the 2017 session.

That's when legislators cobbled together a funding plan to raise $455 million in state funding to help fill the gap. Some provisions of the plan sparked the ire of legislative opponents, who referred those provisions to voters in the form of Measure 101.

Here are the provisions that Measure 101 challenges:

• A 0.7 percent tax on hospital net revenues; the money raised would go into a state fund for health care, if Measure 101 passes.

• A 1.5 percent tax on premiums of health insurance companies, the Public Employees’ Benefit Board and coordinated care organizations (the regional organizations that administer the Oregon Health Plan).

Measure 101 does not challenge other funding mechanisms the Legislature approved. Still, if voters reject the measure, that blows a hole in the state budget that could be anywhere between $210 million to $320 million. Legislators would have to find a way to plug that, especially since that money is used to match federal dollars for the Oregon Health Plan.

Opponents of Measure 101 say they have no desire to see any Oregon resident lose access to health care; instead, they say, legislators can find the money elsewhere.

We're not so sure we want to take that risk. Legislators would have to find that money with little more than a year remaining in the state's two-year budget cycle. And there's considerable uncertainty surrounding the budget proposals floated as substitutes by Measure 101 opponents.

As hard as it might be to picture a situation in which the state removes people from Medicaid rolls, it's happened before in Oregon. (There is no federal requirement mandating coverage for the people who have been included in the expansion, so that coverage in theory could be cut to save money.)

That sort of cutback likely would end up harming the state's bottom line in different ways: People with access to health care have options other than just visiting an emergency room when a medical issue becomes too acute to ignore. And we all save in the long run when children have access to health care.

With all that said, we need to hold elected state officials to their promise when they say that Measure 101 is a temporary measure. We've seen plenty of "temporary" taxes become permanent.

We knew the day was coming when the state would need to shoulder a larger burden of the tab for the Oregon Health Plan. It was the right call to expand the program, and we're seeing benefits from that decision. But now officials need to shoulder a burden they have thus far shrugged off: How do we pay for this expansion in a way that's fair and sustainable? Even if Measure 101 passes two weeks from now, that discussion needs to be pursued with urgency. (mm)   


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