Health care for all builds steam
Legislature - Backers of two state proposals will combine them to "take the next step"

Thursday, March 15, 2007
DON COLBURN

As nearly 200 people rallied on the steps of the Capitol for universal health coverage Wednesday, leaders of two competing plans to revamp Oregon's health system pledged to merge their proposals.

"We're here to celebrate a milestone and take the next step," former Gov. John Kitzhaber told the midday crowd.

He was referring to an agreement to "combine the best elements" of two Senate bills: one based on Kitzhaber's Archimedes Project and the other sponsored by Sens. Alan Bates, D-Ashland, and Ben Westlund, D-Bend, co-chairs of the Senate Committee on Health Care Reform.

Both bills aim to ensure basic health care for all Oregonians, including the estimated 576,000 who lack insurance. Both would pool public and private spending on health care and set up a board to direct more of that money toward preventive care and treatment backed by scientific evidence. Both rely on leveraging more federal matching money.

Neither plan involves raising taxes. Kitzhaber, Bates and Westlund say there is enough money in the health care system to pay for basic universal coverage if it is spent more efficiently and uninsured people get regular care instead of showing up at hospital emergency rooms.

The Kitzhaber plan is the more far-reaching and politically difficult. It would pool all the money Oregon spends on health care -- including Medicare and Medicaid payments and the tax deductions employers get for offering coverage to employees -- into one pot and attempt to spend it more efficiently. It would require an act of Congress to change federal Medicare and income tax laws as they apply to Oregon.

"Oregon has always been a place of big ideas, no matter how difficult the politics," said Kitzhaber, flanked by a dozen Oregon legislators and advocates of universal health care access.

The Bates-Westlund plan would leave Medicare intact. Because it would expand Medicaid coverage for low- and middle-income Oregonians, it would need federal approval but not an act of Congress.

The rally was organized by the Archimedes Project and supported by Oregonians for Health Security, a union-backed coalition that lobbies for universal health care coverage.

Bates said combining the two bills would allow Oregon leaders to "raise issues at the national level that we can't address in Oregon alone," including the restructuring of Medicare, the federal insurance program for people 65 and older.

Merging the two bills allows each plan to go forward simultaneously, proponents say. While the Kitzhaber plan waits for Congressional action on Medicare, the Bates-Westlund plan could work its way through at the state level.

"It's not a slam dunk on either Medicare or Medicaid, but if you don't ask the question, you'll never get an answer," said Sen. Jeff Kruse, R-Roseburg, a co-sponsor of the Kitzhaber bill.

Westlund vowed to get the bill through the Senate committee by the second week of April.

The push for universal health coverage in Oregon is on a separate track from Gov. Ted Kulongoski's Healthy Kids Plan, which would use a tobacco tax increase to expand insurance for children through age 18. That plan is before the Ways and Means Committee. Because it raises a tax, passage requires a three-fifths majority in both houses.

Oregon is the only state with two U.S. senators -- Democrat Ron Wyden and Republican Gordon Smith -- on the Senate Finance Committee. Kitzhaber said that makes congressional action on his plan more likely.

The merger of the two bills, Kitzhaber said, "represents the last, best hope to get this on the national agenda before the election in November 2008."

Don Colburn: 503-294-5124; doncolburn@news.oregonian.com