a state board<\/a> to come up with options for the Legislature to consider in the 2027 session.<\/p>\nI went back and listened to meetings of the board this past week. The goal of a healthier Oregon is unquestionably right, but I don\u2019t see how Oregon gets there from here.<\/p>\n
Oregon is going to need permissions from the federal government. The state needs to be granted waivers for Medicaid (called 1115) and more. Can you see that happening in President Trump\u2019s administration?<\/p>\n
\u201cThe current federal administration has announced that they do not intend to approve any new state proposals or extend existing 1115 waivers,\u201d Jessica Merino of the Oregon Health Authority recently told Oregon\u2019s board. \u201cThat\u2019s something that\u2019s really, really critical to keep in mind.\u201d<\/p>\n
President Trump won\u2019t be president forever. Maybe the next will be more amenable to the idea. Maybe the next Congress will grant Oregon permission to try a state-run system. It\u2019s not guaranteed. It\u2019s uncertainty.<\/p>\n
An Oregon switch to a state-run system will also likely face lawsuits. One may come related to what is called ERISA. The Employment Retirement Income Security Act is a federal law that stops states from interfering in employer choices in providing benefits. Basically, when an employer is self-insured, the state can\u2019t meddle.<\/p>\n
The Oregon plan for universal care has been to raise revenue for the system, in part, through a payroll tax on employers. The line of argument from the health care board is that a new state payroll tax for health care would not directly limit an employer\u2019s rights to offer health insurance to its employees. An employer could choose to continue its health plan or it could stop it and let employees take advantage of the state plan.<\/p>\n
That might work. The impact of such a new payroll tax sure looks like interfering. Isn\u2019t it just a maneuver to elude the law? I don\u2019t know how courts would rule. Congress could change ERISA to allow Oregon to try its plan. Would Congress do that?<\/p>\n
Then there\u2019s cost.<\/p>\n
One of the promises embedded in the idea of universal health care in Oregon is that it would cost less than the status quo.<\/p>\n
The state board has been presented with projections to the contrary, at least in the short run. Cost estimates show the state\u2019s health care costs would be billions more under a universal health care system in its early years than if Oregon proceeded under the status quo.<\/p>\n
It\u2019s almost inevitable. The estimate is that there would be more spending because Oregonians have pent up demand for health care. Some people would also move to Oregon to seek care, because the state would have one of the best opportunities for health care in the country.<\/p>\n
There are more uncertainties that I have not mentioned than those I have. But don\u2019t get me wrong. I think it would be wrong to give up on the Oregon effort.<\/p>\n
Disease and injuries ruin lives. And the health care system we have now, as excellent as it in providing care, ruins finances and has an alarming cost trajectory.<\/p>\n
I want to see the health care board keep trying. It might not find the solutions Oregonians want, but it does create pressure to find solutions.<\/p>\n
Richard Coe is editorial page editor at The Bulletin. He can be reached at richard.coe@bendbulletin.com.<\/p>\n","protected":false},"excerpt":{"rendered":"Column: Oregon is on an alarming health care trajectory Published 6:25 am Sunday, November 30, 2025 Many years…\n","protected":false},"author":3,"featured_media":415944,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[210,1141,1142,67,132,68],"class_list":{"0":"post-415943","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-care","8":"tag-health","9":"tag-health-care","10":"tag-healthcare","11":"tag-united-states","12":"tag-unitedstates","13":"tag-us"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@us\/115640980080463990","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/415943","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/comments?post=415943"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/415943\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media\/415944"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media?parent=415943"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/categories?post=415943"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/tags?post=415943"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}