NAMI Oregon Endorses Measure 101
By Chris Bouneff, executive director | Jan. 9, 2017
On Jan. 23, Oregonians will decide the fate of Ballot Measure 101 in a special election that will have a huge impact on individuals and families living with mental illness.
NAMI Oregon formally endorses Ballot Measure 101 and urges its members and allies to vote “Yes” to preserve Medicaid expansion in Oregon.
It is rare that NAMI Oregon takes a position on ballot measures. However, with the future of Medicaid expansion at stake in this election, the NAMI Oregon Board of Directors felt compelled to take a position. Regardless of where directors fell on the political spectrum, we all recognized that preserving Medicaid in our state is critical to the tens of thousands of adults living with serious mental illness who finally gained health insurance coverage when Oregon expanded Medicaid under the Affordable Care Act.
And we’re not alone in our endorsement. Nearly every health care entity, provider, consumer group, and insurer favors Measure 101. We hope our members and allies will join us in voting “Yes.”
Background: Why Ballot Measure 101?
Oregon is one of many states that expanded its Medicaid program under the Affordable Care Act. Some 350,000 to 400,000 Oregonians became newly qualified for Medicaid as part of this “expansion population.” Among that group was a huge swath of adults living with serious mental illness who did not qualify for coverage of any kind. It also extended coverage to individuals and families often termed as “working poor” in that they made too much to qualify for Medicaid but did not earn enough to afford commercial health insurance.
The federal government paid 100 percent of the cost for the expansion population for three years. After that, the federal match is on a glide-path down to 90 percent with states required to ramp up to provide the other 10 percent.
The 2017 Legislature held a series of workgroup meetings that involved hospitals, providers, insurers, and many other stakeholders to devise a revenue stream that would raise Oregon’s share. After sometimes contentious negotiations, a bill was proposed and ultimately passed that imposes a tax hospitals and on insurers and managed care groups. The taxes are expected to produce about $320 million for the state health plan. The expenditure will draw about $1 billion in federal matching funds, with much of that funding going toward reimbursements for the entities paying the new tax.
A handful of legislators are against the tax and circulated a signature petition to put the proposal up for a statewide vote. A “Yes” vote on Measure 101 preserves the tax. A “No” vote repeals the tax.
While the provider tax isn’t perfect, it is currently the only politically feasible solution to funding Oregon’s share for Medicaid expansion. Without Measure 101, the Legislature will likely look to cut other public services if lawmakers want to preserve Medicaid expansion. Or, they may choose to drop people from Medicaid coverage altogether.
In an editorial favoring Measure 101, Pamplin Media does a good job summarizing the rationale that NAMI Oregon adopted in endorsing the ballot measure.
The Portland Tribune offers a decent primer on the ballot measure.
And The Oregonian columnist David Sarasohn captures the reasons why the health care industry, insurers, and consumer groups are universally lining up in favor of Measure 101.