SALEM, Ore. — Oregon voters are being asked to decide whether the state should be the first in the nation to amend its constitution to explicitly declare that affordable health care is a fundamental human right.
State Sen. Elizabeth Steiner Hayward, a main sponsor of the legislation behind the ballot measure, said making health care a human right is a value statement and is not aimed at pushing Oregon to a single-payer health care system, a longtime goal of many progressives.
But opponents warn the amendment could trigger legal and political woes and open the door to lawsuits.
Measure 111 got onto the Nov. 8 ballot because the Legislature, where Democrats hold a majority, referred the issue to voters last year. There were earlier efforts, including in 2018 as then-President Donald Trump tried to dismantle former President Barack Obama’s health care law, but they died in the statehouse.
Republican lawmakers consistently opposed efforts to ask voters to enshrine health care as a right in Oregon's 163-year-old constitution.
“The bill doesn’t fund any system to deliver on that promise,” then-Senate Republican Leader Fred Girod said when the resolution was debated in March 2021.
Steiner Hayward recently told The Oregonian/OregonLive that if the measure passes next month, the state's current resources can handle any financial impact in the immediate future. But she would not rule out possible future tax increases to help provide that health care.
"Can I guarantee no new taxes? No. I don’t make promises like that,” Steiner Hayward said.
Oregon has a history of being a trendsetter for other liberal states: It was the first to legalize suicide for the terminally ill and was the first to designate itself as a sanctuary state to protect immigrants living in the country illegally. The state has also expanded coverage on abortions and other reproductive services regardless of income, citizenship status or gender identity.
Three dozen organizations, including health workers, unions and educators, called the new ballot measure “a critical first step to creating an Oregon where everyone can afford to be healthy.”
Those signing a statement of support in the voters' pamphlet included the Oregon Nurses Association; Providence Health & Services — a nonprofit Catholic health care system with multiple hospitals; the Oregon Academy of Family Physicians; and the Service Employees International Union, the largest labor union in Oregon.
The proposed amendment states: “It is the obligation of the state to ensure that every resident of Oregon has access to cost-effective, clinically appropriate and affordable health care as a fundamental right.”
It goes on to say that the state's obligation “must be balanced against the public interest in funding public schools and other essential public services.”
But it doesn’t define “cost-effective, clinically appropriate and affordable,” or who is supposed to be footing the bill.
The Oregon Health Authority says 94% of Oregonians already have insurance coverage, and that more are eligible for the Oregon Medicaid plan or a subsidy to reduce the cost of commercial health coverage.
But Steiner Hayward noted that having insurance doesn't guarantee access.
“We know that we have health care deserts in the state. We know that our primary care system is overstretched," she said. “We need to be thinking about how do we change all of those things to ensure that having good health insurance means having good access to health care.”
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The measure was long championed by Democratic state Rep. Mitch Greenlick, who died in 2020 at age 85, a year before the Legislature approved putting it on the ballot.
In 2018, when the bill came up for a vote in the House, Greenlick described how he was diagnosed with lymphoma in 2005 and relied on insurance to pay huge treatment costs.
“If I didn’t have insurance, I wouldn’t be here,” Greenlick said. “I would be dead.”
GOP Rep. Kim Wallan wrote in opposition to the measure in the voters' pamphlet, saying it would likely wind up being litigated.
“The courts would probably force the state to fully fund health care, leaving police and education scrambling for funding,” she wrote.
Tina Kotek, who was then the House speaker and is now the Democratic candidate for governor, supports the initiative and says its goal is “primarily aspirational.”
Republican candidate Christine Drazan opposes Measure 111 because of potential budgetary impacts. Unaffiliated candidate Betsy Johnson voted against the bill when she was a state senator but says she'll implement the mandate if Oregonians approve it and it is financially feasible.
