BEND, Ore. - Here is a transcript of the live half-hour debate NewsChannel 21 hosted on Thursday evening, featuring two state representatives on opposite sides of the only issue on the Jan. 23 special election ballot.
On Jan. 23rd, your votes will be tallied to decide whether an assessment on hospitals and other health care entities should remain in place as approved by lawmakers, or not.
We'll spend the next half hour hearing from both sides of the issue, Measure 101.
Measure 101 would charge some hospitals, insurance companies and other health-related entities to help provide funding for health care for low-income Oregonians.
The veto referendum petition leading to Measure 101 was launched by three Republican state legislators, including one here in studio. And that person is Republican state Representative Julie Parrish, representing "no" on Measure 101. She represents House District 37 which includes Tualatin and west Linn.
Representing "yes" on Measure 101 is Democratic state representative Andrea Salinas. She represents House District 38 which includes Lake Oswego.
Each side will get 90 seconds for an opening statement, and up to two minutes to answer each question.
Representative Andrea Salinas will go first, decided by a coin toss.
Rep. Andrea Salinas (D) District 38
Measure 101 is simple. It’s the only plan to guarantee funding for Oregon’s Medicaid program. Hospitals and insurance companies have agreed to a small assessment on themselves to ensure that Oregon can continue its Medicaid program to stabilize markets and reduce health care costs.
Without Measure 101, people will lose benefits, lose health care programs, or both. There’s no backup plan, and there’s no special pot of money. 165 organizations, including St. Charles, the Oregon Nurses Association, the Oregon Medical Association, AARP and education groups have all endorsed Measure 101. And editorial boards have started to speak up as well, calling the Medicaid opponents disingenuous and spouting gobbledy-gook.
Today, 95 percent of Oregonians have health care coverage. We can’t go back to the days when families face financial crisis from a single hospital visit. Medicaid opponents, including Rep. Parrish are gambling with Oregon’s health care. Health care is too important to too many families in Oregon to do this. That’s why we are supporting Measure 101, and I hope Central Oregon will too.
Rep. Julie Parrish (R) District 37
90,000 Oregonians, including thousands of people right here in Bend, signed a petition so that we could ask the question not whether we should fund Medicaid, but whether the legislation proposed was fair, whether it was equitable, and whether it was sustainable.
The pieces of Measure 101 that we’re attempting to ask you to repeal really is $330 million of a $13.69 billion Medicaid package. Some of that could be matched with federal dollars, but if you look at your Voter’s Pamphlet, it does say subject to federal approval, so that’s not done yet.
But is it fair? Was it fair to put that burden on 217,000 individuals who buy their own health insurance? Is it fair to put it on college students, non-profits, and even take money out of our public schools, because our school districts, including the Bend-La Pine district, buy their health insurance in the large group market, and they’re subject to taxation?
Is it equitable? Should Oregon’s largest self-insured corporations, unions, and insurance companies have been given a free pass to shoulder none of the societal obligation for Medicaid? And is it sustainable? Because two years from now we’ll be right back in this position without a solution when the federal government makes Oregon chip in even more money to help cover Medicaid. As someone who grew up on Medicaid, I am a strong Medicaid supporter, and I urge a no vote on Measure 101.
Our first question: The Voters' Pamphlet calls the money that would be collected an assessment. Is this an assessment or a tax, and what's the difference?
Andrea Salinas (D)
I would like to clarify that this is an assessment. The hospitals and insurance companies have agreed to a small assessment on themselves. What this means is that this small assessment will go back to those that they cover. So those folks who are patients at the hospital system and those who have premiums through insurance companies. So Measure 101 will help to stabilize the insurance markets. The Department of Consumer and Business Services shows that premiums will decrease by 6 percent because of Measure 101, which comes to about $300 annually for families.
Julie Parrish (R)
It’s a tax, and a tax by any other name is still a tax. If voters look at the voter pamphlet, Section 8 of the referendum actually was a piece of policy we took out that said insurance companies can actually pass that tax on to ratepayers. The reinsurance program only benefits the people in the individual markets, so the small businesses, your non-profits, the school districts, they get no benefit from the reinsurance program.
It is truly a tax. The Beaverton school superintendent on Nov. 22 sent an email out to his staff district wide and said yes, Measure 101 taxes will cost us $540,000 per year. As a mom with kids in public schools, I am not interested in seeing tax dollars come out of them in this manner to fund Medicaid. We do think there’s a fair and equitable manner to fund Medicaid that does not include taxing people’s healthcare.
Voters are smarter than this. They’re smarter than the Legislature gives them credit for. Ultimately, at the end of the day, they know that taxing health care doesn’t make it cheaper. When does taxing anything make it cheaper? It simply doesn’t. What it is is a really big windfall for insurance companies who got a real carve-out and a really sweet deal -- particularly given that right now, we have insurance companies that pulled out of markets. Douglas County has only one insurance provider now.
And two years from now, when we say this is not sustainable, when we have to pick up more of that federal share for Medicaid, where do you think that money comes from? That money is going to come from an increased insurance tax. It’s not the equitable or sustainable way to get Medicaid funding, and we have a legal opinion from our own legislative counse that did say this is a 3/5ths vote. It requires 3/5ths of the legislature to raise revenue for taxes. The assessment means the money goes back to who gave it. In this case, when you tax a school district for health care, that money isn’t going back to the school district.
So we want people to look at this. Look at who’s funding the yes side. It’s all insurance companies and hospitals and special interests. We’re beginning to see the cracks of a failure of our Medicaid system, so we’re going to keep urging folks to do their homework and their research.
There seems to be some disagreement on the money.
The Voters' Pamphlet says if the measure is defeated, there will be a loss of $210 million to $320 million in state revenue, and possible reductions in matching Medicaid funds between $630 million to $960 million.
And it's noted in the Voters’ Pamphlet Secretary of State Dennis Richardson does not agree with the estimate of financial impact.
So what will the financial impact really be?
Andrea Salinas (D)
The legislative fiscal office has shown between $300 million and $1.3 billion or more. I'll take the word of the state, where we get these funds will likely mean cuts in health care, benefits and prescription drugs, and other parts of the budget. 160-plus other organizations say yes: The only way to keep kids safe is to vote yes on Measure 101.
Julie Parrish (R)
We've heard these scare tactics before with Measure 97. Voters don't buy into that. We have more revenue than ever. Voters are fatigued about these scare tactics. How about we use the money we have wisely? 55,000 ineligible weren't eligible for Medicaid, hundreds of millions of dollars of waste in the system. The same government that gave us a $300 million Cover Oregon health system that failed. The OHA has wasted $1 billon -- money that didn't go to health care. The jobs the state Medicaid workers bring in is larger than the federal money. Where'd it go? We would have had the money. Then we put old folks and children and disabled folks on the chopping block, if you don't raise other people's health care. Doctors and nurses and the W-2s that they pay, we would have actually had the money that we needed, because it brings in more money to the state and local government than it actually costs us to spend.
I'm going to do a little spin off question here because of that.
There are allegations of mismanagement with all of the money we had allocated, misappropriated, overpayments and Medicaid.
So let me say this: That money is gone, that's a done deal. Maybe the state should have done better in the Legislature on finding the appropriate funds to handle this, but that didn't get done.
So I'm asking: if it doesn't get done, are people going to lose coverage if Measure 101 does not pass? And we will begin with representative Salinas.
Andrea Salinas (D):
It will be up to the Legislature to figure out how to close a $1.3 billion gap for these folks who could potentially lose Medicaid. So we're talking 400,000 children who could lose Medicaid coverage, We're talking about 350,000 adults. About 1 in 4 Oregonians depend on Medicaid. And that's 25 percent of Deschutes County residents that depend on Medicaid, and that's a big chunk.
So yes, the Legislature can decide to cut health care, and to cut Medicaid, but it could also decide to cut school budgets, it could decide to figure out where it's going to cobble together for this funding. But there is no magic pot of money out there. And the Medicaid opponents would like for voters to think there is a magic pot of money that we haven't uncovered, but they have not come up with a solid plan that can pass the Legislature this session where we can fully fund Medicaid. Measure 101 is the only guaranteed way to fund Medicaid right now.
Julie Parrish (R):
Well, Representative Salinas makes as really good argument for if we were repealing all of House Bill 2391, but we're not repealing all of House Bill 2391. We're repealing five pieces, four of them being tax policy, one of them being a piece of policy that lets insurance companies pass this on to ratepayers. We're not repealing $13.6 billion of Medicaid funding, the math just doesn't add up.
The average patient in Oregon who gets a CCO (coordinated care organization) payment for their health care is $430 per patient per month. Well, if you just simply multiply that by 350,000 Oregonians and we budget in a 2-year cycle, that's $3.61 billion that we would have to repeal, to have 350,000 Oregonians lose their health care.
And Representative Salinas is new to the Legislature, she wasn't here for that vote, and maybe she really hasn't had a chance to look at those numbers in depth. But for seven years, and I served on the Health Care Committee, I spent four years on the Human Services Committee. I have been in the Legislature as we implemented every piece of the ACA, and what we're seeing right now, your community may not be in tune to it: One of the state's oldest and largest Medicaid providers is being forced to shut down by the state of Oregon at the end of this month.
That's the real threat to health care, is when you have a state agency that's out there, pushing on Medicaid providers, and 115,000 people are going to lose their Medicaid home. They'll still have Medicaid, but they will not have the access to their same doctors, and most certainly they are going to be left in limbo, all over a rate-setting issue with the Oregon Health Authority. So this is the agency we're asking to trust to keep managing our money well, the same one that is actually forcing Medicaid providers out of business right now.
So we want voters to look at the really holistically. Again, look who's funding the yes campaign. When was the last time you had an insurance company beg you to tax them? Voters should have a little cognitive dissonance on about why they are actually saying, 'Hey yes, do this.' A lot of this is a sweetheart deal for special interests, including those for-profit Medicaid organizations, some of them who we can, Lee go back and get some of that money back from them. The governor was sort of shamed into that by newspapers and has said, we'll go get $74 million of those dollars back.
If Measure 101 passes ladies -- let's say that it does pass, what is the likelihood then that this just gets trickled down, the cost. Will it get passed along to the consumer as a health care sales tax?
Andrea Salinas (D):
No, not necessarily. I don't know what the insurance companies are going to do and I don't know what the hospitals are going to do, but what they do want is to finance health care in the most effective way possible. And that means providing preventive care to the one in four Oregonians who depend on Medicaid. That means when somebody needs access to a hospital, to a doctor, to a nurse, to their medication, they have access to go get it. This keeps costs down. I think Oregon voters are smart enough to recognize that.
The Medicaid opponents are trying to conflate different budgetary issues. And what we are talking about, right here, right now, is propping up Medicaid at the tune of $1.3 billion. $300 (million) from the state, and the other $1 billion from the federal government. We can't leave that on the table, and voters know that. We need to make sure we draw down that money from the federal government. To fund Medicaid, there are other issues that need to be dealt with. We need to figure out cost drivers in our health care system, but Measure 101 doesn't address any of that. That's why I'm not sure where our opponents are getting that special pot of money when we lose that $300 million. Measure 101 is the only way to guarantee this funding for 400,000 kids and 350,000 adults.
Julie Parrish (R):
Well, I've just been shocked to learn that now the number of people to lose health care is 750,000 -- 350,000 children and 400,000 adults. The numbers from the proponents who are begging for these taxes -- we are struggling to understand their math. Myself and Dr. Cedric Hayden, who is a Medicaid practicing dentist -- he has spent 25 years of his practice serving the hardest of the hard and the lowest income patients in the state -- to hear us described as Medicaid opponents when the very first bill I passed into legislation as a freshman lawmaker was a bill to expand Medicaid to the prison population after my sister had overdosed after coming out of Coffee Creek after Governor Kitzhaber has signed that into law.
This is a population for myself and Dr. Hayden that we absolutely care about, we are interested in making sure they have coverage. The question is how? Should individuals and small businesses pay a tax that your Starbucks doesn't have to pay? We're not saying no to Medicaid funding. Contrary to what Rep. Salinas says, there actually was a proposed bill on it. So we weren't saying no to taxes, we were saying no to taxing other people's health care. I hear all the time from my Democratic colleagues that health care is a basic human right. We do need to find fair, sustainable ways to do that. But we don't think that $330 million piece of a $13.6 billion budget was the equitable solution to fund Medicaid.
Representative Parrish, you mentioned that you were in agreement with someone in the medical community. But in the Voters’ pamphlet there are many doctors and community clinics that are in favor of Measure 101. I'd like for you to both address that. and also the fact that this is not necessarily straight political lines. Voting in approval on this, there are Republicans and democrats on both sides of this. And I'd like to find out why the medical community has supported Measure 101?
Rep. Andrea Salinas (D):
I think that the medical community realizes what happens when people don't have access to health care coverage. It means they don't go see their doctor, they don't address preventative medical needs and they end up in the emergency room, where it is more costly and just simply more expensive to treat a patient, rather than providing them with the health care coverage, the access to doctors and nurses when they need it, not when there's a crisis. The emergency room is where we will end up with many of these patients if Measure 101 does not pass. So we need to make sure that we are funding preventative medicine. Medicaid gives people that coverage and allows access to the health care that they need.
Rep. Julie Parrish (R):
Well, you know first of all, I want to thank the thousands of voters in Deschutes County who signed this petition. and guess what? They were not all Republicans. We could not have gotten this to the ballot without the signatures of thousands of registered Democrats, thousands of non affiliated and independent voters. Frankly, voters in every part of the state signed this petition, and we are grateful. Because it's not an R or D issue, it's a checkbook issue. It is one of, can you afford your own health care?
You know, you'll hear and see a bunch of slickly produced ads by a Washington D.C. firm who's out there trying to get you to vote yes on these things about people who might lose their health care.
But let's talk about the people who we talked to during that whole campaign. People like Stan. And Stan lives in Waldport, and Stan is an 83-year-old veteran, and his health care is covered through the VA, which is not subject to this tax, unless you have out-of-pocket hospital costs, and then you would probably see that tax from the hospitals passed onto you.
But Stan buys health insurance for his daughter Jeannine, who is 55 years old. She is not old enough for Medicare, she is not poor enough for Medicaid, she is not disabled enough for SSI. He is spending half of his military pension buying her health care. And then he gets a letter from Regence that says: You know what? We're not going to serve your daughter any more, and you're left now with one choice on the insurance market. Stan does not have a lobbyist, Stan does not have to money to write big campaign checks.
The people who voted yes on this took $2.8 million of campaign money from for-profit Medicaid organizations that benefit directly from the tax. So of course when you see All Care and some of the other for-profit CCOs putting hundreds of thousands of our Medicaid dollars, washed through their political action committees for a yes vote.
And if you don't think there's a financial incentive, even the head of the hospital associations since the ACA's implementation has had a $700,000 pay raise. Those are our Medicaid dollars being washed through the hospital assessment system. There's a financial incentive for people who are tied to the industry to say yes. There is no lobbyist for Stan, or for the small businesses in your communities who are going to be forced to pay this tax.
Alright ladies, times almost up. Thank you very much for both of you for coming in. I'll say that it's been a nice discussion tonight. We go to the polls - ballots start getting counted in 19 day,s folks. Before we give a good night here, we're going to both participants one more opportunity to share: For or against. And we will again start with Representative Andrea Salinas
Rep. Andrea Salinas (D)
Salinas: Thank you. So as we discussed this evening. Measure 101 is the only way to guarantee funding. The Medicaid opponents have essentially brought in other confusing factors and other pieces of legislation and broadened the discussion to how we should finance our overall health care system. But our seniors, children and people with disabilities know that they can count on Medicaid; if we get a yes on Measure 101. That's why the yes campaign is 165 supporters strong - including non-profits, hospitals, insurers, teachers, nurses and, as you said, many doctors. We have strong leadership in Senator Merkley and Senator Wyden; who helped prevent rollbacks at the federal level. And now we must do the same here in Oregon to protect Medicaid
Rep. Julie Parrish (R)
Thanks. For many of us it's not as complicated as we think. It's not funding Medicaid, but how? And did the Legislature do that fairly? Did they tax college students and small businesses in favor of corporations and unions and insurance companies that have deep pockets and really by lobbyists? Was that fair? Is that equitable when in two years we'll need that money? Why aren't we having the long-term conversation? We do believe there is another way to fund Medicaid. We have more money than we've ever had. I urge you to vote no.
Ladies, thank you.
If you'd like to watch this special program again, or would like to learn more about the special election, you can visit our website, KTVZ.COM. We will have links to the ballot measure, as well as links to both groups, yes and no on Measure 101.