Oregon Legislation Creates Universal Health Plan Governance Board

Sept. 22, 2023
Governance Board is directed to bring plan to Legislature for implementation of a new universal healthcare plan in Oregon

Oregon Gov. Tina Kotek has signed Senate Bill 1089 passed by the 2023 Legislature to create a Universal Health Plan Governance Board, which will create a detailed, publicly funded, single-payer universal health plan. The goal is that the board will present its plan to the Legislature, so that implementation could start as soon as 2027. 

“Right now, Oregonians are at the mercy of the insurance industry, forced to choose between vital medical care and paying their bills. The status quo is not acceptable. Our current system is immoral and puts Oregon families at risk. This Governance Board and the new plan they will propose will put people ahead of profits. Inaction is not an option,” said Senator James I. Manning Jr. (D-Eugene), in a statement.

In 2019, Senate Bill 770 established the Joint Task Force on Universal Health Care to solicit input from the healthcare industry, employers, unions, and citizens in every corner of Oregon on how to implement a new, more effective healthcare system for the state.

A key recommendation from the task force’s meetings was to create a Governance Board with the directive to develop and oversee the implementation of a new universal healthcare plan in Oregon.

In a public letter urging Kotek to sign the bill, Carly Hood-Ronick, CEO of nonprofit Project Access NOW, a community-based organization providing access to healthcare and health-related resources for underserved communities, applauded the creation of a Universal Healthcare Plan Governance Board.

“Project Access NOW exists specifically to fill those gaps in coverage and access, a testament to the need for new solutions to health care challenges,” she wrote. “Oregon’s current piecemeal solution creates massive inefficiencies and leaves many of the most marginalized Oregonians behind. A governance board to guide this work in creating a Universal Health Plan will be invaluable, as there are infinite moving pieces to a strong single-payer health care system and the nuts and bolts to such a system will inevitably be vastly complex and require the guidance of such an entity. As details like plan benefits, provider networks, consumer cost-sharing, eligibility requirements, and enrollment platforms are all ironed out over the course of this process, a governance board will both act as the critical convener of public engagement on these issues as well as the stabilizing, neutral support to these efforts that will lead to their success.”

In a signing statement, Kotek, a Democrat, expressed some reservations about the effort. “While we share the intent of Senate Bill 1089, I have implementation concerns following a thorough review process. This session the legislature invested in implementing the Basic Health Plan, 1115 Medicaid Waiver, Essential Healthcare Trust expansion, and Healthier Oregon coverage expansions,” she wrote. “All of these contribute to the goal of increased access to quality healthcare at lower costs based on our ability to leverage Medicaid infrastructure. As Senate Bill 1089 advances a new program that will require significant financial investments in future years, I call upon the sponsors of the bill and legislative leadership to provide clearer direction to the Governance Board on their charge when you reconvene in February.”

She noted that the legislative record lacks a distinction between the work of the Task Force on Universal Health Care assembled through Senate Bill 770 in 2019 and the new Universal Health Plan Governance Board, as well as the charge of each body. “This presents a potential risk of duplicative efforts and inefficient spending of $2 million in taxpayer funding. At the very same time, given the scope of this pending programmatic change, it is equally likely that $2 million underestimates the resources required to fulfill the intent of the bill.”

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