Next Tuesday, Oregonians will decide the fate of Ballot Measure 101, which ratifies the revenue package passed by the 2017 legislature to fund the Oregon Health Plan for the next two years.
Polling suggests that the vote will be very close. If the measure fails it will throw the state into a fiscal crisis, less than eight months into our two-year budget. Rebalancing the current budget will become the top legislative (and constitutional) priority. Under those circumstances it will be difficult to find space for a thoughtful long-term solution. It’s more likely all that either another stopgap, short term measure will be slapped on, or (worst case scenario) we drop several hundred thousand people from coverage. If the measure passes, we still have the challenge of creating a more stable funding source for Medicaid.
This past year the budget crisis was around $1.4 billion with over half of that coming from Medicaid. The projection for the 2019-21 biennium (assuming BM 101 passes) is another $1.4 billion total with Medicaid contributing $500-600 million—mostly from a reduction in federal match rate for Medicaid and CHIP. In 2021-23, the deficit grows to $1.9 billion, with the sunset of the provider tax being the largest contributor from the Medicaid side. The point is, that Medicaid funding has now become part of the state’s structural budget deficit and, in my view, can’t be solved as a separate issue.
My concern is that serious conversations around building a consensus strategy might not take place until after this year’s general election… when it will be too late to develop a solid bipartisan solution. We need to figure out how to jumpstart this conversation now and it has to involve both the health care sector as well as the larger corporate community. I don’t think we can get from here to there if the two groups approach this separately as they did last year.
Long story short, the day after the vote on 101 – pass or fail – the top priority in Oregon must be to put together a strategy for squarely addressing our structural budget deficit (including long term Medicaid funding) the 2019 session. That will give us a 10-month runway. We can’t waste a minute of it.