Governor’s Health Plan Debated
By David Steves, The Register-Guard, Eugene, Ore.
Jan. 23–SALEM — Monday was the day Gov. Ted Kulongoski decided to make his first personal appearance before a legislative committee.
But he didn’t seem to mind that some of his gubernatorial thunder was stolen by a few less-renowned Oregonians, who spoke out in support of Kulongoski’s plan to raise cigarette taxes and expand health coverage for uninsured children.
One of them was Sarah Bacon. Bacon silenced lawmakers in the crowded hearing room when she recounted the anguish of losing her daughter Molly as a toddler during a period when her job as a restaurant server didn’t provide health insurance.
“In this day and age, it’s unusual to bury your child,” said the 22-year-old Medford woman. She suggested that had Molly been insured, more medical tests would have detected her illness sooner and her life might have been spared.
The first hearing on Kulongoski’s proposal, contained in both Senate Bill 31 and House Bill 2201, was a carefully scripted affair. Unions and other groups that support the plan lined up a teacher, a nurse and several workers to testify to the hardships that the lack of children’s health insurance has brought to their families.
Kulongoski himself made it the first issue of the session on which he visited a hearing room to speak to lawmakers. Kulongoski called his plan “sensible, responsible and practical.”
He said that for every $1 spent by the state on health care for low-income children, the federal government would provide at least $1.50 in matching funds.
More than half the 117,000 children the governor is seeking to cover would fall into the low-income category. The only reason so many aren’t already enrolled in the Oregon Health Plan, for which they are eligible, is that the state hasn’t aggressively sought to sign them up, given its lack of dollars to cover them, Kulongoski said.
But the governor emphasized that the children in line for coverage under his plan aren’t from the ranks of impoverished and idle; most are in families with one or more working adult.
“They are the children of our working families, whose parents are struggling to make ends meet and whose employers are either unable or unwilling to pay for health insurance for their employees’ children,” he told lawmakers.
The proposal covers children from working- and middle-class families through subsidies that would be determined by an ability-to-pay sliding scale. Kulongoski called this the “shared responsibility” concept behind his effort to extend government help beyond low-income children who qualified for traditional government assistance.
“We can meet them halfway and put health care for their children within their reach,” he said. During his 11 minutes of testimony, Kulongoski avoided his more politically dicey plan for paying for the proposal.
That plan relies on boosting the cigarette tax by 84.5 cents a pack. Under Kulongoski’s proposal, the state’s tobacco tax would rise to just over $2.02, tied with Washington for the third highest in the nation — the fourth highest if sales taxes are factored into the ranking.
The tax would generate up to $190 million. In the 2007-09 spending cycle, those dollars would cover both the Healthy Kids Plan as it ramps up as well as the expansion of school-based health clinics, anti-smoking programs and the enrollment of low-income adults in the Oregon Health Plan after cutbacks earlier this decade.
In 2009-11 and beyond, money from cigarette tax increase likely would be limited to children’s health care, said Dr. Bruce Goldberg, director of the Oregon Department of Human Services.
Rep. Linda Flores, R-Clackamas, said there was very little disagreement that the Healthy Kids Plan represents good policy. But, she added, “I think the other component, the funding mechanism, is where we’re going to find our areas of concern.”
Flores said she and other Republicans were troubled by questions of sustainability when it comes to relying on a cigarette tax, given that tobacco use is on the downswing. She also questioned whether smokers would avoid the tax increase by buying from online vendors or stocking up when out of state. And she doubted the fairness of relying on one segment of society, smokers, to pay for a broad public service.
Bill Phelps, a spokesman for cigarette producer Philip Morris USA, cited identical reasons for his company’s opposition to the plan.
Russ Walker, who heads the Oregon and Washington operation of the conservative group FreedomWorks, said he planned for other anti-tax activists to join him in speaking out against the proposal when it was up for additional public hearings on Wednesday and Friday.
Kulongoski made it clear to lawmakers that he understood they also were being asked to consider more ambitious plans for universal coverage, for all Oregonians, including the more than 600,000 without insurance. Kulongoski said he was committed to this “noble goal” but cautioned that it should not be allowed to endanger more immediate, incremental steps such as his.
“We must not let our pursuit of that larger goal distract us from enacting this proposal,” he said. “And we must not keep our children waiting any longer.”
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MO,