Health Care for All Oregon launches push for universal care

Nancy Forrest: On April 19, 2026, the Lane County chapter of Health Care for All Oregon (HCAO) hosted a town hall in Eugene to present progress being made on a multiyear campaign designed to reform how health insurance is delivered in Oregon.

Approximately 200 local citizens attended the event and were very engaged. HCAO staff provided updates on the campaign, including progress made thus far and what to expect next.

Speakers included local and statewide politicians, as well as two members of the Universal Health Plan Governance Board.

The audience was asked to complete a survey to inform HCAO’S work going forward, seeking input on how to best navigate a very difficult process.

After all, by using this process, Oregon may become the first state in the union to create and implement a single-payer health insurance system, sometimes referred to as ‘Medicare For All.’

HCAO’s Hannah Bishop provided details of the campaign and how to get involved.

Hannah Bishop: My name is Hannah Bishop and I am with Health Care for All Oregon, Lane County chapter here. 

We’re really here today to tell you about our mission, which is to bring universal health care to the people of the state of Oregon, with really the eventual goal of making universal health care a reality in the United States.

Because we believe that health care is a human right, and it’s something that everyone should have access to by virtue of being a human being, and so that is our mission. And all the work we do is in service of that goal.

Oregon is a great place for this to happen. First, I think Oregon is the first state to have actually written into its constitution that health care is a human right? Yes. A couple years ago we passed Measure 111, which established the statement that health care is a human right in our state constitution. 

So along with that, the legislature several years ago created the Universal Health Plan Governance Board to actually design a plan, figuring out where would the money come from, what would it cover, all of those little details. They’ve actually been working on that and they’re going to be presenting that claim to the legislature this year.

I probably don’t need to convince anyone in this room that our current health care system is incredibly broken, pretty much every aspect of it. It’s like you look at the whole house of cards and it seems really precarious. It’s dysfunctional, it’s failing, and in many ways it’s cruel, it’s harming people, actively harming people, and we can do better than that.

We’ve got all these health insurance providers that provide coverage and every clinic and hospital has to interface with those providers. And it’s an incredible mess. And it makes things way more complicated than they need to be.

This is a profit-driven system, importantly, like this whole system, so many layers of the system are really about driving a bottom line of return. And these companies, big insurance companies, United Health, Aetna, all of these companies are operating in the capitalist system that we all operate in, and they ultimately have shareholders, and they are beholden to their shareholders.

The most important thing is shareholder value, period. Full stop. Everything else comes after that. So actually providing you care and providing you what the insurance is nominally supposed to do is secondary to their profit. Bottom line, that’s just the fact of the matter. 

And at Health Care for All Oregon, we believe that that is a fundamental conflict of interest, fundamental conflict of interest. These things should not mix. 

So yes, this means high premiums, high costs, and then less money for patient care because of that importance on the bottom line and the cost of health insurance keeps going up. You probably saw headlines last year that were explaining that the current average family health insurance premium costs more than a new Toyota Corolla. It’s like $27,000 a year for a family plan. That’s like average.

That’s wild. That’s completely wild. And so these costs just keep going up. They keep ballooning.

We are losing providers due to moral injury, meaning, providers are not only burnt out because again, when we’re talking about the importance of the bottom line, we’re going to cut corners wherever we can.

And that means maybe having fewer providers at the emergency room, right? It’s like, let’s not have as much support staff because we can’t afford that. We’ve got to think about this bottom line. We’ve got to think about how much money you’re spending.

And, this puts providers in a situation where they don’t only get burnt out because they don’t have the support that they need, but they actually feel morally compromised. 

You know, they’ve been trained to provide high-quality care, and they’re there because they want to provide high-quality care. That’s why they went into this line of work, and now they’ve been thrust into a position where now they’re having to make difficult decisions that are not in alignment with what is best for their patients. 

And no one wants that. And people will quit their jobs because of that. People will leave the force because of that right? So, we’re bleeding people. Basically we’re hemorrhaging support, we’re hemorrhaging these professionals.

And then all in this context, remember that health care CEO salaries just keep going up. There are still people in this context making a lot of money and they’re making more and more and more money every year.

I can’t describe or come up with a bigger injustice, like, that is so wrong. And that’s what we are here to fight. So, we as a nation spend more than any other country, any other wealthy nation in the world on health care per person. And, you could maybe think like, okay, well we’re spending more per person and maybe that means that we get more for our money.

Turns out we do not. The United States spends significantly more money and we do not get more for our money over and over again.

We score worse than these other nations that are spending at least like half as much as we are. So something is wrong here. This is the kind of thing that should spur all of us to action.

Now there’s also big changes that are coming down the pike that we’re already starting to feel. The ‘Big Beautiful Bill’ that was passed. There are going to be a lot of changes that affect people who are on Oregon Health Plan, are on Medicaid across the country.

So, it’s estimated that about 238,000 people could lose their Oregon Health Plan coverage due to the eligibility requirements that are being implemented.

Oregon hospitals are expected to receive 25% less in Medicaid revenue, so that’s about a $17 billion impact over the next 10 years. And this is going to mean something that I sometimes hear from people is, ‘I don’t want to pay for other people’s health insurance. I don’t want to pay for other people’s health care.’ 

And my response to that is, you already are, because there are laws in this country that require hospitals to provide care when someone arrives at the hospital with an acute need in an acute crisis.

They’re required by law to provide care even if that person can’t pay. And so that person, if they can’t pay, the hospital eats that cost, and they increase their prices on everyone else who can pay. Insurers know this. And so when the Big, Beautiful Bill was passed, insurers preemptively baked in some higher costs into their insurance premiums.

That’s part of the reason why insurance premiums spiked so much this year, is that they see that coming down the pike. Once these changes come into place, there’s going to be fewer people with coverage. They’re not going to see the doctor when they should, until things hit an acute crisis point.

And they end up at the hospital and they’re still going to get that care. They’re still going to get it, and they won’t be able to pay for it, and we will all be paying for it. So, this is affecting all of us, right? Even if you aren’t one of these people that are on Medicaid that might get dropped, this is still affecting you.

And then there are hospitals and specialty departments around the state that are closing: our specialty hospital in Portland; Ashland Community Hospital; the Bay Area Hospital; these are hospitals that a lot of their patients are on Medicaid.

So at Health Care for All Oregon, we believe that there is a better way, our vision for the best path forward is universal health care. Health care provided to everyone regardless of their employment status, right? Like right now we have the system where health care is tied to our employment.

For any of you who have experienced changing a job or suddenly losing your job when you didn’t expect to, and the stress that goes along with, ‘Oh, now I don’t have health care.’ It doesn’t need to be that way.

And importantly, it isn’t that way in other wealthy nations in the world, We’re the only country in the world that does it like this. Every one of ’em has some form of universal health care. We are the only country that doesn’t have it. We are behind the times and maybe we can catch up to everyone else.

So universal health care means it’s uncoupled from your employment. It means there’s no co-pays, deductibles, premiums, or out-of-pocket costs. You go to the doctor, you get the health care that you need. There’s no surprise bill in the mail later. Funds go into a public trust, excess funds returns to that trust.

This means that there’s a dramatic reduction in administrative costs. So, fun fact is that the United States spends roughly five times that of all the other wealthy nations in administrative costs in health care. So a lot of where our money is going is just getting pushed around between a lot of middlemen. It’s not actually going to providing health care.

So this is a dramatic reduction in administrative costs when you have one entity that is paying and in the way that it’s being designed here, it means that you can receive care from any provider in the state.

So no more like in-network, out-of-network. If this provider is a provider in the state of Oregon, you can see them. Single-payer is universal health care and, again, proven in other higher income nations, this is a public plan that covers everybody, cuts costs, boosts access, because it’s universal, right?

Those folks right now that aren’t going to the doctor until there’s an acute crisis, they’re going to be going to the doctor sooner and maybe they won’t get to that acute crisis.

So some background: In 2019, a Senate bill established a joint task force on universal health care. They did a 30,000-foot view, like feasibility study of, like, ‘Does this make sense for Oregon to even do this? To think about this?’ 

And the answer, their answer in the form of a 250-page document, which you can read, was, ‘Yes, this makes sense. We should try to pursue this.’

Right after that, the legislature formed the Universal Health Plan Governance Board, and they’re the folks that for the last almost three years, they’ve been actually designing a plan. And you’re going to hear from them today.

So they’re about to deliver their plan, what’s next? The three possible pathways after they present their plan to the legislature is either that the legislature could pass it or the legislature will refer it to voters. (At HCAO, we think that’s probably what is most likely to happen.) 

Or if they don’t take any action, we’re going to gather signatures to put it on the ballot. So most likely this will be on the ballot, probably 2028.

And so there are lots of ways that you can engage publicly such as these town halls like the one you’re at today. Thank you so much for coming and having your voice heard.

Nancy Forrest: Next up, two members of the Universal Health Plan Governance Board, Amy Fellows and Mary Lou Hennrich:

Amy Fellows: Our overarching principles for the Universal Health Plan Governance board: health equity, maximizing health, fair distribution of medical resources, minimizing financial hardship for individuals and families, and community sense of ownership. I think we all are here today ’cause we know why it matters. 

This is the part that’s most important. This is our preliminary recommendation.

So the key elements of our plan are eligibility, that all people who live in Oregon qualify for the plan; guaranteed coverage that health care coverage is no longer connected to employment; the plan benefits will be based on the kind of level of benefit that state employees get. Not necessarily their plan, but that kind of level of benefit; and choice of provider. Individuals covered by the plan will be able to will see any authorized provider.

More key elements. Affordability. So minimal or zero cost sharing will be required. Behavioral health—making sure there’s additional funding that will be provided for behavioral health services.

The structure will be a Oregon public nonprofit corporation that will administer the plan, maintaining public accountability with operating flexibility. And the governance will be a board of directors appointed by the governor and confirmed by the Senate, which will govern the public corporation.

What would be covered? Physical and behavioral health. Prescription drugs with a formulary, dental and vision. We still are in conversation. And people on Medicaid would receive the same benefits at the same cost, which is nothing to them today, including long-term services and supports.

And I think that’s another area that we are still sorting out, ’cause when we get into that area, it brings expenses to a whole ‘nother level. So we’re still sorting through that, but want your feedback. 

So the preliminary recommendations, so the funding objectives, the financial pieces are to preserve federal Medicaid and Medicare funding streams; to maintain existing Oregon corporate income tax deductibility benefits where applicable; and to ensure revenue adequacy, financial sustainability, and administrative feasibility. 

So the three-legged stool for funding: This thing includes federal funding, business contributions, and household contributions. So the federal funding is going to be through what we receive through Medicaid, Medicare, and other sources.

We have business contributions, so instead of employers paying premiums and all of that, the way that they do now, will be funneled to helping support and pay for a universal health plan. And households, instead of premiums, deductibles and co-pays, will have a health care personal income contribution.

And one of the decisions that the board did make was that this will only impact people above 2200% federal poverty level in terms of having a contribution.

So where we are now in 2026, our main focus is getting through as many of these decisions as we can. So that we have the elements of a plan to give to the legislature on Sept. 15, 2026.

It’ll be really important for having our advocate friends, like all of you in Health Care for All Oregon working and advocating to the legislature to put something into legislation for this long session, 2027. There’s also a possibility that it could go out for a vote in 2028.

Nancy Forrest: HCAO’s Hannah Bishop:

Hannah Bishop: We do want your help. This is a monumental task as you can imagine. The folks that are on this governance board have spent three years designing this, and there was three years before that of the task force doing feasibility.

And folks in HCAO, many of whom are health care providers and practitioners themselves, have been working on this for 25 years. There are people that have been in this movement for the long haul. And, you know, this is hard. This is going to be hard, and it’s especially going to be hard once this plan is presented.

All of the money that the powers-that-be have, that don’t want this to happen, is going to come out of the woodwork in force. And they’re going to do everything they can to make everyone think that this is a bad idea, because they’re going to lose a lot of money.

So, we need your help. And the way that you can help is, first of all, sharing your public comments with the governance board so that we can make the best possible plan that we can. They want to make a plan that everyone wants to choose, right? They want to make a plan that you want so that you will vote for it.

And so they need your input in order to do that. And then also just signing a statement of support. HCAO has statements of support that you can sign, stating that you are behind this movement. 

Join your local chapter. As Jensina (Hawkins) was saying, we have meetings the first Tuesday of every month, 7 p.m. at the first United Methodist Church. We would love to have you join. 

We have interesting speakers. A lot of times last month we actually had somebody from Eugene Emergency Physicians speak, so we get to hear about things going on in the community and other work that’s getting done. So we’d love to have you, and then support through donations as well.

We are an entirely volunteer-run organization, and so all of your donations make a difference and allow us to do things like putting on this town hall and just printing up the posters and your programs today. And all that costs money. So your donation matters. 

This is a 501(c)(3), so these are tax-deductible contributions. And we are up against—this is a serious David and Goliath moment, right—the billions and billions that these corporations have. Like I said, it’s going to come out of the woodwork. And they are going to do everything they can with that money to fight. So anything you can give would make such a huge difference for us.

Nancy Forrest: HCAO Lane County Chapter meets on the first Tuesday of every month at 7 p.m. at the First Methodist Church in Eugene. And of course, go to their website for additional information and to keep track of this campaign. And that would be HCAO.org. This story has been produced by Nancy Forrest for KEPW 97.3 FM.