Number of uninsured grows in Oregon, U.S.

Labor leaders and representatives of Portland-area business came together March 14 to discuss the rising number of Oregonians without health insurance and the impact it's having on society.

The Portland City Club hosted the forum as part of a national "Cover the Uninsured Week," a grass-roots initiative comprised of business, labor and the health care industry to raise awareness and find solutions for spiraling health care costs.

A new study released at the Portland forum shows that more Oregonians than ever are not covered by health insurance. The Robert Wood Johnson Foundation reported that 890,000 Oregon residents under 65 (almost 1 out of 3) were uninsured at some time in 2001-02. Some 678,000 of those (78.2 percent) were uninsured for at least six months.

According to U.S. Census figures released in 2002, 41.2 million people were uninsured for all of 2001, an increase of 1.4 million from the previous year - the largest single-year increase in nearly a decade.

"Two-thirds of uninsured people in the U.S. are in working families, but are either not offered health insurance through their employer or cannot afford it when it is offered," said Alice Dale, president of Service Employees Local 49, who spoke at the Portland forum representing labor. "We know that without increased attention to this issue, millions more American workers could lose their health insurance."

The Johnson study also showed that companies of all sizes expect a 17 percent average increase per year in their health care insurance costs for the next five years. This comes on the heels of an increase of approximately 14 percent in 2002.

"Most businesses can't absorb these increases," said Barney Speight, director of public policy and government for Kaiser Permanente, who spoke at the City Club forum. "These are very worrisome times for people" who don't have insurance, and the rise in uninsureds is spilling over to those who have insurance.

In other words, Speight said, "the insureds are picking up the cost" in the form of higher premiums, higher deductibles and higher co-payments for prescription drugs.

Because of the higher co-pays, many lower-wage workers are unable to come up with the funds to keep their health insurance. The result is more working families "live sicker and they die earlier," Dale said. According to the national AFL-CIO, health care has become "the number one issue in bargaining, in strikes and has been the number one issue for workers trying to form a union."

And while forums like the City Club event dramatized the plight of Americans without health insurance, two bills were filed in the Oregon Legislature last week that would expand employer support and leverage more federal dollars to solve the problem at the state level.

House Bill 3285 would guarantee health care coverage to all Oregon children through a combination of private health care plans and an expansion of the Oregon Health Plan.

Coverage for Oregon's 900,000 children would be funded with a 2 percent payroll tax, payable by employers, and by federal matching funds that are available for children in families earning up to 300 percent of the federal poverty line.

"Since the federal match would be available for two-thirds of Oregon children, the program would be very cost-effective. (For a family of four, for example, the federal match would be available for children in families with incomes up to $55,200 per year)," the Oregon AFL-CIO said.

Parents would have the option of enrolling or continuing their children in employment-based private health care coverage if it is available; if not, the new program for children under 19 years of age would provide health benefits identical to those now available to children in the Oregon Health Plan. Employers that choose to provide coverage for the children of their employees would receive a tax credit for the cost of doing so.

Currently, most employers provide health care benefits for their employees and their families. Others, like Wal-Mart, cover very few of their workers and leave out their families entirely. That means that some employers are not paying their fair share, and responsible employers suffer unfair competition from their irresponsible counterparts, the AFL-CIO said.

Also, in many cases, taxpayers subsidize the Wal-Marts of the world by providing coverage for their employees and their families under the Oregon Health Plan. This bill levels the playing field for employers and taxpayers alike.

The payroll tax would replace all existing tax dollars paid by Oregonians to cover children in the Oregon Health Plan. The general fund savings would amount to approximately $180 million per biennium - savings that could be used to protect health benefits for adults now threatened in the current budget crisis, the AFL-CIO said.

HB 3286 is a more comprehensive version of HB 3285. It would use federal matching funds to supplement a larger payroll tax to provide coverage for all working people and their families, including children.

Like HB 3285, the bill would cover Oregonians either through employment-based insurance or through an expanded Oregon Health Plan, funded by an employer payroll tax. Employers who already provide benefits would receive tax credits that would significantly reduce or eliminate any increase tax liability.

[The bill proposes a 2 percent payroll tax, but the AFL-CIO estimates it would require a tax of approximately 12-15 percent, which would amount to much less than many employers now spend for family health care benefits for their workers.]

Workers and their families would also be eligible for health care benefits under this program for a period of time after they lose a job, so that families wouldn't lose their insurance at this critical time.

These bills would also reduce or eliminate the cost-shifting that now occurs from the uninsured to the insured, the AFL-CIO said.

"Covering the uninsured is an important goal in itself," said Oregon AFL-CIO Research Director Lynn-Marie Crider, "but it's also important because it will force more employers to provide coverage for their workers, help lower the cost of health insurance for employers and working families who are struggling to keep their health insurance and free up badly-needed funds at the state level. These are win-win-win proposals for employers, workers and government."

The bills' sponsors are Representatives Alan Bates of Ashland, Mitch Greenlick and Diane Rosenbaum of Portland, Laurie Monnes-Anderson of Gresham and Carolyn Tomei of Milwaukie.