Oregon Has Options to Move Toward Universal Health Coverage; Repeal of the Affordable Care Act Would Make All Options More Difficult
Jan 19, 2017
This report compares the projected impacts and feasibility of four options for financing health care for Oregon residents. The Single Payer option and the Health Care Ingenuity Plan would achieve universal coverage, while the Public Option would add a state-sponsored plan to the Affordable Care Act Marketplace. Under the Status Quo option, Oregon would maintain its expansion of Medicaid and subsidies for nongroup coverage through the Marketplace.
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This report describes four options for financing health care for residents of the state of Oregon and compares the projected impacts and feasibility of each option. The Single Payer option and the Health Care Ingenuity Plan would achieve universal coverage, while the Public Option would add a state-sponsored plan to the Affordable Care Act (ACA) Marketplace. Under the Status Quo option, Oregon would maintain its expansion of Medicaid and subsidies for nongroup coverage through the ACA Marketplace.
The state could cover all residents under the Single Payer option with little change in overall health care costs, but doing so would require cuts to provider payment rates that could worsen access to care, and implementation hurdles may be insurmountable. The Health Care Ingenuity Plan, a state-managed plan featuring competition among private plans, would also achieve universal coverage and would sever the employer–health insurance link, but the provider payment rates would likely be set too high, so health care costs would increase. The Public Option would be the easiest of the three options to implement, but because it would not affect many people, it would be an incremental improvement to the Status Quo. Policymakers will need to weigh these options against their desire for change to balance the benefits with the trade-offs.
Background and Context
The Four Options
Overview of Methods and Assumptions
Comparisons of the Options
Implementation and Administrative Considerations
Alternative Specifications for the Options and Other Considerations
Assessment of the Options
Recommended Next Steps
Methods, Data Sources, and Detailed Results
The work was sponsored by the Oregon Health Authority and conducted by researchers from RAND Health and Health Management Associates.
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