In February of 2018, an attempt to add an amendment to the Oregon Constitution to declare health care as a basic human right, came to an abrupt halt. Although the state’s House had already voted 35 to 35 in support of the amendment, the Senate Health Care Committee never even brought it up for a vote because they believed it wouldn’t pass in the Senate. The amendment would have ensured that every resident had access to cost-effective, medically appropriate care.
Despite Democratic control of both state legislatures, there were serious concerns that the state could not guarantee universal access to health care and this would leave the state vulnerable to litigation. Lawmakers said that there wasn’t enough time to secure the necessary number of votes during the five-week legislative session. It is likely that the proposal would have required extensive retooling to obtain majority support.
In many ways, this initiative to guarantee health care as a right was a response to President Donald Trump’s efforts to dismantle the Affordable Care Act. Since its passage in 2010, almost 20 million Americans have gained coverage through the sponsored health insurance marketplaces or through the Medicaid expansions.
Last year, President Trump helped push through a repeal of the individual mandate, a critical component of the Affordable Care Act, and halted payment of cost-sharing subsidies. Both of these efforts are likely to raise premiums on many health plans sponsored by the ACA, pushing people off coverage.
These are merely the latest salvos in an argument that has been raging for some time. The United States is the only major developed nation that does not guarantee access to health care for all of its citizens. This has not only presented challenges to maintaining the health of the U.S. population, but has hampered economic growth as American companies have struggled to compete while burdened with the costs of covering employees.
Still, this debate has less relevance than it once did. In 2016, almost 92 percent of Americans had some type of health insurance. Almost half of the U.S. population has coverage through an employer, with 19 percent insured through Medicaid and 14 percent insured through Medicare. With less than 9 percent of all Americans uninsured, this may be a marginal issue.
There is mounting concern, however, that these numbers could shift dramatically in the future. From 2005 to 2015, 94 percent of job growth involved freelancing, independent contracting or temping. Most of these employment methods did not provide health coverage, leaving many partially employed wholly responsible for their health insurance.
Even for many fully employed workers with traditional health plan arrangements are concerned that their coverage is in name only. More employers are shifting much of the financial burden of deductibles onto their workers. In 2016, almost 30 percent of employer plans had a high deductible compared to only 20 percent just two years earlier. As workers shoulder more of these coverage costs, fewer are able to enjoy the benefits of health insurance that they once did.
Dr. Robert Moghim, CEO Moghim Medical Consulting Inc.