Oregon Voters May Take Up Student Policies

Published August 1, 2008

Voters in Portland, Oregon may be asked to decide whether they and their fellow taxpayers will begin shouldering the financial burden for providing health insurance to the city’s elementary and high school students.

Gathering Signatures

According to the Virginia-based American Medical Student Association (AMSA), nearly 10 million Americans age 18 and under lack health insurance, and more than 9,000 uninsured students attend Portland public schools.

Dr. Gregg Coodley, a Portland internist, initiated a signature campaign late last year aimed at prompting the Portland City Council to appropriate $3 million to $4 million in taxpayer funds each of the next two years to finance a health insurance program for all Portland students. After two years of City Council funding, the responsibility for insuring students would be shouldered by the Portland School District.

If the City Council finds the 38,500 signatures gathered are legitimate, the measure will be placed on the city’s ballot in November as a referendum item.

Taking a Political Stance

“One of the objectives was to try to give some basic health insurance to all students in our schools,” said Coodley, “and try to figure out how they are tracked in their health care, and also to attract more families to the city and keep our kids in public schools.

“We are losing kids to the suburbs because the core of the city is a very expensive place to live,” Coodley added.

“At the height of our enrollment in Portland Public Schools in the early ’70s we were at about 85,000 students,” noted Matt Shelby, Portland Public Schools’ information officer. “Now we are holding steady at 46,000 students.

“Dr. Coodley is trying to address two issues,” Shelby said, “obtaining health care coverage for uninsured students, and attracting families back into the city by offering taxpayer-funded health coverage to Portland residents.”

Crowding Out Private Coverage

Devon Herrick, Ph.D., a senior fellow with the National Center for Policy Analysis, says such a program can drive up health insurance costs as parents who have already been providing health insurance for their children opt out for the free plan.

“Proponents often tout these types of programs as a low-cost way to cover students, who are generally healthy with few medical needs,” said Herrick. “But if students have access to free care, many parents will drop their private family coverage. Over time this crowding out by public insurance will drive the costs well above early estimates.”

Mary Katherine Stout, director of the Center for Health Care Policy at the Texas Public Policy Foundation, called the Oregon initiative another “bad idea by well-intentioned people.”

“This is outside the scope of public education,” said Stout.

Contemplating Options

“We are not quite sure yet how we feel about it,” said Shelby, citing the long-term effect the measure will have on the district’s budget. “We believe healthy kids are good for the schools and the community, but how we provide that is still up for discussion.

“After two years it becomes the school district’s liability. Coodley’s logic is that more students will come to the district, which in turn will bring more revenue and money to the district,” Shelby said.

“The majority of our funding comes from the State of Oregon, and his thinking is the more students, the more money,” Shelby continued. “That’s true, but what isn’t being talked about in this campaign is all of those new students will need to be educated–which means more teachers, books, etc. So it is going to increase our costs for new kids coming in.

“In addition, there are a lot of questions, including what will the proposed health insurance plan look like? What happens when parents take the free coverage as opposed to covering their child under their own insurance plan? How does that work? There is just a lot of analysis that needs to happen on our end,” Shelby added.

Coodley said the City of Portland currently has a $38 million surplus, and “They should be able to put $3 to $4 million aside to pay for health insurance for all the kids.”

Affordable Coverage Available

“I don’t think this is the greatest thing since sliced bread,” said Coodley, “but it is more than nothing.”

Policy experts disagreed.

“‘Do it for the children’ is a powerful campaign,” said Stout. “But there is a mistaken belief that health insurance is unaffordable for children.”

John R. Graham, director of health care studies at the Pacific Research Institute, concurred, pointing out children’s health insurance plans are available in Oregon beginning at $88 per month–an affordable plan, he said, for almost any budget.

A state’s top objective should be “removing barriers for its citizens to purchase insurance in a competitive health care marketplace,” Stout concluded. “When insurance plans are competitive and companies are delivering a product of value, consumers will have more choice when it comes to health insurance.”

J.E. Loomis ([email protected]) writes from Indiana. Ingrid Jacques ([email protected]) writes from Michigan.

For more information …

“Facts on Uninsured Children,” American Medical Student Association: http://www.amsa.org/cph/CHIPfact.cfm