Stories from a Health Care Organizer

Oregon has made important strides over the past decade in increasing the amount of people with some form of health coverage. Unfortunately, health insurance is still unaffordable for too many and often doesn’t provide the quality of care Oregonians deserve. For example, since 2014, premiums on Oregon’s Health Insurance Marketplace have risen an average of 71 percent statewide, making it harder for both individuals and businesses to afford coverage. Over the last few weeks, I have been reaching out to Oregon residents and business owners to find out how this has affected them. Here are a couple of their stories.

Nearly 50 percent of Oregonians get health care through their employer, so what happens when their employer can’t afford to provide it?

Until a few weeks ago, Diamond in the Rough Auto Detailing in Redmond offered health insurance to all its employees. But paying half the premium for seven employees (owners included) per month adds up. Given that many small businesses have had to close their doors permanently over the eight months of the COVID-19 pandemic, Diamond in the Rough recently changed its benefits plan. The auto body shop has grandfathered in current employees, but co-owner Kristina Edwards says she and the other owner made the tough decision not to extend insurance benefits to new hires.

“When your health care is more than your lease or anything else, it’s pretty expensive,” she said. “If we could get the price down, that’s something I’d love to be able to offer again.”

Even though 94 percent of Oregonians had health insurance prior to the pandemic, that doesn’t mean they can afford to use it.

Dr. Sharon Smith has seen this firsthand in her practice. One of her patients was losing her vision, but put off cataract surgery for years because she couldn’t afford the deductible. Instead, she waited until she qualified for Medicare, which would cover the procedure. Dr. Smith said when patients — especially those who are self-employed — have to pay high deductibles before they get anything out of their insurance, they sometimes need to make tough choices about what to spend that money on. 

“[Insurance] works if you’re dealing with the occasional flu vaccine, but if you really needed to be in a hospital, it doesn’t work,” she observed.

Dr. Smith accepts the Oregon Health Plan (OHP), Oregon’s Medicaid program, which provides coverage for low-income Oregonians. She sees a need for more options for people who don’t qualify for either OHP or subsidies. For some patients who earn more than the income threshold for those programs, the increased cost of insurance is a net negative. That has ripple effects on their lives. Can they expand their business? Can they take a dream job?

Dr. Smith told me that for many of her patients, the priority is instead “to make sure they stay qualified [for OHP].” 

Oregonians need better and more affordable options when it comes to health insurance.

Just because Oregon has a high rate of insured residents doesn’t mean that we can be complacent with the quality of our health care system. To ensure the health and wellbeing of ourselves and our families, Oregonians need affordable health insurance plans to choose from. That is why OSPIRG is working to create a public option health plan in Oregon. If there were more plans offered on the marketplace at a lower cost, the increased competition would help lower prices for everyone. Small businesses would be more able to afford their employee benefits. Individuals would be able to use their insurance when getting medical treatment. That is what we are striving toward when we support a public option.

These are two stories out of hundreds experienced every day in Oregon. You can help us pass a public option and change the outcome for businesses like Diamond in the Rough and patients like the ones Dr. Smith described. Signing this petition in support is a great first step. Together, we can improve the quality of health care in Oregon by providing more insurance options that don’t break the bank.