Universal Health Plan Governance Board reports progress, says revenue work and waivers remain central hurdles
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Summary
The Universal Health Plan Governance Board told a Senate committee it has developed core plan principles (universal eligibility, common benefit, regional administration), a proposed 15% primary‑care investment carve‑out, and a tentative timeline to deliver a final plan by September 2026, while noting significant financing, federal‑waiver and ERISA challenges remain.
Members of the Universal Health Plan Governance Board presented a progress report to the Senate committee and described core design ideas, implementation challenges and a multi‑stage timeline for finishing a final plan.
"We are creating a strong, workable plan so everyone in Oregon can get the high quality, equitable care they deserve," said board members, who described a plan that would decouple health insurance coverage from employment, offer a single basic benefit level with supplemental options, eliminate network restrictions for authorized providers, and build on Oregon’s patient‑centered primary care models.
The board said it plans to adopt a progressive revenue strategy but has not finalized tax structures. Members described a proposed 15% carve‑out of total plan spending to bolster primary‑care payment and transition to value‑based primary care models: "We've decided to recommend a 15% carve out, in the universal health plan for primary care," the board said, and said a single‑payer‑style system would make value‑based primary care payments more feasible across the state.
Board members identified major hurdles: securing federal Medicaid and Medicare waivers, potential ERISA legal challenges from employer plans, workforce shortages in primary and behavioral health services, and the consequences of a likely increase in uninsured residents if federal subsidies or eligibility change. On ERISA, the board described an approach that would rely on state tax authority and optional employer behavior to reduce the risk of a preemption challenge while acknowledging legal uncertainty.
The board has convened more than 40 public committee members across operations, finance, plan design and communications, hired consultants and prioritized areas such as hospital global budgets, uniform rate schedules and prescription drug purchasing alignment. Board members said they will submit an annual report to the legislature on Dec. 1 and intend to deliver a final plan in September 2026.
Committee members pressed for more concrete tax and financing details; board staff said those are being developed and will be reconciled with plan design and the finance committee’s proposals. No formal action or votes were taken during the hearing.