January 26, 2022

In This Issue
Welcome to NAHU's State Update!
States Consider Universal Healthcare Ballot Initiatives
Connecticut Announces New Broker-Training Program
California Single-Payer Advocates Attempt to Pass Bill Ahead of Deadline
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States Consider Universal Healthcare Ballot Initiatives

Earlier this month, the South Dakota secretary of state’s office announced that a constitutional amendment to expand Medicaid would be on the 2022 ballot for residents to vote for or against. This week, we’re looking at a few other states that may have healthcare ballot initiatives this coming November.

In Oregon, voters will see a “right to healthcare” amendment on the ballot in November. This is the ninth time in the last 16 years that the amendment, nicknamed the “Hope Amendment,” has been proposed; this is the first time that it has successfully made its way to the ballot box. The amendment would alter the Oregon Constitution, establishing a right to "cost-effective, clinically appropriate and affordable healthcare" for every Oregon resident.

The amendment would require the state to balance the obligation of ensuring a right to healthcare against funding public schools and other essential public services. The amendment also states that legal remedies for lawsuits brought against the proposed section may not interfere with the balance between a right to healthcare and funding other essential public services. The actual text of the amendment does not explicitly direct the state to implement a public option or single-payer system, but rather to ensure that, whatever the current policies, residents have access to affordable healthcare services.

The Hope Amendment was approved by the Beaver State legislature on a partisan basis, passing the Oregon House of Representatives by a vote of 36-21 with three excused. One Democrat joined the Republican minority in voting against the amendment’s inclusion in November’s ballot.

Moving north to Washington State, single-payer advocates tried and failed to include a universal healthcare coverage initiative on their ballot in November. The Washington Universal Healthcare Coverage Initiative, submitted by universal healthcare advocacy group Whole Washington, would have created the Washington Health Trust to “ensure all Washington residents can enroll in nonprofit health insurance coverage providing an essential set of health benefits including medical, prescription, dental and vision benefits.”

The Washington Health Trust would have established a state healthcare program for all residents by November 2023. The initiative’s language was modeled after SB 5204, a single-payer bill introduced at the beginning of 2021 that failed to make it out of committee. Supporters of the initiative needed to obtain at least 324,516 valid signatures by December 31, 2021, in order to get the initiative on the ballot this year but were unable to do so.

Over in Maine, it is still up in the air whether voters will be seeing a ballot initiative that would direct the legislature to create a comprehensive, publicly funded healthcare system for all residents. Maine’s initiative is closest to a public option of all three initiatives reviewed here, with the state creating its own coverage in addition to private coverage. More specifically, the Maine Publicly Funded Health Coverage Legislation Initiative would charge a legislative joint standing committee to develop legislation that “provides to every resident of the state all services determined to be medically necessary, continues the existing practice of providing healthcare services through public and private providers of those services, provides residents of the state the freedom to choose their provider, and provides prompt payments to healthcare providers at prevailing rates.”

Proponents of the initiative must obtain at least 63,067 signatures by January 30 for the initiative to appear on the ballot in November. In the Pine Tree State, the number of signatures required to qualify an indirect initiated state statute for the ballot is equal to 10 percent of the total votes cast for governor in the most recent gubernatorial election. Petitions can be circulated for up to 18 months, but signatures must be no more than one year old to be valid.

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