The first debate over the Jan. 23 health care referendum on the Oregon ballot focused on how it would affect the state's Medicaid recipients.
Supporters of Measure 101 argued that rejecting the proposed taxes on health care providers and insurers could blow a huge hole in the program covering low-income Oregonians.
Measure 101 asks voters to pass judgment on as much as $320 million in taxes levied on hospitals, insurers and some other health care entities.
Opponents are "putting 350,000 people's health care in danger," said Felisa Hagins, political director for Service Employees International Union Local 49 at a Portland debate sponsored by the Oregon Health Forum.
Related: Oregon Voters Will Decide The Provider Tax, But What Is That?
"Nobody loses their health care on Jan. 24 and we're committed to that," countered Rep. Julie Parrish, R-West Linn. She is one of the three GOP lawmakers who sponsored the successful petition drive to refer to voters the health care taxes approved by the Legislature.
The taxes covered by Measure 101 were part of a larger package of levies aimed at raising money for the state share of Medicaid, which is mostly paid for by the federal government. About a quarter of the state's population — more than a million people — now get coverage through the program.
Using the Affordable Care Act signed during the Obama administration, Oregon aggressively expanded its Medicaid population to the point that about 95 percent of the state now has coverage.
Parrish and Rep. Cedric Hayden, R-Fall Creek, said during the debate that they pursued their referendum because they thought the taxes could have been structured differently to avoid hurting some consumers.
"This is a tax on people who don't have a lobbyist," said Parrish, complaining that some individuals and smaller businesses could end up paying through passed along costs. She also said it could raise school district costs and affect some college students.
Measure 101 supporters accused the Republican lawmakers of using inaccurate numbers and exaggerating the impact of the taxes.
"When your colleagues on the budget committee heard these kinds of proposals that just didn't add up, they rejected them," said Jessica Adamson, director of government affairs at Providence Health and Services. "So why should the voters listen to you?"
Adamson said a wide variety of health care groups made a series of tough compromises to raise enough money to keep Oregon's Medicaid program impact. The Legislature would be hard-pressed to keep Medicaid whole if the tax measures are defeated, she said.
Hagins added that insurance rates are already set for 2018 and won't change regardless of what happens with Measure 101.
Related: Oregon Health Authority Misspent Millions, State Audit Finds
The debate frequently veered off into broader health care politics. Parrish repeatedly criticized the Oregon Health Authority as being inefficient and said the state has failed to reduce public employee health care costs that are too high.
"Ultimately it needs fixing," she said of the Medicaid program. “You know, sometimes the way to heal that broken bone that didn’t heal right is to break it and reset it, and that’s kind of what Measure 101 is about.”
Hagins, the service employees official, agreed that the Oregon Health Authority has its problems. But she said Oregon is making progress in holding down the rise in health care costs.
"That change has been slow because it takes a while to change a giant ship," said Hagins, "but it's also been incredibly successful."
She added that she does agree with President Donald Trump on one thing: "Health care is complicated."