Oregon's plan to overhaul how residents pay for health care hit a wall Thursday when the state board charged with designing a single-payer system voted unanimously to delay its final report by nearly three months, unable to answer the most basic question: how to pay for it.

The Universal Health Plan Governance Board pushed its deadline from Sept. 15 to Dec. 1, the Oregon Capital Chronicle reported. None of the board's nine members expressed confidence the extra time would be enough to resolve a funding gap estimated at $30 billion to $35.5 billion.

The delay matters locally because Salem's own state senator chairs the committee that will decide what happens next. Sen. Deb Patterson, a Salem Democrat who leads the Senate Health Care Committee, said at the Aug. 6 meeting that lawmakers cannot move forward without a financial plan.

"At the end of the day, I think the Legislature is going to have to get down to the final details," Patterson said. "But they need to have a framework that does include some type of financial plan."

The numbers behind the stall

The proposed system would spend roughly $75.2 billion annually starting in 2032, according to estimates presented to the board. That dwarfs Oregon's roughly $19 billion General Fund budget, board finance committee member Jeff Gudman noted.

Gudman, an investor and former candidate for state treasurer, signed a minority report saying the model overstated revenues while underestimating expenses.

To close the funding gap, the model relies on a new employer payroll tax covering slightly more than half the shortfall, plus a progressive personal income tax capped at about 14% for the wealthiest households. Board chair Dr. Helen Bellanca acknowledged the proposed tax structure runs counter to recommendations from Gov. Tina Kotek's business advisory group, which called for lowering taxes.

The plan would offer dental, vision and fertility coverage with little or no cost-sharing, Bellanca said. But board member Dr. Bruce Goldberg, a former state health official, said what the board has produced so far amounts to an interim report, not a comprehensive plan. He recommended the board leave a revenue strategy out of its report to lawmakers entirely.

What comes next

The board was created in 2023 by Senate Bill 1089 after Oregon voters enshrined access to health care as a constitutional right through Ballot Measure 111 in 2022. The timeline envisions a possible 2028 voter referendum on single-payer, with full implementation by 2032.

State Rep. Travis Nelson, a Portland Democrat and chief co-sponsor of SB 1089, said lawmakers will try to advance single-payer legislation during the 2027 session but acknowledged much depends on the board's final product.

Bellanca said the board is proposing legislation to secure additional funding for public engagement and a more detailed economic analysis.

Patterson said she wasn't sure that was possible given federal funding cuts but said she would try if "that truly is what is needed."

The delay arrives as residents across Oregon face rising costs on the current system. The state's Division of Financial Regulation approved an average 16% increase in health insurance premiums for individual marketplace plans in 2027, with small business plans rising 15.5%.

The board's revised report is due Dec. 1. No hearing date has been set for the Senate Health Care Committee to take up single-payer legislation.