Medical Matters from the Lane County Medical Society
Oregon’s Path to Universal Health Care: The Work of the Universal Health Plan Governance Board (UHPGB)
By Dr. Nicholas Jones, MD, Family Medicine Clear Health DPC, Lou Sinniger, Lane County Chapter Chair for Health Care for All Oregon (HCAO), and Dr. Antonio German, MD, MPH, Vice President of HCAO and practicing physician in Woodburn, OR
We all know the feeling: healthcare costs keep rising, administrative tasks multiply making it difficult to run a practice, and insurance complexity grows year after year. Physicians are spending more time navigating prior authorizations, quality metrics, and payer rules than caring for patients. Meanwhile, insurance companies continue to consolidate, Medicare and Medicaid cuts hit community-based practices hardest, and value-based programs often mean more reporting with little impact on outcomes. Patients are confused, staff are burning out, and many practices are struggling to stay independent.
It’s becoming increasingly evident that our system needs reform. Across Oregon, discussions are underway to explore what a universal, publicly financed healthcare plan could look like one that ensures equitable access to care while supporting fair payment for the people who deliver it.
Oregon Takes a Step Forward
In 2023, the Oregon Legislature passed Senate Bill 1089, establishing the Universal Health Plan Governance Board (UHPGB). This nine-member board, each serving a four-year term, who are appointed by the Governor and confirmed by the Senate, is tasked with developing a comprehensive plan to finance and administer a universal health plan covering all Oregon residents, regardless of income, employment, or immigration status.
Under ORS Chapter 751, the board must deliver its proposal to the Legislature by September 2026. The UHPGB brings together experts in health care delivery, finance, and public administration, along with community engagement specialists to ensure the plan reflects the needs and realities of both providers and patients.
The Subcommittees Doing the Work:
The UHPGB’s work is divided among four subcommittees, each meeting at least monthly:
● Community Engagement and Communications
● Finance and Revenue
● Operations
● Plan Design and Expenditures
UHPGB members must:
● Support the development of a comprehensive plan to finance and administer a
universal health plan that is responsive to the needs of the state and
expectations of the residents of this state as outlined in SB 1089.
● Support the values and principles expressed in SB 1089.
● Represent a variety of health care professionals and community perspectives,
including individuals with experience as enrollees in Medicare and Medicaid, as
well as those living without health insurance.
These groups are exploring everything from how a universal plan would be funded, to how providers would be reimbursed, to how operations could be simplified. Importantly, they are seeking more physician participation — especially from those actively delivering care in outpatient, hospital, and rural settings. Without our insights, legislators and the public cannot make an informed decision at a time when we all feel the need to do something about it.
Why This Matters for Physicians
If implemented, a universal, publicly financed system would represent a major shift in how Oregon healthcare is funded. For physicians, the implications could be significant — potentially improving equity and efficiency across the system:
● Equitable reimbursement: Payment would not depend on a patient’s insurance status, plan tier, or ability to pay.
● Reduced administrative burden: A unified payment system could streamline billing, reduce preauthorization hassles, and simplify reporting.
● Improved access: With cost barriers removed, patients could seek preventive and primary care earlier, reducing avoidable complications and improving outcomes.
Physicians’ input is essential to ensure the plan is practical, evidence-based, and sustainable. The legislation specifically requires that the UHPGB engage with healthcare providers before submitting its proposal. Without clinician involvement, decisions about payment models, access standards, and practice structures may be made without the voices of those who understand patient care best.
The Role of Health Care for All Oregon (HCAO)
Health Care for All Oregon (HCAO) is a statewide nonprofit supporting this transition. HCAO advocates for a universal, publicly financed health system and emphasizes that healthcare workers, patients, and communities must all have a seat at the table. The Lane County Chapter of HCAO is particularly focused on connecting local clinicians with state-level discussions and ensuring that proposed solutions reflect on-the-ground realities.
Whether you’re skeptical or supportive of universal coverage, this is the moment to get involved. The way Oregon finances and organizes healthcare is poised for significant change. As Physicians, we have a unique opportunity, and responsibility, to help design a system that both protects patient access and sustains high-quality medical practice.
Supporting this work isn’t about endorsing a specific political vision; it’s about ensuring that any reform is informed by medical expertise and grounded in the realities of caring for patients.
Learn More and Get Involved
The UHPGB’s meeting calendar, minutes, and recorded sessions are publicly available online www.oregon.gov/uhpgb. Subcommittee meetings are open to the public, and opportunities for provider testimony and written feedback are ongoing.
To stay informed or to participate locally, visit www.hcao.org. The Lane County Chapter welcomes physicians and healthcare professionals interested in contributing ideas or learning more about the process.
The Universal Health Plan Governance Board was established by Oregon Senate Bill 1089 (2023) and codified in ORS Chapter 751. The board is responsible for developing a comprehensive plan to finance and administer a universal health plan for Oregon. Meeting schedules, minutes, and materials are available on the board’s official website. For questions or to get involved locally, contact Lou Sinniger at sinniger@efn.org.
Nicholas Jones, MD
Physician and Founder of Clear Health Direct Primary Care
Finding a Clear path to your best Health.
Find out more at ClearHealthDPC.com
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