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Oregon Voters Deliver Big Wins for Kids on Medicaid Expansion and Universal Preschool

Oregon voters delivered big wins for children on ballot measures in November. Statewide, voters passed a tax increase on cigarettes and tobacco vaping products that will provide the last piece in the puzzle in fully funding the expansion of Medicaid eligibility. And in Multnomah County, where Portland is located, voters supported a tax increase on high income earners that will fund a county-wide universal preschool program. Both of these victories highlight the power of creating a broad coalition for developing and campaigning for policies that benefit children.

Full Funding for Medicaid Expansion with New Revenue Stream

Oregon voters overwhelmingly supported Measure 108 which will provide the revenue needed to sustainably fund Medicaid in the state, covering everyone earning up to 133 percent of the Federal Poverty Level. The measure raises revenue by increasing existing taxes on cigarettes and adding a new tax on tobacco vaping products. Together, these taxes will raise an estimated $160 million of additional revenue for the state each year.

The revenue will go toward a variety of health care programs including the state’s Medicaid program. Over 135,000 children between the ages of 0-5 are on Medicaid in Oregon (about 40% of Oregon’s children). Without this measure, Oregon would have faced a Medicaid funding shortfall which could leave 400,000 Oregonians on Medicaid uninsured within the next two years, which would have severely cut the number of children with access to health insurance. 

Similar to the preschool measure, the tax increase was supported by a broad coalition including the healthcare industry, doctors and nurses, and policy organizations, including our allies at Children’s Institute.

Prior to the increase, Oregon had a relatively low tobacco tax rate and had not passed an increase in over 20 years. In 2007, a similar measure overwhelmingly failed, making this year’s victory even more impressive. Supporters credit the victory to the broad coalition of advocates, support from the healthcare industry, and a growing awareness of the need for expanded affordable health care options, said Dana Hepper, Director of Policy and Advocacy at Children’s Institute, the Alliance for Early Success’ Oregon ally.

The fact that we had lost several years ago did not stop us from fighting for increased funding again. Advocates tend to become hesitant because they don’t want to lose, but this victory shows that a loss can actually be the first step toward a win.”

Dana Hepper
Director of Policy and Advocacy, Children’s Institute

Universal Preschool in Multnomah County

The Preschool for All measure will provide free preschool for all 3- and 4-year-olds by expanding on current center, home, and public school based providers, adding an additional 7,000 slots by 2026. The measure also increases salaries of lead teachers to match salaries of kindergarten teachers in the county and the wages of assistant teachers to at least $18 per hour.

The expansion will be funded through a tax on high earners. Individuals earning over $125,000 or households earning over $200,000 will pay a 2.3% tax, and individuals earning over 250,000 and households earning over $400,000 will be taxed at 3.8%. This is estimated to generate $133 million in 2021, increasing to an estimated $202 million in 2026.

The Preschool for All measure also has a $20-million set-aside to protect infant toddler child care.

The policy was created by a broad coalition of policy organizations, law makers, providers, teachers, parents, and cultural groups. The original task force was formed over two years ago with funding from Social Venture Partners, a Portland based venture philanthropy organization, and support from County Commissioner Jessica Vaga Pederson.

While the coalition was broad, the task force worked to ensure that the voices of parents, especially BIPOC parents, were at the center of the conversation. The Early Learning Hub of Multnomah reached out to parents accessing Head Start, home visiting, home-based care, and other early childhood services. There was a deliberate effort to reach out to cultural groups and provide translation services at meetings, and parents were asked to provide feedback and vote on recommendations at multiple points throughout the process.

Hepper, who is also a member of the Preschool for All task force, said that the broad base of support was the key to both developing a plan that could serve the needs of a diverse community and creating a successful election campaign.

“What made this process incredibly unique was the broad and inclusive group who worked together to create a plan that worked for everyone. There were multiple points where parents and other partners were brought in as voting decision makers. So when it came time to campaign, the people who were needed for organizing were already heavily bought into the plan.”

Dana Hepper
Director of Policy and Advocacy, Children’s Institute

The success of the Preschool for All campaign has garnered national attention for its broad scope and unique coalition building, suggesting that it could be a model for expanded preschool access nationwide.

These victories in Oregon demonstrate that increases in funding, especially those focused on equitable outcomes, can be successful even as states struggle with COVID recovery and the financial crisis, as was discussed in our October state action call: Creating a Bigger Pie: Revenue Generating Strategies for Early Childhood Programs.

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