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COULD OREGON CHART THE COURSE FOR UNIVERSAL HEALTH CARE IN THE US?  
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Kevin Foster
August 27, 2025
Waging Nonviolence
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_ Oregon is on the verge of enacting a single-payer health care plan,
but continued organizing is needed to secure this historic victory. _

, health Care for All Oregon

 

In 2022, Oregonians narrowly passed Measure 111, amending their
constitution and guaranteeing affordable health care as a fundamental
right to every resident of the state. Through years of organizing,
coalition building and planning, Oregon may enact its Universal Health
Plan as early as fall 2027
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In the face of extreme Medicaid cuts from the Trump administration,
which will leave roughly 16 million people
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without health coverage by 2034, a state-level universal plan could
mean the difference between cared-for, insured patients and thousands
of preventable deaths. 

Oregon’s single-payer health care dream still has hurdles to
overcome, but with a constitutional amendment voted in by the people,
it may have a leg up over previous state-level campaigns, such as
Vermont’s Green Mountain Care in the early 2010s. Even so, a clear
understanding of what went wrong in previous campaigns — as well as
continued organizing in Oregon — is needed to push it through. 

If successful, Oregon could lead by example and set the stage for a
better, more efficient health care system in other states. While a
national campaign isn’t on the table, organizers can look to Oregon
for how to push a bold health agenda in their state.

WHAT HAPPENED IN VERMONT?

In 2011, Vermont’s state government set in motion the steps to enact
a publicly-funded, universal health care program across the state. 

For over a decade, organizers in Vermont fought for a single-payer
health care system. Through forums, rallies and public education
campaigns, groups like Vermont Health Care for All, the Vermont
Workers’ Center and Vermont Businesses for Social Responsibility
built a broad coalition to push for universal coverage.

The program, referred to as Green Mountain Care, came very close to
implementation, but it was shot down in 2014. It did not have the
buy-in from then-Gov. Peter Shumlin, who cited significant tax
increases as his primary issue. 

Dr. Deborah Richter, a physician and president of Vermont Health Care
for All, spoke at over 500 events in the lead-up to Green Mountain
Care in 2011. Richter agreed that taxes were the greatest barrier in
Vermont’s state-level campaign, but highlighted a key flaw with this
logic. 

Under a publicly-funded system, the taxes are all out in the open,
making it easier to criticize. Under the private insurance system,
health care costs are generally hidden — often in the prices of
goods — with the financial burden falling on individuals with
medical needs. 

“We do a lot of cost shifting,” Richter said. “You don’t
realize that when you go into a store, and they’re paying for health
insurance, that you’re paying higher prices for that the goods that
are in that store. You’re paying higher property taxes to pay for
public employees’ health insurance. You’re paying a lot of other
hidden taxes to pay for health care for other people.”

For Vermont, this meant people saw a scary price tag and may not have
understood the tangible benefits. According to Richter, what a
publicly-funded system really does is shift the cost-burden onto the
wealthy, creating a fairer, more efficient and more complete system.
Getting that message across, however, is its own challenge.

ORGANIZING AGAINST A BEHEMOTH  

A number of less-comprehensive plans would later be proposed in
Vermont, such as universal primary care, but the single-payer system
drifted into the background. Oregon will likely face many of the same
challenges, but with the distinct advantage of a constitutional
amendment on the books.

According to Collin Stackhouse, communications coordinator for Health
Care for All Oregon, or HCAO, Oregon’s Universal Health Plan
Governance Board aims to propose the next draft of the health care
plan in fall 2025. Stackhouse and multiple other HCAO members and
affiliates serve on the Universal Health Plan Governance Board and its
four committees.

Over the past three years, HCAO has built a multifaceted organizing
apparatus. With an emphasis on community outreach and voter education,
they’ve conducted crowd canvassing, tabling at events and given
presentations with a wide variety of community organizations, such as
faith groups, Rotary clubs and neighborhood associations.

Robyn Gottlieb, an organizer with HCAO, emphasized a few key elements
in their strategy. Throughout the process, HCAO asks people to sign up
for their mailing list to further help mobilize volunteers and also
informs people about the Governance Board. 

“We have folks writing testimony to the Governance Board advocating
for the strongest health plan possible with the most coverage,”
Gottlieb said. “We want dental, we want vision, we want all the
things.” 

These efforts aim to create a strong network of advocates that can
push a comprehensive health plan over the line without backstepping.
With the final draft of the health plan due from the Governance Board
by September 2026, engaging as many people as possible will be crucial
over the next year.

Activists with HCAO at the annual Pride parade in 2024. (HCAO)

Even with this push from HCAO, the general lack of knowledge about
universal health care still presents a challenge.

“I answer the comments [on our organization’s social media] and
there’s a lot of misinformed people,” Stackhouse said.
“There’s no way to give any detail or nuance in a 90-second
clip.”

Disinformation from opponents of Oregon’s universal health plan is
expected, and Stackhouse emphasized the need to connect with people in
their communities in order to overcome this — especially given how
complicated the current health system is. 

“Part of our hope as an organization is that we can reach everybody,
every person in every corner of the state in some capacity,”
Stackhouse said. “It’s becoming a pretty central part of our next
year, these things called community conversations: actually having
local people … go speak publicly in these different communities with
their neighbors about the plan.”

What this really boils down to is recognizing the lack of information
around health care, then finding a way to pull back the veil on the
health care system with people across the state. 

“One of the main key points that I think everybody [needs to know]
is that universal health care is cheaper,” Stackhouse said. “Our
taxes probably will change, but we have the most expensive health care
system in the whole world. Everybody is spending less money, and they
have universal health care. All of the countries that have the best
health care have universal health care.”

For some, the buy-in may come from learning about universal health
care itself, but others may need a more personal understanding.
Getting individuals to consider the reality of never needing to pay
another copay or deductible can make the difference. If there’s
time, Gottlieb emphasized the power of telling a personal story as
well.

There are still some details to iron out in Oregon’s plan, such as
residency requirements and how the system would work for Oregonians
traveling in other states. However, if Oregon is able to overcome the
many challenges, it could clear a path for the United States to join
all other high-income countries
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in providing affordable health care to its people. 

THE SMALL ORIGIN OF CANADIAN UNIVERSAL HEALTH CARE

Universal health care in Canada began with the founding of the
Co-operative Commonwealth Federation, or CCF, in 1932, one of the
earliest democratic socialist parties in North America. In the early
1940s, the party’s grassroots engagement and political education
efforts dramatically boosted party membership and led to a sweeping
victory in Saskatchewan, where they won 47 out of 52 seats in 1944.

Following through on one of its many political aims, in 1947, CCF
introduced the Saskatchewan Hospital Services Plan, the first
universal hospital insurance program in North America. By 1962, the
Saskatchewan Medical Care Insurance Act took effect, bringing
publicly-funded health insurance to the entire province. 

While the process wasn’t without pushback, including a failed
doctors’ strike, Saskatchewan’s Medicare system would pave the way
for Canada’s nationwide universal health plan, culminating in the
Canada Health Act of 1984. 

Through effective organizing based on working-class values and
affordability, the CCF was able to kickstart dramatic change. The
first domino that fell in favor of national universal health care in
Canada came from a rural province with only around five percent of the
population at the time. 

In the U.S., Oregon is not the only state working on a single-payer
plan. The nonprofit One Payer States
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country with active movements or infrastructure for universal health
care plans, but Oregon is closest to the finish line. 

Even with cross-state support, significant resistance is expected in
Oregon and nationally. 

Philip Verhoef, the immediate past president of Physicians for a
National Health Plan, emphasized the need for administrative
simplicity to build a viable health care system in Oregon, especially
when facing down the private insurance industry. 

“I assume the various private insurance companies that do business
in Oregon are going to fight this tooth and nail because it’s going
to effectively take them out of the game,” Verhoef said. “You
almost need to make the argument impervious to money. The people
fighting for single-payer are never going to outspend the insurance
company, so instead they simply have to get everyone on their side.”

The reality facing advocacy groups like HCAO is a U.S. private health
insurance industry worth over a trillion dollars
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Getting everyone on your side is far from a simple task, but that’s
where the on-the-ground organizing comes in. 

HCAO’s community conversations, health care education efforts and
volunteer mobilizing could make the difference in passing a universal
health care plan that is both comprehensive and affordable.  

Oregon could be the domino that universal health care needs to spread
across the country. It will require community effort, cultivating a
deeper understanding of the vast inefficiencies in American health
care and ultimately realizing a dream of something better. 

As we careen toward significantly more health care-related deaths due
to the Trump administration’s cuts, the situation may be bleak.
However, Richter suggests universal coverage could be a light at the
end of the tunnel.

“You hope [that people] at least wake up and realize you can’t
just keep kicking the can down the road, that this is not going to get
better,” Richter said. “I’m optimistic because things are so
bad. There is no other way to solve this problem.”

Kevin Foster is a journalist who reports on the intersection of
politics and social justice, aiming to increase representation for
marginalized voices in the public sphere. He is also an associate
producer on the new film "The Palestine Exception: What's at Stake in
the Campus Protests?"

_Waging Nonviolence_ is a nonprofit media organization dedicated to
providing original reporting and expert analysis of social movements
around the world.

* single-payer health care
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