24 Jan

D.C. attack on higher education felt in Oregon

It’s clear, as we mark the one-year mark of the Donald Trump show, that the Official Dislike list includes immigrants, many of the countries they come from, corporate taxes and reporters who ask annoying questions.

But there is also a clear dislike, and multiple moves against, the nation’s higher education institutions, part of what The Atlantic calls “The Republican War on College.”

This regime is deeply suspicious of people who think they know something.

Michael Schill, president of the University of Oregon, calls the situation “alarming,” noting that “We are getting a message from some members of Congress and the president that’s hostile to higher education.”

The effects are reaching toward Oregon colleges and universities, creating what Wim Wiewel, former president of Portland State University and current president of Lewis & Clark College, calls “a bit of a sense of a wholesale assault.”

Efforts undermining higher ed include the new tax bill, the approaching Higher Education Reauthorization act, the administration’s proposals for sharp cuts in research funding and official attitudes making the United States about as inviting to foreign students as mandatory gym. After a long tradition of government considering higher education as an asset – it produces medicines, weapons and taxpayers – higher ed largely serves the current administration as a target.

The new tax bill, among other things, limits the deductibility of interest on student loans, and for the first time taxes the income of the largest college endowments. (The tax doesn’t bring in much, but it sends a message.) The House version would have taken a small nick out of the Reed College budget; the Senate raised the threshold enough to exclude all Oregon colleges – for now.

The Senate also blocked the House’s effort to turn tuition waivers, given to graduate student and college employees, into taxable income, which could have given a number of students the gift of a tax bill larger than their income.

(The tax bill, with its limit on state tax deductibility, also squeezes high income tax states like Oregon, and decades have shown that state squeezes are felt first in the higher ed budget.)

The next blast comes in the impending Higher Education Reauthorization , recently pushed through the House education committee on a party-line vote after the Democrats first saw the bill just before a 14-hour markup session. “In the end,” says Oregon Rep. Suzanne Bonamici, a senior Democrat on the committee, “it will make it harder for low-income students.”

Elements include charging student loan interest earlier, from the time of borrowing instead of graduation; eliminating programs of student loan forgiveness after years spent in certain professions; and eliminating graduate students from federal work-study programs – as well as dropping the funding from a 3-1 federal match to 50-50.

But the proposed bill does follow Trump administration policy of eliminating the Obama administration’s limitation for-profit colleges, established because the for-profits too often left students with no useful degrees and sizable debt – to be largely covered by the feds. Curbing that outcome is now considered an interference with school choice.

For next year’s budget, the Trump administration is proposing cutting federal research spending in half. (As noted, the administration is suspicious of people who know things, or want to learn them.) This would be a major hit to universities around the country; in Oregon, it could land heavily on Oregon State, where a major oceanography research grant just raised the university’s annual research funding to $441 million. Oregon State president Ed Ray says he’s worried about it “very much,” and that universities might depend more on non-federal research funding, such as corporations and foundations.

Bonamici says that Congress looks more favorably on research, and “Fortunately, it’s the legislative branch that makes appropriations.” But as the events of the last week have shown, the D.C. budget process is now a roller coaster with very weak guard rails.

Currently, Washington undermines higher ed in another way unrelated to budget. Increasingly, American universities have been drawing international students, who pay out-of-state tuition and build global reputations. Now, says Schill, “Students are wondering whether this is a congenial place to go to school,” and the U of O’s international applications are down, part of a national trend.

The roots of the hostility are not hard to see. Stephen Moore, an economist and journalist who advised the Trump campaign, reflected considerable conservative opinion by calling universities “playpens of the left,” and a recent Pew poll found 58 percent of Republicans believing that “colleges and universities have a negative effect on the way things are going in this country.”

It’s certainly true, as Ed Ray notes, that higher ed has always been criticized, and that its current critics are still generally enrolling their children. But American higher education has been strengthened by a general understanding that the system is an economic asset and a route for social mobility – and dismissing that awareness will lead to major losses.

It’s a problem if our model of higher education is Trump University.

NOTE: This column appeared in The Sunday Oregonian 1/21/18.

06 Jan

Healthcare community riding together on 101

Measure 101, the subject of the ballots that dropped into Oregon mailboxes last week, stands almost alone among the vast bushels of Oregon tax measures.

For this one, some of the folks who would pay it are its strongest supporters.
It’s like homeowners demanding to pay more property taxes.

Measure 101 puts a small tax on health care providers, and yet just about everybody in the Oregon health care community – doctors, nurses, hospitals, insurance providers, disease advocates, mothers who want their children to be doctors – supports it. In the medical community’s thinking on Measure 101, it’s not easy to find a second opinion.

The money raised by the tax would bring in a much larger amount from the federal government, protecting the health insurance of hundreds of thousands of Oregonians recently added to Medicaid. The strategy has already worked for Oregon and its health care community, and for some other states and their health care communities – which may be why so many providers are in such unusual agreement on a tax, even if they’re paying it.

“It’s very important that the majority of healthcare in Oregon is working behind 101,” agrees Kevin Ewanchyna, a Corvallis family physician and Oregon Medical Association board member. “My colleagues and I all have stories about lives saved because people came in for primary care when they had coverage.”

Over two years, the tax would collect between $210 million and $320 million from the Oregon healthcare community. But as matching funds, it would bring in $630 million to $960 million from the federal government, covering the 350,000 Oregonians added to Medicaid by the Affordable Care Act, and supporting the reforms Oregon has made to its healthcare system in recent years.

Folks in healthcare aren’t always in total agreement; doctors complain about insurance providers, hospitals complain about doctors. There are always conflicts, admits Jessica Adamson, director of government affairs for Oregon at Providence Health and Services, “But on this one we agree. We believe it’s important to stand together to defend this package.”

Oregon – as well as other states – has done this before. In 2009, the legislature adopted a similar strategy to maximize the state’s use of the Children’s Health Insurance Program. That tax has lapsed now, after helping cut the proportion of uninsured Oregon children from 12 percent to 2 percent.

Everybody in Oregon healthcare also agrees that doing that was a good idea.

On the other hand, risking the federal support for insuring 350,000 Oregonians is a problem for everybody. Uninsured people endanger their own health, hurting themselves and the economy. But as we learned over decades, lack of insurance, preventing primary care, causes expensive emergency room appearances and late-stage treatment, costs landing on the entire system.

“When people lack access to affordable care,” points out Janet Bauer of the Oregon Center for Public Policy, “everybody else’s costs go up.”

This would be especially true of defeating Measure 101, which includes a reinsurance plan protecting insurers against extreme individual expenses, otherwise spread over everyone’s premiums – raising them by an estimated $300 a year.

The Voting Pamphlet arguments against Measure 101, mostly from individuals, argue against any taxes, against providing health coverage for undocumented children, against abortion, against state college tuition levels and against Nike (it’s a long story). They also object to the cost and quality of health care in Oregon, although it’s not clear how risking billions in federal money helps that.

But, state Rep. Cedric Hayden insists, “There’s NO RISK 350,000 low-income Oregonians will lose healthcare if you vote NO on 101! Income tax revenue created by Oregon’s $5 BILLION DOLLAR healthcare industry exceeds the revenue we need to fund Medicaid patients.”

The state’s just spending its money wrong, he explains, so all the legislature would have to do in its short session next month is redesign the state budget.

People in Oregon healthcare are less confident. Measure 101 “is the only guarantee we’ll be able to qualify for the Medicaid benefit,” says Adamson of Providence, currently the only statewide individual insurance provider. “Anything else is a gamble.

“There is no Plan B.”

Never a comforting medical opinion.

It took six months – and multiple trips through the number-crunching Legislative Fiscal Office – for the legislature to put together the program and the budget behind Measure 101, and to gather the overwhelming support of Oregon healthcare behind it.

“That’s why,” explains Kevin Ewanchyna, “the physicians of Oregon have to support the expansion of the Medicaid program, and Measure 101. From my perspective, it’s either Measure 101 or it’s not happening.”

To the people who provide health care in Oregon – who treat the patients and keep the facilities working – Measure 101 isn’t just a proposal.

It’s a prescription.

NOTE: This column appeared in The Sunday Oregonian, 1/7/18.