Sept. 8, 2026
If you’ve never experienced a major earthquake, it’s difficult to describe the feeling when the ground suddenly and dramatically shifts beneath you. In November 2018, I was in a magnitude 7.1 earthquake in Anchorage, Alaska. The quake and its aftershocks sent pictures flying from walls, toppled cabinets and dressers, cracked buildings, and damaged roads. The aftermath was eerie and surreal as a basic assumption—that the ground beneath me was solid—was shaken.
Earthquakes teach us something important: What happens in an instant is often the result of stress building for years. The rupture may happen suddenly, but the forces beneath the surface have been accumulating for a long time.
Oregon’s health care system is under similar pressure. We are already seeing the effects as communities lose hospitals and hospital services, insurers exit markets, and Oregonians struggle to get the care they need.
Without action in the 2027 legislative session to relieve pressure on the system, these stresses could trigger the health care equivalent of an earthquake: More hospital closures, shuttered services and layoffs, with aftershocks that could affect communities for years.
For years, hospitals have absorbed chronic underpayment, inflation, escalating labor costs, workforce shortages, and growing administrative demands. Since 2022, Oregon hospitals have lost more than $1.25 billion caring for patients, forcing them to make difficult decisions about services, staffing, and whether they can continue providing the care communities depend on.
Now, changes in federal law will add even more pressure. Implementation of H.R. 1 will reduce state resources by roughly $12 billion over the next several years and result in an estimated 200,000 Oregonians losing health insurance. More uninsured Oregonians means more people delaying care, more uncompensated care for hospitals, and more financial strain on a system already under stress.
We don’t have to wait for the ground to move beneath us.
Oregon needs a patient-centered plan to strengthen the foundation of our health care system while making care more affordable. That starts with three things:
- Protecting and strengthening Medicaid payment for hospital services. As the state faces billions in losses in federal Medicaid funds due to H.R.1, more people will lose health insurance, putting their health at risk, increasing uncompensated care at hospitals, and straining the health care system. We should act now to protect and strengthen Medicaid payments for hospital services.
- Requiring insurers to make it easier for patients to get the health care they need and return more of the health care dollar to the bedside. Health care workers should be caring for patients—not navigating layers of complex insurance paperwork that make care less affordable and accessible. Oregonians should be protected from insurance company tactics that stand in the way of good care.
- Reducing the red tape that harms the ability of hospitals to provide patient care. Oregon has built complex layers of excessive rules, paperwork, and duplicative administrative requirements that don’t serve patients and the health care providers caring for them. Oregonians need affordable health care, not outdated, inflexible requirements that don’t help patients.
When people have nowhere else to turn, hospitals are there. In the best and worst moments of their lives, whether sick, injured, or welcoming a new baby, Oregonians can count on their local hospital. Hospitals are also essential anchors of the communities they serve, providing jobs and economic stability. But their presence is not a given, and their foundation is shaky.
The pressure is building. The question isn’t whether Oregon’s health care system can withstand unlimited pressure. It can’t.
The question is whether we will act before the rupture—or wait until the ground shifts beneath us.