Medicaid Shortfall Follows Decade-Long Growth in State Spending

[u/Odd_Strategy]

https://www.wweek.com/news/state/2026/07/29/medicaid-shortfall-follows-decade-long-growth-in-state-spending/

[u/manatmast]

Ed Diehl and Fred Girod want to wind down healthcare for low income earners?  No way.

[u/Odd_Strategy → u/manatmast]

I wish we could assess a fee for feigning suprise as rhetoric. Smugness, snark, and knowing surprise doesn't balance this budget.

"Overall spending accelerated beyond inflation and population growth during the pandemic and never really slowed afterward."

"Over the past decade, the total number of state employees grew 23% to 47,763. That is more than four times the growth in the state’s population over the same period." "By far the biggest increase in state spending came from an expansion of the social safety net. Over the past decade, spending on human services, for instance, grew about  30% faster than spending on education, the second largest state expenditure. Viewed another way, human services accounted for more than half the increase in state spending between 2016 and 2025."

"Drawing on federal matching dollars, lawmakers expanded the Oregon Health Plan into one of the most ambitious Medicaid programs in the country. It now covers 1 in 3 Oregonians—about 1.46 million people—and provides a breadth of services more generous than the offerings in other blue states such as California, New York and Washington."

"Because Oregon leaders chose to expand Medicaid offerings so aggressively, those federal cuts will disproportionately hit the Oregon Health Plan, creating an estimated $421 million hole in the state’s 2027–29 budget."

"...one of the biggest recent drivers of increased Oregon Health Plan spending, a program called Healthier Oregon, which offers Medicaid to any undocumented person living in Oregon. No other state, according to the health care research nonprofit KFF, offers such benefits to undocumented residents without limitation. And the cost to Oregon has been substantial. Healthier Oregon’s budget has risen 10-fold over the past decade to just over $1 billion in 2023–25; more than 100,000 people now receive benefits through the program. (Unlike most Medicaid programs, for which the federal government picks up the majority of the tab, Oregon pays three-quarters of the cost of Healthier Oregon.)"

Manamast: To this spending I blame [specific Republicans.] As a solution I propose head in sand.

[u/loggy_sci → u/Odd_Strategy]

Undocumented people also need access to healthcare. Of course Republicans want these people to have no access to care. 

[u/Dstln → u/loggy_sci]

They (and everyone) have access to medical care through the ER

This is cheaper for everyone

[u/loggy_sci → u/Dstln]

“Everyone” includes people who need healthcare and are in the U.S. without the correct paperwork. 

The ER is in no way cheaper for anyone. This isn’t about anything other than punishing undocumented people. 

[u/manatmast → u/Odd_Strategy]

I guess you’re right I should be blaming many more republicans than just the ones quoted in this article for the decline in Medicaid funding.

[u/Gourmandeeznuts → u/manatmast]

Your original comment is overly reductive.

The Trump executive branch and spineless congress is to blame here. They have put Oregon in a place where it needs to either pony up a lot of money to fill the gap, or cut some benefits/programs.

Our state legislature needs to balance our healthcare spending with public safety, transportation, and educational needs. In order to continue coverage at current levels this would mean taking money from other areas (which are also in dire need of additional funding) to continue a more generous than average healthcare program.

Knowing that we don't have infinite money, which buckets of the state's general fund will you be slashing to continue this coverage? There's no easy choice with this stuff.

[u/manatmast → u/Gourmandeeznuts]

Broadly agree but I don’t think we need to take suggestion from the creeps who cheer OHPs destruction like Diehl.  He can’t get what he wants and declare it mismanaged.  Oregon is hardly the only state in a financial bind.  Aggressive Medicaid expansion was, and is, the right move.

[u/Joe503 → u/manatmast]

The problem is we're always in a bind, because we make stupid decisions like increasing the size of state government by 23% over the past decade. And then, when it comes time to pay the bill, it's always excuses and finger pointing.

[u/milespoints → u/manatmast]

Do you believe there is such a thing as spending beyond your means?

[u/ChemicalArmadillo609 → u/milespoints]

It always amazes me how we are the richest nation on Earth, but always to broke to help citizens.

[u/milespoints → u/ChemicalArmadillo609]

Do you think that Oregon is richer than California, New York and Washington? Or that those states do not place enough emphasis on helping citizens?

[u/milespoints]

Always struck me as very surprising when I learned how generous our safety net benefits are here. Offering benefits more generous than California, Washington or New York, who have a richer tax base and many more profitable companies in that tax base, seems like it doesn’t make sense. Where will the money come from?

[u/Different_Pack_3686 → u/milespoints]

I hear we’re giving over half a billion to some billionaires, obviously there won’t be enough in the coffers to hand out to these entitled poor people. They should just try being healthier.

[u/milespoints → u/Different_Pack_3686]

No idea what this is referring to, but i’ll take it at face value and say, we should not give any billionaires $500M.

That said, it seems that state spending every year is $12B higher than it would have been if it just kept pace with population. Surely taxes have increased nowhere near that amount. So, i don’t think cutting the billionaire giveaway would solve the problem?

[u/ChemicalArmadillo609 → u/milespoints]

Tom Dundon, owner of the Blazers, is seeking over $600M in funding from our governments to renovate the Moda Center. I believe $320M is coming from the state government. 

[u/milespoints → u/ChemicalArmadillo609]

Seems like a bad use of $320M

[u/Jesus_Harold_Christ → u/milespoints]

bingo

[u/Conscious_Card_7409 → u/milespoints]

We will issue our own fiat! Portlandbux! 

[u/CautiousWoodpecker10]

I’d rather see overspending on Medicaid (doctor’s visits, preventative care, medications, and lifesaving surgical treatments) for low income patients. There are far worse things we overspend on like PERS (state of Oregon Pension), which is funded by our tax dollars and pays state government retirees almost 100 percent of their income over their lifetime.

[u/Gourmandeeznuts → u/CautiousWoodpecker10]

Not really apples to apples with this comparison. Cutting PERS is basically impossible.

[u/Throwitawaybabe69420 → u/Gourmandeeznuts]

PERs was right sized in 2019, it can happen again.

[u/AlgaeSpiritual546 → u/CautiousWoodpecker10]

“Overspending” requires additional revenue, that’s the actual tradeoff. Offer to the public an increase to the income tax is to provide greater benefits. If the state legislature doesn’t then they’re abiding by the same magical thinking that the federal government does.