Kitzhaber's second try

By Dylan Matthews

While everyone is busy arguing over whether Republicans won bigger in the House because of health-care reform, arguably the most consequential race in the country for health issues has finally been called. John Kitzhaber (D), who was governor of Oregon from 1994 to 2002, has been elected to a third term in that office.

Kitzhaber, a former ER doctor, was best known during his previous terms as governor and during his time in the state senate for helping create the Oregon Health Plan (OHP), which was among the first state attempts to experiment with federal Medicaid money to provide broader care. Rather than set up a traditional Medicaid program, OHP aimed to provide fewer, higher-value services to more residents. The system worked well at first, cutting the uninsurance rate from 18 percent in 1992 to 11 percent in 1996, but then started to unravel when an expanded version was passed in Kitzhaber's last year in office.

Kitzhaber then spent the next few years touting this model, saying that national health reform shouldn't focus on insurance reforms but on providing a core package of benefits to as many people as possible. He was supportive of health-care reform in 2009 but has been clear this cycle that he doesn't think it goes far enough.

All of which is to say that I'd bet on Kitzhaber applying for a Waiver for State Innovation under health-care reform. He clearly thinks he can do better than the federal model, and the Affordable Care Act gives him the opportunity to take billions in federal money and craft the system he wants with it. Interestingly, the provision allowing state waivers was written by Oregon Sen. Ron Wyden (D), who might have had exactly this situation in mind.

Dylan Matthews is a student at Harvard and a researcher at The Washington Post.