• Ballots have been mailed to registered voters and should be received no later than the middle of this week.

• Measure 101 is the only item on the ballot.

• A “Yes” vote means the law passed by the Legislature should go into effect.

• A “No” vote means the portions of the law included in the referendum would not go into effect.

• Voters can fill out the ballot and mail them back to county election officials in the envelope provided. Alternatively, voters can return to the ballots up until 8 p.m. at officially designated drop boxes. Ballots must be received by the county clerk by the deadline — postmarks do not count.

SALEM — To partisans on either side of the only issue on the special election ballot this month, Measure 101 is the salvation of the state’s medical safety net or an unfair targeted sales tax on health care.

That’s the choice as cast by supporters and opponents of the Jan. 23 referendum. But with mail-in ballots arriving to homes across the state, Measure 101’s success or failure is already in motion.

The core question is whether voters will ratify the Legislature’s decision last summer to place a 0.7 percent assessment on many hospitals, and a 1.5 percent assessment on the Public Employees Benefit Board, managed care organizations and insurers.

The referendum is the only item on the ballot. The description takes up less than half a page in the Voters’ Pamphlet. But the level of contentiousness over the issue is illustrated by more than 30 pages of pro and con arguments that follow.

Supporters say a “Yes” vote will generate up to $320 million in revenue to pay for health care for the state’s neediest residents. With federal matching funds, the total climbs to up to $1.3 billion. It’s a solution hammered out in the Legislature and signed into law by Gov. Kate Brown.

Opponents say the more than 84,000 signatures they gathered to put the referendum on the ballot showed that residents were not satisfied with the solution found by Salem. Opponents say they want to put the Legislature back to work finding a solution that shares the pain and gain more evenly.

At a debate of Measure 101 on Friday at the Portland City Club, Measure 101 proponent Jessica Adamson, head of government affairs for Providence Health and Services, said the new law was a safeguard and good public policy.

“This is the only way to guarantee Oregonians will have access to health insurance,” Adamson said.

Supporters say 95 percent of Oregonians have health care, up from 84 percent in 2013. But proponents say the federal government has cut the amount it will pay for care of low-income people, forcing states to find a way to make up the shortfall.

Many of those affected use the Oregon Health Plan, the state’s vehicle for the Medicaid program.

Proponents say 30 percent of Deschutes County residents get their health insurance through the health insurance marketplace put in place under the federal Affordable Care Act or via the Oregon Health Plan. The percentages are 39 percent in Jefferson County and 36 percent in Crook County, putting both in the state’s top five counties utilizing low-income health care programs.

Ensuring there is money to provide health care for those residents requires a Measure 101 win, said Felisa Hagins, a member of the Oregon Health Policy Board and political director for Service Employees International Union Local 49. Appearing at the Portland debate, Hagins said the kind of health provider assessments in Measure 101 are used in 49 other states to ensure low-income health care. Rejecting Measure 101 in hopes the Legislature would be able to plug the gap during its upcoming short session would be irresponsible.

“There is no magic money,” Hagins said. “The reality is we have to deal with the budget we have.”

Opponents say the “assessment” is a tax on the sale of health care. They say many people not on the Oregon Health Plan will see higher premiums under Measure 101 and that it unfairly targets small businesses, college students and schools, while leaving corporations and unions largely unaffected.

Rep. Julie Parrish, R-West Linn, a leader of the opposition to Measure 101, said at the Portland debate that it would be foolish to think health providers like Providence will not make consumers pay in the end when the law explicitly allows for premium hikes of up to 1.5 percent to cover costs.

“Is Providence actually going to pay that out of the goodness of their heart?” Parrish said.

Parrish and other Measure 101 opponents say that Providence and hospitals are supportive of the measure, despite the surface appearance that they will have to pay new or higher taxes, because under Oregon law they are required to treat uninsured poor people. With Measure 101, they will have an avenue to recoup those costs.

“We’re taxing small businesses and college students” to do that, Parrish said.

Opponents point out that the taxes are for only two years, setting up a likely new crisis after the end of the 2017-19 budget cycle even if Measure 101 passes.

“What happens two years from now when all this sunsets?” Parrish said.

If voters cast a majority “no” vote, opponents say it will force the Legislature to make hard decisions on taxes and cuts that can not only make it through the Democratic-dominated Capitol, but appeal to enough non-affiliated voters and Republicans to withstand a ballot challenge like the one mounted against Measure 101.

— Reporter: 541-525-5280,