Steven Jerry Chapin@Wrygryn
UNDERSTANDING “HEALTHIER OREGON” AND STATE FUNDED HEALTH CARE IN OREGON
SUBJECT: This article will mostly be covering Medicaid (OHP) and Ed Diehls involvement to date.
HB 3352 is a house bill passed by Democrats in 2021 that renamed “Health Care for All Oregon Children” to “Cover All People,” and extended low income free medical coverage (Medicaid/OHP) to all non-citizens including illegal immigrants. “Cover all People” later became “Healthier Oregon” and is sometimes referred to as “Healthier Oregon Program” or HOP. Oregon is one of only 6 states that have done this, and these “Medicaid-like” programs claim to only use state generated tax dollars to fund the healthcare for illegal immigrants. The term “illegal immigrants” is used specifically because while federal funding does have a few carve outs where it can be used, (IE—Refugees, emergency room visits made by illegal immigrants, etc) it mostly can’t be used to provide free healthcare to illegal immigrants. HB 3352 changed that and allowed illegal immigrants to receive free health care which is paid for by Oregon citizen tax dollars so long as they meet the requirements.
Ed Diehl was not in politics in 2021 when bill HB 3352 passed, so he did not vote for it. (Ed wasn’t a state Rep until November 2022). Any claims saying Ed voted for this bill, are therefore incorrect.
In January 2023, Ed Diehl and 5 other Republicans voted YES on HB 2010, which generates billions in federal matching funds for Oregon’s Medicaid program (OHP) and extends taxes that were due to sunset to pay for it. These taxes/assessments that Ed voted for help fund HB 3352 significantly. The way this is done is a bit of a shell game though, and it’s why Oregon and the 6 other states that have these programs are currently under investigation by the federal government.
First, the fees are charged to the hospitals. That money is then used in a matching program where the federal government doesn’t just match the dollars, but often returns 3 times the cost of the fees. OHP takes roughly 65% of the revenue that is generated by the hospital fess in HB 2010, are keeps it. The remaining 35% or less is given back to hospitals. These fees are important to hospitals because they allow them to get paid whenever people are treated at the hospital but are unable to pay the hospital for its services. This is most notably seen when illegal immigrants use hospitals and then do not pay. Without these fees the hospitals would not get paid at all in these situations, and they would still be required, by law, to provide service to anyone who seeks emergency aid.
The portion of the fees that hospitals pay is considered “State generated funds” and OHP keeps as much of this as they legally can—preferring to use the federal dollars to pay back the hospitals who paid the fees. These “state generated funds” and the remaining federal matching funds, can then be used by OHP to provide any of its qualifying services. Under HB 3352, the “state funds” can be used to pay for “Healthier Oregon” which provides free health care to illegal immigrants that qualify.
In the recent gubernatorial debate David Medina asked Ed Diehl to explain his vote on HB 2010 and claimed that HB 2010 helped fund insurance for illegal immigrants and pay for transgender surgeries. Ed Diehl claimed this was a lie and went on to say:
“…Medicaid cannot be used for illegal immigrants it’s against federal law…that bill has nothing to do with that, absolutely nothing. What that bill does is…it is a fee that hospitals pay…they give it to the state, the state uses that to draw down Medicaid dollars and all that money goes back to the hospitals, all that money goes back.”
This is completely incorrect, and is the exact opposite of what is going on. As previously stated, over 65% of the money generated by these fees is kept by OHP and used for other things—hospitals only get 35% of the money back. Furthermore, the fees that Ed Diehl is describing above are one of the primary ways that OHP is funded in Oregon.
Remember that hospitals are required to help anyone who shows up. This fact is used and abused by the illegal immigrant population to get free healthcare even if they are not registered to OHP’s Healthier Oregon Program. To keep them from going bankrupt, hospitals are reimbursed for the illegal immigrants and anyone else who uses their emergency services, and doesn’t pay. This further casts incredulity on Ed’s claim that the money doesn’t have anything to do with free health care for illegal immigrants, because they are the largest group that uses emergency care and doesn’t pay, and thus the largest group supported by these fees generated by HB 2010.
Ed Diehl went on to say that:
“You guys have a hospital here right, bay area hospital? Without that funding that hospital would not exist, it’s as simple as that.”
This statement is disturbingly similar to what Governor Tina Kotek said when she forced HB 3991 (the gas tax) into law.
Tina Kotek said:
"if we don't pass the gas tax bill people would be fired and roads wouldn't get fixed."
Ironically, when Tina Kotek tried that tactic, Ed responded by saying:
"Governor Kotek is giving Oregonians a false choice: either hike the gas tax or cut road maintenance and lay off crews."
Republican’s should not resort to Democrat scare tactics and false choices. Claiming hospitals would be closed if Ed didn’t sign HB 2010 is a false choice, and a scare tactic. As David Medina later pointed out in rebuttal, Ed could have pushed for changes to legislation to remove illegal immigrants from what OHP provides services to, instead of siding with Democrats to extend taxes and fund it.
15 Republican’s voted NO on HB 2010, while Ed Diehl and 5 other Republican’s supported this bill and sided with Democrats. Interestingly, Cyrus Javadi was one of the 5 who voted YES with Ed Diehl on this bill (Javadi is the infamous Republican traitor who not too long ago switched from Republican to Democrat). Democrats voted unanimously in favor of HB 2010.
Voting no on HB 2010 would not have “shuttered all rural hospitals in Oregon” as some have claimed, it would have just forced Democrats to make cuts, offer compromises to Republicans, or maybe force Democrats to cut some of their DEI and social welfare programs (healthcare for illegal immigrants would have been a great choice to cut). Cutting illegal immigrants out of OHP would have saved Oregonians roughly 300-350 million dollars in annual expenses. HB 2010 will continue to help fund HB 3352 until the year 2032, and continues to attract illegal immigrants who want free health care—which exacerbates the problems of illegal immigrants showing up to hospitals, receiving service, and then not paying. Do you see how this cycle feeds itself? The more illegal immigrants that use hospitals and don’t pay, the more the Fed needs to reimburse hospitals, and the more money OHP generates and keeps.
How does this all tie in with the recent Medicaid fraud claims from Dr. Oz and others?
In November of 2025, CMS (Centers for Medicare and Medicaid) publically came out and announced they were auditing the 6 states that have been giving out free healthcare to illegal immigrants. CMS asserted that states have been illegally using federal Medicaid dollars to pay for the state programs that provide benefits to illegal aliens (I.E. “Healthier Oregon Program (HOP)”). Since Federal Medicaid dollars can normally only be used to pay for US citizens or people legally here in the US, this would be illegal, and the Fed could demand those dollars be paid back. Oregon denies any wrong doing, but refuses to turn over records that could prove the federal government wrong in its accusations. CMS is currently suing them to get access to the records so they can determine for themselves whether or not federal funds were used correctly.
Here is the tricky part though, many numbers get thrown around and people misquote them all the time. The problem is, CMS has not made any claims yet as to how much Oregon has or has not misused federal funds, and likely won’t for a while because the court case is ongoing. You may have heard the “1.25 to 1.35 billion” number being thrown around? That number specifically is referring to the projected biennium budget (2025-2027) for HOP (which is a subset of OHP). This is the two year budget that pays for non-citizens “free” health care, and works out to be 600-750 million dollars per year. Very little of what goes to pay this should be paid with Federal tax dollars, but there are some exceptions. Two examples of exceptions are: a person with “official refugee status” and “a non-citizen being admitted to a hospital for emergency care”. Until CMS concludes its investigation, we won’t know how much of these federal dollars were spent on legit things, and how much was spent illegally.
You may have heard the “5.4 million dollar” number mentioned somewhere. The 5.4 million number isn’t Medicaid money being “clawed back”, it’s a negative grant award (fancy phrase for reduction in federal payments) tied to a federal notice in Sep. 2024 that is unrelated to this. The notice stems from a claim that Oregon misused some federal COVID dollars that were provided to Oregon during COVID.
The “300 million” number floating around X is tricky because it could refer to several different things. The CMS Administrator (AKA—Dr. Oz) said he had already “clawed back 300 million” but he was referring to money that he got back from California specifically—this was not in reference to Oregon as he has not gotten any money back from Oregon yet.
There’s also a “300 million” number that refers to the federal funded part of HOP’s budget. CMS claims that states are blending the two together to help pay for rising health care costs due to trying to support programs like HOP, but nothing concrete has been released yet.
The final “300 million” number is actually “300-350 million” which is an estimate on what the State of Oregon spends every year on just illegal immigrants through “Healthier Oregon”. According to OHP’s web dashboard, 99,723 total non-citizens receive free health care from HOP (current as of 3/18/2026), but the breakdown that shows how many are legal and illegal isn’t available to the public. GROK estimates that roughly 80-90% of people using HOP are likely illegal immigrants, and the “300 million spent on illegal immigrants” lines up perfectly with that number—so likely it’s where it stems from.
NOTE: the “300 million” number in the last example only matches up if you use the low end of GROK’s estimate which was 80%--the numbers come out significantly higher if you instead assume the top of the range, 90%.
Did Ed Diehl vote for HB 2010 on purpose, or on accident? Ed is a strong proponent of only deporting illegal immigrants that are “violent criminals,” so it’s not unreasonable to wonder if Ed was trying to provide healthcare intentionally to illegal immigrants who are non-violent as he has no intention of deporting them—that is certainly what Democrats have been using it for. It’s more believable than the alternative—that he ignorantly voted in lock-step with Democrats and Cyrus Javadi (one of the 5 other “republicans” that voted YES on HB 2010), which is concerning since Ed is running for Governor.
After all, Ed put his foot down with NOTAXOR, so why didn’t he do the same thing for HB 2010? The answer to this is simple; Ed doesn’t want to get rid of illegal aliens, just illegal aliens that are also violent criminals. Every single time he talks about or supports deportation it’s always only “violent criminals”. Ed appears to be just fine with non-violent illegal aliens staying here, and he voted to extend taxes that help pay for free healthcare for them. A simple search using AI or on X will verify these statements as fact, not opinion.
HB 2010 was a Democrat bill designed to help them pay for HB 3352 which provided free healthcare to the illegal immigrants in Oregon that Democrats want to make into new voters. Ed Diehl has supported this endeavor by voting YES on HB 2010, just like traitor Javadi did. Ed either doesn’t know where the money goes or lied about it, but either way, it is funding healthcare for illegal immigrants, trans surgeries, and every other server OHP provides.
Choose wisely Oregon, let legislator votes dictate how you view candidates, and who you pick to be your next Governor for Oregon.
