- Oregon Health Plan
Health care in the United States Public health care
- Federal Employees Health Benefits Program
- Indian Health Service
- Military Health System / TRICARE
- State Children's Health Insurance Program (SCHIP)
- Veterans Health Administration
Private health coverage
- Health insurance in the United States
- Consumer-driven health care
- Managed care
- Health maintenance organization (HMO)
- Preferred provider organization (PPO)
- Medical underwriting
Health care reform law
- Emergency Medical Treatment and Active Labor Act (1986)
- Health Insurance Portability and Accountability Act (1996)
- Medicare Prescription Drug, Improvement, and Modernization Act (2003)
- Patient Safety and Quality Improvement Act (2005)
- Patient Protection and Affordable Care Act (2010)
State level reform
- Massachusetts health care reform
- Oregon Health Plan
- Vermont health care reform
- SustiNet (Connecticut)
Municipal health coverage
- Fair Share Health Care Act (Maryland)
- Healthy Howard (Howard Co., Maryland)
- Healthy San Francisco
The Oregon Health Plan is Oregon's state Medicaid program.
It was intended to make health care more available to the working poor, while rationing benefits. At the time, Oregon was considered a national leader in health care reform. The law passed in Oregon was not initially compatible with federal law, so a waiver was needed. President Bill Clinton approved the plan on March 20, 1993, though he required a revision to the plan due to a concern about whether disabled people would have equal access. At the time, Medicaid covered 240,000 Oregonians.
In 1994, the plan's first year of operation, nearly 120,000 new members signed up, and bad debts at Portland hospitals dropped 16%.
New enrollment in the program were closed from mid-2004 until early 2008, when a lottery-based system was introduced. Tens of thousands of Oregonians signed up, competing for 3,000 new spots in the plan.
Basic eligibility requires that the applicant be a resident of Oregon, as a citizen or otherwise. The level of coverage is based on income, age, mental and physical condition.
Since a February 2003 adjustment to the Oregon Health Plan, it consists of two main plans, OHP Plus and OHP Standard.
OHP Plus is a full benefit package offered to children and adults who are eligible for Medicaid or for the Children's Health Insurance Program. The OHP Plus package has no premiums, but some adults may be required to pay small copayments for outpatient services and some prescription drugs.
In January 2010, most vision and some dental benefits were cut from OHP Plus due to budget deficits. In January 2011, John Kitzhaber again took office for a third term as governor, and has proposed new reforms and cuts to OHP Plus.
OHP Standard is a limited benefit package covering a limited number of uninsured adults who are not eligible for Medicaid. In 2003, when OHP Standard began requiring small premiums of most adult participants, around 40,000 Oregonians (many homeless, destitute or mentally ill) were unable to pay the premium and were disenrolled from the program. Significant cuts were made to the Oregon Health Plan's budget in 2003. Today, the monthly premiums are still required, but there are no copayments.
The Oregon Health Plan became the focus of national scrutiny in 2003, after deep budget cuts led to 100,000 people in mental health and/or substance abuse treatment losing prescription coverage under the program.
During 2008 and 2009, the Oregon Health Plan stirred up controversy when enforcing 1994 guidelines to only cover comfort care, and not to cover cancer treatment such as chemotherapy, surgery and radiotherapy for patients with less than a 5% chance of survival over five years.
Springfield resident Barbara Wagner said her oncologist prescribed the chemotherapy drug Tarceva for her lung cancer, but that Oregon Health Plan officials sent her a letter declining coverage for the drug, and informing her that they will only pay for palliative care and physician-assisted suicide. She appealed the denial twice, but lost both times. Tarceva drugmaker Genentech agreed to supply her the $4000-a-month drug free of charge. Wagner's plight garnered a flurry of attention from the media, the blogosphere, and triggered protest from religious groups. Wagner died in October 2008.
Ongoing legislative efforts
Following the end of two terms as Governor of Oregon, Kitzhaber established the Archimedes Movement, which aims to be a grassroots effort toward crafting legislation and solving Oregon's health care problems. The Archimedes Movement also has a close relationship with the Foundation for Medical Excellence.
The 2007 Oregon legislative session passed the Healthy Oregon Act (Senate Bill 329), which established the Oregon Health Fund Board. This seven member advisory panel worked with former Governor Ted Kulongoski to propose legislation for the 2009 session. Among other challenges, the board has been advised that changes in federal requirements will affect funds that currently support 24,000 Oregonians on the OHP Standard plan.
- ^ a b c d Lydgate, Chris. "In sickness and in health". Willamette Week 25 Years retrospective. http://wweek.com/___ALL_OLD_HTML/25-1993.html#sick.
- ^ Jacklet, Ben (August 5, 2005). "Activist’s ideals give rise to ideas". Portland Tribune. http://www.portlandtribune.com/news/story.php?story_id=31159.
- ^ Korn, Peter (February 27, 2007). "Some forge ahead on reform". Portland Tribune. http://www.portlandtribune.com/rethinking/story.php?story_id=117234505483715600.
- ^ a b Pear, Robert (March 20, 1993). "U.S. Backs Oregon's Health Plan for Covering All Poor People". The New York Times. http://query.nytimes.com/gst/fullpage.html?res=9F0CEFDB1030F933A15750C0A965958260. Retrieved 2008-07-14.
- ^ Korn, Peter (February 27, 2007). "Elsewhere, there are saner ways to help mentally ill". Portland Tribune. http://www.portlandtribune.com/rethinking/story.php?story_id=117234479689470100.
- ^ a b Clark, Taylor (June 9, 2004). "Code Red". Willamette Week. http://wweek.com/editorial/3032/5173/.
- ^ "Thousands seek a spot on state health plan reservation list". Portland Tribune. February 4, 2008. http://www.portlandtribune.com/news/story.php?story_id=120215255406776300.
- ^ Skidmore, Sarah (March 4, 2008). "Oregon Holds Health Insurance Lottery". Associated Press. http://ap.google.com/article/ALeqM5gyDshNIHe6mH1iqKyPvzvCtAtY9QD8V6KH6O0.
- ^ Steves, David (August 5, 2009). "Governor signs bill assuring kids health insurance". Eugene Register Guard. http://special.registerguard.com/csp/cms/sites/web/news/cityregion/18175109-41/story.csp.
- ^ Kalinoski, Stacie (March 17, 2010). "Healthy Kids Boosts Numbers". KEZI. http://kezi.com/page/166553.
- ^ http://www.leg.state.or.us/ors/414.html
- ^ Steves, David (October 26, 2003). "40,000 Poor Lose Coverage". Eugene Register-Guard. http://news.google.com/newspapers?id=2nYVAAAAIBAJ&sjid=qusDAAAAIBAJ&pg=5519%2C6347082.
- ^ "Oregon DHS". http://www.oregon.gov/DHS/healthplan/data_pubs/faqs/faqapply.shtml.
- ^ Egan, Timothy (March 3, 2003). "A Prescription Plan Lauded as a Model Is a Budget Casualty". The New York Times. http://www.nytimes.com/2003/03/05/us/a-prescription-plan-lauded-as-a-model-is-a-budget-casualty.html.
- ^ "Statement of Intent for the Prioritized List of Health Services, page SI-1". http://www.oregon.gov/OHPPR/HSC/docs/Apr08Plist.pdf. .
- ^ Stevens, Jr., M.D., Kenneth R. (March 26, 2009). "Oregon Rationing Cancer Treatment but Offering Assisted Suicide to Cancer Patients: Paying to Die but not to Live". PCM Online. http://www.ohsu.edu/pcmonline/docs/Oregon%2520Rationing.pdf.
- ^ Harding, Susan (July 31, 2008). "Letter noting assisted suicide raises questions". KATU TV News. http://www.katu.com/home/video/26119539.html.
- ^ http://blogs.rep-am.com/worth_reading/?p=4326
- ^ Christie, Tim (June 3, 2008). "A Gift of Treatment – When the Oregon Health Plan fails to cover a cancer drug, the drug maker steps in". Eugene Register-Guard. http://www.articlearchives.com/health-care/health-care-professionals-physicians-surgeons/186347-1.html.
- ^ Donaldson James, Susan (August 6, 2008). "Death Drugs Cause Uproar in Oregon". ABC News. http://abcnews.go.com/Health/story?id=5517492&page=1.
- ^ http://wizbangblog.com/content/2009/08/04/oregon-health-plan-has-already-weighed-the-cost-of-life-1.php
- ^ http://thehappyhospitalist.blogspot.com/2009/08/it-looks-like-oregon-has-established-5.html
- ^ http://www.southernbellepolitics.com/2009/06/are-you-ready-to-die-soon.html
- ^ http://www.mofopolitics.com/2009/08/03/video-oregon-says-no-to-chemotherapy-offers-doctor-assisted-suicide/
- ^ http://www.catholicnewsagency.com/new.php?n=12857
- ^ http://www.lifenews.com/bio2608.html
- ^ http://www.lds.net/forums/current-events/24495-obamacare-met-barbara-wagner.html
- ^ Maynard, Steve (November 11, 2008). "Oregon Death with Dignity program spurs fierce debate, intense criticism". Tacoma News-Tribune. http://www.thenewstribune.com/1078/story/532612.html.
- ^ About Us | We Can Do Better - The Archimedes Movement
- ^ tfme.org - Home
- ^ Glascock, Stuart (March 10, 2008). "A Healthy Wager". Los Angeles Times.
- ^ Kulongoski, Ted (2008-06-10). "Governor Kulongoski's letter to the OHFB" (PDF). Governor of Oregon. http://www.oregon.gov/OHPPR/HFB/docs/Meeting_Materials_HFB/2008/Governor_Letter_to_OHFB_6.10.08.pdf.
Topics in Oregon legislation Crime and sentencing Elections and voting Gay rights Environment Land use Health careDeath with Dignity Act · Oregon Health Plan Minimum wage Taxation Miscellaneous Influential peopleLoren Parks · Bill Sizemore Background, further reading
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