OREGON: Grown Up Health Plan Faces Difficulties
The Oregon Health Plan -- hailed as a national model five years ago in the heady days of state health care reform -- is "hitting roadblocks" in its efforts to use rationing to expand health care to uninsured populations. Yesterday's New York Times reported that the OHP has "abandoned its promise of universal care," that physicians "routinely find ways to get around [that] rationing" and that the Health Care Financing Administration has "impeded efforts to deny more treatments." In addition, the plan has failed to deliver the "expected savings," leaving it with mounting financial problems. And in some ways the plan has backfired, making access to care more difficult because of premiums. The state has conceded that a zero rate of uninsurance -- one of the plan's key goals -- is an impossibility. Gov. John Kitzhaber (D) says he would settle for a rate of 5% or 6%, but to date the plan has cut the state's rate of uninsurance from 15% to 11%. To save money, Kitzhaber wants to toughen screens for applicants and lengthen the approval time of new applications, as well as "raise the rationing line 10 more notches, to No. 564" -- which would cut out treatment for "repairs of ligament damage to knees, treatment for contact dermatitis ... and treatment for genital warts." But Kitzhaber faces "intense federal scrutiny," as well as a Republican- controlled Legislature that is "considering lowering the income levels for eligibility" (Kilborn, 1/3).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.