Helping vulnerable Oregonians

The Oregon Health Plan opens its doors to new participants for the first time since 2004.

The woman on the phone said she had no health insurance, and she wouldn't be eligible for Medicare coverage for another couple of years. She said she takes good care of herself and is in good health, but her statement was nevertheless startling.

"I haven't seen a doctor since 1995," she said.

She was among more than 91,000 low-income Oregonians who put their names on a reservation list in February in hopes of receiving an application for the Oregon Health Plan's Standard benefit package.

"Seeing 91,675 Oregonians sign up just for a chance to apply for health insurance is a reflection of the vigorous demand for medical coverage," said Jim Edge, state Medicaid director in the Oregon Department of Human Services. "And these people represent only a fraction of the nearly 600,000 Oregonians without coverage."

OHP-Standard is designed for low-income adults who do not qualify for traditional Medicaid coverage.

Nearly one in six Oregonians has no medical insurance, and people who put their names on the reservation list for a chance to receive an application came from all 36 Oregon counties. Enrollment in OHP-Standard, closed since June 2004, is being reopened temporarily because the number of people covered (17,700) has fallen below the number the budget will support (a monthly average of 24,000).

The first 3,000 people whose names were randomly drawn from the reservation list were mailed applications March 10. More applications are scheduled to be mailed in subsequent months.

Randomly drawing names from the reservation list, often called a "lottery," was considered the fairest way of giving everyone an equal chance at a program that can enroll fewer than 20 percent of those believed eligible.

DHS consulted with medical, legal, disability and other stakeholders to craft a process that would be fair to people regardless of where they live or when they put their names on the reservation list; the federal government subsequently authorized the process. To get the word out, DHS undertook the most comprehensive public awareness effort in its history -- working with more than 1,800 stakeholders statewide, distributing posters in English and Spanish, printing 670,000 brochures in 10 languages and sending direct mail to 330,000 Oregon households.

Oregonians had six ways to put their names on the reservation list, including phoning a call center that was open for 25 days (including Presidents Day) from 7 a.m. to 7 p.m.

OHP-Standard covers physician visits, prescription drugs, chemical dependency and mental health treatment, emergency medical care, and limited dental, hospital and vision benefits.

OHP-Standard is a part of the larger Oregon Health Plan, or Medicaid, which enrolls more than 398,000 people statewide. The larger OHP-Plus benefit package always is open to Oregonians who are aged, blind, disabled, pregnant, younger than 19 or recipients of Temporary Assistance to Needy Families benefits. For information about OHP-Plus, call 1-800-359-9517.

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