637:
was denied because of the drug's limited benefit and very high cost, which would have led to the denial of access to well-established, first-line treatments for other cancer patients. Kitzhaber and Saha stated that "the idea that treatment has ever been denied because death would be more 'cost effective'...is both abhorrent and a blatant distortion of the facts. he fact that is covered by the health plan has no bearing on the decision in this or any other case."
532:
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
636:
newspaper in response to the twisting of Wagner's story in the media. According to
Kitzhaber and Saha, the Oregon Health Plan covers nearly all chemotherapy prescribed for cancer patients, including the multiple rounds of chemotherapy that Wagner received; Wagner's request for second-line treatment
462:
or CCOs. A CCO is a network of all types of health care providers who are working together for people who receive health care coverage under the Oregon Health Plan. CCOs integrate physical, mental and eventually dental care for better health, better care and lower costs. CCOs focus on prevention of
425:
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 enrolled, and bad debts at
686:
In June 2011, the Oregon
Legislature with bi-partisan support created Medicaid (Oregon Health Plan) transformation with House Bill 3650. The goal of this legislation is to develop a health care delivery system managed by Coordinated Care Organization for Oregon Health Plan clients that are
450:
Oregon's proposed Oregon Health Plan (Medicaid) transformation was initiated by Oregon House Bill 3650, which was passed by the state
Legislature with bi-partisan support in June 2011. In March, Oregon Senate Bill 1580 was signed into law by Governor John Kitzhaber establishing
687:
community-based, and have the flexibility to deliver better care, better health at lower costs. In March, 2012, Oregon Senate Bill 1580 was signed into law by
Governor John Kitzhaber establishing Coordinated Care Organizations for Oregon Health Plan clients.
438:
began implementing changes to
Medicaid policy to increase screening rates and provide more access to services for young children at risk of developmental disorders. Some of these changes included revising certification requirements for patient-centered
446:
The Oregon Health Plan was expanded to cover 80,000 uninsured children through legislation that passed in 2009. The program has enrolled 38,000 additional children through
February, 2010. As of 2012, there are more than 100,000 children enrolled.
571:
In 2017, the second-largest
Medicaid insurer, FamilyCare, shut down; its 100k Portland-area will largely be absorbed by another Medicaid insurer, Health Share. Health Share is related to CareOregon, which absorbed 80k members.
587:
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.
232:
429:
The cost of the Oregon Health Plan increased from $ 1.33 billion in 1993–1995 to $ 2.36 billion in 1999–2001, leading to budget-tightening measures in the early 2000s; significant cuts would follow in 2003.
414:, and Dr. Ralph Crawshaw, a Portland activist. It was intended to make health care more available to the working poor, while rationing benefits. During the 1990s, Oregon was considered a national leader in
433:
New enrollment in the program was 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 openings. In 2008, the
1783:
220:
533:
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.
521:
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.
362:
625:
agreed to supply her the $ 4,000-a-month drug free of charge. Wagner's plight garnered a flurry of attention from the media, the internet, and triggered protest from religious groups.
902:"State Medicaid Program Adopts Multiple Policies to Significantly Increase Screening Rates and Enhance Access to Services for Young Children at Risk of Developmental Disabilities"
1653:
1778:
683:. 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.
214:
591:
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
208:
1983:
901:
1993:
355:
1768:
524:
In January 2010, most vision and some dental benefits were cut from OHP Plus due to budget deficits with the benefits partially restored later in January 2014.
77:
1621:
769:
498:
613:
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
1449:
1024:
985:
537:
238:
226:
1484:
348:
36:
131:
1998:
200:
71:
1473:
660:
effort toward crafting legislation and solving Oregon's health care problems. The Archimedes Movement also has a close relationship with the
576:
144:
1988:
1413:
960:
1376:
1274:
1107:
1582:
536:
Effective January 2014, the OHP Standard package was transitioned into OHP Plus as part of the state's implementation of the federal
699:
1848:
1614:
1248:
680:
668:
565:
267:
727:
1875:
1431:
618:
179:
173:
167:
22:
1957:
1687:
83:
1350:
923:
1978:
1885:
1880:
1859:
1823:
1819:
1799:
1647:
561:
459:
452:
1178:
443:(PCMH) status to include developmental screenings for children at the 9-month, 18-month, and 30-month well-child visits.
1842:
1713:
1642:
1502:
632:
and Somnath Saha, a Portland physician and then-chairwoman of the Oregon Health Services Commission, issued an op-ed in
149:
113:
661:
1937:
1703:
1607:
509:
Since a February 2003 adjustment to the Oregon Health Plan, it consists of two main plans, OHP Plus and OHP Standard.
455:, which will focus on prevention and coordination of physical, mental and dental care for Oregon Health Plan clients.
125:
803:
564:, which included some of the preexisting organizations such as CareOregon, PacificSource, and FamilyCare as well as
1942:
1735:
1311:"Oregon Rationing Cancer Treatment but Offering Assisted Suicide to Cancer Patients: Paying to Die but not to Live"
327:
287:
102:
1154:
1078:
828:
777:
1672:
1020:
107:
575:
From 2016 to 2018, CareOregon, which was founded in 1994 by providers with the Oregon Primary Care Association,
2003:
1708:
672:
305:
54:
1453:
2008:
1085:
887:
868:
553:
467:
435:
388:
1231:
1127:
1046:
482:, as a citizen or otherwise. The level of coverage is based on income, age, mental and physical condition.
1677:
463:
illness and disease and improving care to keep patients healthy and to manage existing health conditions.
421:
The law passed in Oregon was not initially compatible with federal law, so a waiver was needed. President
119:
62:
1377:"A Gift of Treatment – When the Oregon Health Plan fails to cover a cancer drug, the drug maker steps in"
1900:
1745:
1682:
549:
494:
310:
42:
999:
579:, and Multnomah County Health Department, lost about $ 96m. Various other plans showed losses as well.
552:
system, the plan has contracts with a number of private and nonprofit companies who provide care for a
1947:
1740:
1064:
690:
In August 2012, the first Coordinated Care Organizations opened to serve Oregon Health Plan clients.
187:
493:, folding previous OHP eligibility requirements into a single income requirement; up to 138% of the
1890:
1750:
1664:
653:
602:
486:
411:
1895:
1760:
1730:
1589:
649:
490:
415:
154:
964:
750:
1952:
1854:
1837:
1773:
1310:
979:
1395:
1207:
1135:
614:
557:
1578:
1517:
676:
629:
517:
OHP Plus is a full benefit package offered to children and adults who are eligible for
407:
400:
333:
315:
1292:
1155:"Oregon's second largest Medicaid carrier will shut down after impasse with the state"
1139:
1972:
1921:
735:
633:
257:
596:
592:
458:
Starting in 2012, Oregon Health Plan clients have a new type of health plan called
440:
422:
320:
161:
1000:"Where the states stand on Medicaid expansion; 28 states, D.C. expanding Medicaid"
1916:
1354:
466:
The legal foundation for the OHP is generally spelled out in Chapter 414 of the
281:
1599:
1332:
1249:"Oregon Health Insurance Companies Report Big Losses In 2018 | The Lund Report"
1128:"Oregon's High-Risk, High-Reward Gamble On Medicaid Expansion | Health Affairs"
657:
606:
1293:"Statement of Intent for the Prioritized List of Health Services, page SI-1"
622:
403:
1485:"Oregon health plan covers assisted suicide, not drugs, for cancer patient"
1518:"Oregon Death with Dignity program spurs fierce debate, intense criticism"
501:
programs had increased to 1,030,940 people (26% of the state population).
621:. She appealed the denial twice, but lost both times. Tarceva drugmaker
518:
384:
277:
48:
850:
1414:"Oregon Health Plan has already weighed the cost of life ... (Wizbang)"
1208:"CareOregon, major Medicaid player, approaches $ 100 million in losses"
671:
passed the Healthy Oregon Act (Senate Bill 329), which established the
610:
66:
599:
for patients with less than a 5% chance of survival over five years.
479:
380:
1535:
261:
233:
Health Information Technology for Economic and Clinical Health Act
640:
Wagner died in October 2008, three weeks after starting Tarceva.
1603:
675:. This seven member advisory panel worked with former Governor
478:
Basic eligibility requires that the applicant be a resident of
942:
804:"U.S. Backs Oregon's Health Plan for Covering All Poor People"
221:
Medicare Prescription Drug, Improvement, and Modernization Act
869:"Thousands seek a spot on state health plan reservation list"
399:
The Oregon Health Plan was conceived and realized in 1993 by
1275:"A Prescription Plan Lauded as a Model Is a Budget Casualty"
904:. Agency for Healthcare Research and Quality. 2013-09-11
497:. By December 2014, enrollment in Oregon's Medicaid and
1536:"About Us - We Can Do Better - The Archimedes Movement"
1108:"Public gets sneak peek at Oregon Health Plan's future"
1563:
Glascock, Stuart (March 10, 2008). "A Healthy Wager".
829:"Elsewhere, there are saner ways to help mentally ill"
1450:"Southern Belle Politics: Are You Ready to die Soon?"
1549:
924:"Governor signs bill assuring kids health insurance"
1930:
1909:
1868:
1830:
1813:
1792:
1759:
1723:
1696:
1663:
1635:
215:
Health Insurance Portability and Accountability Act
51:/ State Health Insurance Assistance Program (SHIP)
1333:"Letter noting assisted suicide raises questions"
209:Emergency Medical Treatment and Active Labor Act
1002:. The Advisory Board Company. February 11, 2015
1615:
356:
78:Program of All-Inclusive Care for the Elderly
8:
1779:Land Conservation and Development Act (1973)
797:
795:
721:
719:
717:
715:
1179:"Four implications of FamilyCare's closing"
628:On August 26, 2008, former Oregon Governor
1622:
1608:
1600:
1583:"Governor Kulongoski's letter to the OHFB"
1503:"The values behind state health decisions"
1309:Stevens, Kenneth R. Jr. (March 26, 2009).
1201:
1199:
1025:Centers for Medicare and Medicaid Services
538:Patient Protection and Affordable Care Act
363:
349:
239:Patient Protection and Affordable Care Act
227:Patient Safety and Quality Improvement Act
18:
1394:Donaldson James, Susan (August 6, 2008).
844:
842:
37:Federal Employees Health Benefits Program
1800:Death with Dignity Act (1994 Measure 16)
1021:"Oregon - Medicaid-Marketplace Overview"
1550:"The Foundation for Medical Excellence"
888:"Oregon Holds Health Insurance Lottery"
711:
21:
1984:United States state health legislation
984:: CS1 maint: archived copy as title (
977:
751:"Activist's ideals give rise to ideas"
732:Willamette Week 25 Years retrospective
1994:Medicare and Medicaid (United States)
145:Health insurance in the United States
7:
1516:Maynard, Steve (November 11, 2008).
1396:"Death Drugs Cause Uproar in Oregon"
941:Kalinoski, Stacie (March 17, 2010).
560:designed a new type of plan called
485:In 2014, the state implemented the
72:Children's Health Insurance Program
1045:Steves, David (October 26, 2003).
648:Following the end of two terms as
14:
1784:Measure 37 (2004) & 49 (2008)
1351:"Worth Reading » Death care"
1140:10.1377/forefront.20170110.058188
1079:"OHP Standard to Plus Fact Sheet"
886:Skidmore, Sarah (March 4, 2008).
827:Korn, Peter (February 27, 2007).
768:Korn, Peter (February 27, 2007).
700:Oregon Medicaid health experiment
662:Foundation for Medical Excellence
609:prescribed the chemotherapy drug
605:resident Barbara Wagner said her
577:Oregon Health Sciences University
566:independent practice associations
406:(and subsequent Oregon governor)
1849:Measures 47 (1996) and 50 (1997)
1436:thehappyhospitalist.blogspot.com
1331:Harding, Susan (July 31, 2008).
1106:Budnick, Nick (6 January 2019).
922:Steves, David (August 5, 2009).
426:Portland hospitals dropped 16%.
268:Massachusetts health care reform
1273:Egan, Timothy (March 3, 2003).
802:Pear, Robert (March 20, 1993).
749:Jacklet, Ben (August 5, 2005).
679:to propose legislation for the
669:2007 Oregon legislative session
387:program. It is overseen by the
180:Preferred provider organization
174:Health maintenance organization
168:Exclusive provider organization
23:Healthcare in the United States
1688:List of Oregon ballot measures
1650:(mandatory minimum sentencing)
1375:Christie, Tim (June 3, 2008).
849:Clark, Taylor (June 9, 2004).
562:Coordinated Care Organizations
556:fee. In 2012, a Section 1115
460:Coordinated Care Organizations
453:Coordinated Care Organizations
139:Private Fee-For-Service (PFFS)
84:Veterans Health Administration
59:Prescription Assistance (SPAP)
1:
1999:1994 establishments in Oregon
1886:Alcoholic beverages in Oregon
1716:(homosexuality and education)
1232:"CareOregon: The Early Years"
1153:Oregonian, The (2017-12-21).
943:"Healthy Kids Boosts Numbers"
150:Health insurance marketplaces
16:Oregon state Medicaid program
1630:Topics in Oregon legislation
1206:Manning, Jeff (2018-08-25).
770:"Some forge ahead on reform"
652:, Kitzhaber established the
114:Health reimbursement account
1989:Healthcare reform in Oregon
1931:Background, further reading
1047:"40,000 Poor Lose Coverage"
728:"In sickness and in health"
644:Ongoing legislative efforts
126:High-deductible health plan
2025:
1943:Direct democracy in Oregon
328:Fair Share Health Care Act
288:Vermont health care reform
103:Consumer-driven healthcare
31:Government health programs
1673:Direct Legislation League
300:Municipal health coverage
108:Flexible spending account
1876:Compulsory Education Act
1709:Oregon Citizens Alliance
673:Oregon Health Fund Board
619:physician-assisted dying
544:Managed care contractors
306:Healthcare in California
1432:"The Happy Hospitalist"
1086:Oregon Health Authority
468:Oregon Revised Statutes
436:Oregon Health Authority
389:Oregon Health Authority
132:Medical savings account
97:Private health coverage
1958:Oregon ballot measures
1654:Measure 40 (1996) etc.
336:(Howard Co., Maryland)
120:Health savings account
63:Military Health System
1901:Drug policy of Oregon
1381:Eugene Register-Guard
1253:www.thelundreport.org
1132:www.healthaffairs.org
1051:Eugene Register-Guard
928:Eugene Register Guard
656:, which aims to be a
550:Medicaid managed care
495:federal poverty level
311:Healthy San Francisco
43:Indian Health Service
1979:Government of Oregon
1851:(adjusted Measure 5)
1665:Elections and voting
1636:Crime and sentencing
1489:Catholic News Agency
188:Medical underwriting
1522:Tacoma News-Tribune
1088:. November 15, 2013
890:. Associated Press.
875:. February 4, 2000.
654:Archimedes Movement
487:Affordable Care Act
1938:Oregon legislature
1910:Influential people
1896:Cannabis in Oregon
1845:(landmark tax law)
1805:Oregon Health Plan
1643:Capital punishment
1590:Governor of Oregon
1279:The New York Times
808:The New York Times
650:Governor of Oregon
491:Medicaid expansion
416:health care reform
377:Oregon Health Plan
273:Oregon Health Plan
252:State level reform
201:Health care reform
155:Premium tax credit
1966:
1965:
1948:Oregon government
1860:Measure 97 (2016)
1855:Kicker tax rebate
1774:Beach Bill (1967)
1704:Same-sex marriage
1656:(victims' rights)
1648:Measure 11 (1994)
1565:Los Angeles Times
373:
372:
2016:
1843:Measure 5 (1990)
1714:Measure 9 (1992)
1624:
1617:
1610:
1601:
1594:
1593:
1587:
1575:
1569:
1568:
1560:
1554:
1553:
1546:
1540:
1539:
1532:
1526:
1525:
1513:
1507:
1506:
1499:
1493:
1492:
1481:
1475:
1471:
1465:
1464:
1462:
1461:
1452:. Archived from
1446:
1440:
1439:
1428:
1422:
1421:
1420:. 4 August 2009.
1410:
1404:
1403:
1391:
1385:
1384:
1372:
1366:
1365:
1363:
1362:
1353:. Archived from
1347:
1341:
1340:
1328:
1322:
1321:
1315:
1306:
1300:
1299:
1297:
1289:
1283:
1282:
1270:
1264:
1263:
1261:
1260:
1245:
1239:
1238:
1236:
1228:
1222:
1221:
1219:
1218:
1203:
1194:
1193:
1191:
1190:
1175:
1169:
1168:
1166:
1165:
1150:
1144:
1143:
1124:
1118:
1117:
1115:
1114:
1103:
1097:
1096:
1094:
1093:
1083:
1075:
1069:
1068:
1061:
1055:
1054:
1042:
1036:
1035:
1033:
1032:
1017:
1011:
1010:
1008:
1007:
996:
990:
989:
983:
975:
973:
972:
963:. Archived from
957:
951:
950:
938:
932:
931:
919:
913:
912:
910:
909:
898:
892:
891:
883:
877:
876:
873:Portland Tribune
865:
859:
858:
846:
837:
836:
833:Portland Tribune
824:
818:
817:
815:
814:
799:
790:
789:
787:
785:
776:. Archived from
774:Portland Tribune
765:
759:
758:
755:Portland Tribune
746:
740:
739:
734:. Archived from
726:Lydgate, Chris.
723:
365:
358:
351:
19:
2024:
2023:
2019:
2018:
2017:
2015:
2014:
2013:
2004:Oregon statutes
1969:
1968:
1967:
1962:
1926:
1905:
1881:Adoption rights
1864:
1826:
1809:
1788:
1755:
1719:
1692:
1659:
1631:
1628:
1598:
1597:
1585:
1579:Kulongoski, Ted
1577:
1576:
1572:
1562:
1561:
1557:
1548:
1547:
1543:
1534:
1533:
1529:
1515:
1514:
1510:
1501:
1500:
1496:
1483:
1482:
1478:
1472:
1468:
1459:
1457:
1448:
1447:
1443:
1430:
1429:
1425:
1418:wizbangblog.com
1412:
1411:
1407:
1393:
1392:
1388:
1374:
1373:
1369:
1360:
1358:
1349:
1348:
1344:
1330:
1329:
1325:
1313:
1308:
1307:
1303:
1295:
1291:
1290:
1286:
1272:
1271:
1267:
1258:
1256:
1255:. 11 March 2019
1247:
1246:
1242:
1234:
1230:
1229:
1225:
1216:
1214:
1205:
1204:
1197:
1188:
1186:
1183:State of Reform
1177:
1176:
1172:
1163:
1161:
1152:
1151:
1147:
1126:
1125:
1121:
1112:
1110:
1105:
1104:
1100:
1091:
1089:
1081:
1077:
1076:
1072:
1063:
1062:
1058:
1044:
1043:
1039:
1030:
1028:
1019:
1018:
1014:
1005:
1003:
998:
997:
993:
976:
970:
968:
961:"Archived copy"
959:
958:
954:
940:
939:
935:
921:
920:
916:
907:
905:
900:
899:
895:
885:
884:
880:
867:
866:
862:
855:Willamette Week
848:
847:
840:
826:
825:
821:
812:
810:
801:
800:
793:
783:
781:
780:on June 8, 2011
767:
766:
762:
748:
747:
743:
725:
724:
713:
708:
696:
646:
615:palliative care
585:
558:Medicaid waiver
546:
530:
515:
507:
476:
397:
369:
340:
339:
301:
293:
292:
253:
245:
244:
204:
193:
192:
98:
90:
89:
32:
17:
12:
11:
5:
2022:
2020:
2012:
2011:
2009:1993 in Oregon
2006:
2001:
1996:
1991:
1986:
1981:
1971:
1970:
1964:
1963:
1961:
1960:
1955:
1953:Oregon history
1950:
1945:
1940:
1934:
1932:
1928:
1927:
1925:
1924:
1919:
1913:
1911:
1907:
1906:
1904:
1903:
1898:
1893:
1888:
1883:
1878:
1872:
1870:
1866:
1865:
1863:
1862:
1857:
1852:
1846:
1840:
1834:
1832:
1828:
1827:
1817:
1815:
1811:
1810:
1808:
1807:
1802:
1796:
1794:
1790:
1789:
1787:
1786:
1781:
1776:
1771:
1765:
1763:
1757:
1756:
1754:
1753:
1748:
1743:
1738:
1733:
1727:
1725:
1721:
1720:
1718:
1717:
1711:
1706:
1700:
1698:
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1680:
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1669:
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1661:
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1658:
1657:
1651:
1645:
1639:
1637:
1633:
1632:
1629:
1627:
1626:
1619:
1612:
1604:
1596:
1595:
1581:(2008-06-10).
1570:
1555:
1541:
1527:
1508:
1494:
1476:
1466:
1441:
1423:
1405:
1386:
1367:
1342:
1323:
1301:
1284:
1265:
1240:
1223:
1212:oregonlive.com
1195:
1170:
1159:oregonlive.com
1145:
1119:
1098:
1070:
1056:
1037:
1027:. January 2015
1012:
991:
952:
933:
914:
893:
878:
860:
838:
819:
791:
760:
741:
738:on 2008-12-07.
710:
709:
707:
704:
703:
702:
695:
692:
677:Ted Kulongoski
645:
642:
630:John Kitzhaber
595:, surgery and
584:
581:
545:
542:
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1814:Minimum wage
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1678:Vote-by-mail
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528:OHP Standard
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441:medical home
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423:Bill Clinton
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321:My Health LA
272:
162:Managed care
1917:Loren Parks
1793:Health care
1746:Solar power
1731:Bottle bill
1724:Environment
1683:Term limits
603:Springfield
583:Controversy
474:Eligibility
282:Connecticut
1973:Categories
1838:Tax revolt
1751:Coal power
1741:Wind power
1697:Gay rights
1460:2009-08-11
1361:2009-08-11
1318:PCM Online
1259:2019-06-15
1217:2019-06-15
1189:2019-06-15
1164:2019-06-15
1113:2019-06-15
1092:2015-03-07
1031:2015-03-07
1006:2015-03-07
971:2019-01-28
908:2013-09-18
851:"Code Red"
813:2008-07-14
706:References
658:grassroots
607:oncologist
330:(Maryland)
1824:25 (2002)
1820:36 (1996)
1818:Measures
623:Genentech
554:capitated
410:, then a
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1831:Taxation
1761:Land use
1400:ABC News
1134:. 2017.
980:cite web
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519:Medicaid
513:OHP Plus
505:Coverage
385:Medicaid
278:SustiNet
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49:Medicaid
611:Tarceva
395:History
67:Tricare
39:(FEHBP)
480:Oregon
404:doctor
381:Oregon
241:(2010)
235:(2009)
229:(2005)
223:(2003)
217:(1996)
211:(1986)
164:(CCP)
128:(HDHP)
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1586:(PDF)
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