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Oregon’s Health Care Rationing Plan for Poor and Uninsured in Trouble

Oregon’s controversial health care rationing plan is in serious financial trouble.

The plan is unique among state Medicaid programs because it rations medical treatment for poor and low-income uninsured Oregonians by ranking services according to priority.

Treatments ranked above a cut-off line are covered; those beneath the cut-off are not.

The line is set every two years based largely on budgetary constraints. In 1994, the list of possible treatments numbered 1 to 745, with the cutoff line at 606. In 2004, only 730 treatments were listed, with the cutoff line at 546. [OR Health Services Commission, "Report to Governor & Legislature," 3/05]

Today, the plan lists fewer services (710), covers fewer people (enrollment is down 75%), and the state’s uninsured rate has jumped to 17%. [Health Affairs, 12/19/06]
The situation puts the poor and uninsured in the dangerous position of not being able to pay for needed and costly care in a state where the inexpensive treatment called physician-assisted suicide (ranked 262 on the list under "comfort care") is readily available.

It may be the only "treatment" some people can afford.
[, Vol 21, No.1, 2007]