Welcome to Scribd. Sign in or start your free trial to enjoy unlimited e-books, audiobooks & documents.Find out more
Download
Standard view
Full view
of .
Look up keyword
Like this
5Activity
0 of .
Results for:
No results containing your search query
P. 1
Evaluation of the Oregon Medicaid Proposal

Evaluation of the Oregon Medicaid Proposal

Ratings:

5.0

(1)
|Views: 591|Likes:
Published by Chris Nash
On August 16, 1991, Oregon petitioned the Federal Government for permission to use Federal funds in a novel health care financing program. The proposed program is premised on two basic assumptions:

1. all uninsured poor people should have publicly funded health care coverage, and
2. coverage for this population can be made affordable to the taxpayers through a combination of two mechanisms: the explicit prioritization of health care services, and the delivery of covered services through managed care systems.

Oregon’s plan to revamp its system of health care coverage was motivated by the steadily increasing costs of health care to the public treasury and the large number of Oregonians who have no health insurance. The State has estimated that between 400,000 and 450,000 Oregonians, or about 16 percent of the State’s population, are uninsured.

To address this latter problem, the Oregon legislature passed the Oregon Basic Health Services Act in 1989, which established three mechanisms for increasing access to health insurance. For individuals who could not qualify for private insurance due to a ‘‘preexisting health condition, ’ the State established a high-risk insurance pool with subsidized premiums. For individuals whose employers do not offer health insurance benefits, the State established a program that provides incentives for, and ultimately mandates, small businesses to provide such insurance to their employees. And for poor uninsured individuals, the Basic Health Services Act expanded the State Medicaid program to cover all residents with incomes up to 100 percent of the Federal poverty level (FPL).
On August 16, 1991, Oregon petitioned the Federal Government for permission to use Federal funds in a novel health care financing program. The proposed program is premised on two basic assumptions:

1. all uninsured poor people should have publicly funded health care coverage, and
2. coverage for this population can be made affordable to the taxpayers through a combination of two mechanisms: the explicit prioritization of health care services, and the delivery of covered services through managed care systems.

Oregon’s plan to revamp its system of health care coverage was motivated by the steadily increasing costs of health care to the public treasury and the large number of Oregonians who have no health insurance. The State has estimated that between 400,000 and 450,000 Oregonians, or about 16 percent of the State’s population, are uninsured.

To address this latter problem, the Oregon legislature passed the Oregon Basic Health Services Act in 1989, which established three mechanisms for increasing access to health insurance. For individuals who could not qualify for private insurance due to a ‘‘preexisting health condition, ’ the State established a high-risk insurance pool with subsidized premiums. For individuals whose employers do not offer health insurance benefits, the State established a program that provides incentives for, and ultimately mandates, small businesses to provide such insurance to their employees. And for poor uninsured individuals, the Basic Health Services Act expanded the State Medicaid program to cover all residents with incomes up to 100 percent of the Federal poverty level (FPL).

More info:

Categories:Types, School Work
Published by: Chris Nash on Jul 26, 2008
Copyright:Attribution Non-commercial

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
download as PDF, TXT or read online from Scribd
See more
See less

09/06/2012

pdf

text

original

 
 Evaluation of the Oregon Medicaid Proposal
May 1992
OTA-H-531NTIS order #PB93-116192
 
Recommended Citation:
U.S. Congress, Office of Technology Assessment,
 Evaluation of the Oregon Medicaid Proposal, OTA-H-531
(Washington, DC: U.S. Government Printing Office, May 1992).
I
 
()]
 
\cilcs
 
h}
 
the
 
[1
S (
io~t.rnl]lcnl
 
PIIfI(IIlg
 
ot
 
IICC
\upL$l
 
Illtcll{lclll
 
(It
 
l)(lcumL’
Ill\,
Nl,lll
slop
Ssol’,
 
u
 
Jdllllgt(m.
I)(
20402”
 
9
 
3?s
I SBN 0-16 -038015-4
 
Foreword
As part of an eventual statewide set of health insurance reform measures, the State of Oregon has proposed implementing a demonstration program, with Federal cofunding, thatwould change the State’s existing Medicaid program in three fundamental ways. It would: 1)
expand coverage to include all persons with incomes up to 100 percent of the Federal poverty
level; 2) enroll all covered persons in some form of managed care, such as with a health
maintenance organization or a ‘‘gatekeeper’ primary care physician; and 3) determine
acuteand primary health care benefits according to a ranked list of services, with actual benefitsdependent on the level of program funding.
Concern about the effects of Oregon’s Medicaid proposal on program recipients, and the
potential ramifications of the proposal for the ongoing national health care debate, prompted
Congress to ask the Office of Technology Assessment to examine the proposal in detail. This
report was prepared in response to a request from Representative John Dingell, chairman of the House Committee on Energy and Commerce, and Representative Henry Waxman,chairman of the House Subcommittee on Health and the Environment, The request for thisstudy was endorsed by Senator Al Gore, Chairman of the Senate Subcommittee on Science,Technology, and Space, and by the Oregon delegation, including Senator Bob Packwood,
Senator Mark Hatfield, Representative Les AuCoin, Representative Peter DeFazio, Represen-tative Mike Kopetski, Representative Ron Wyden, and Representative Robert F. (Bob) Smith.
Many individuals-both in favor of and opposed to the Oregon proposal-have urgedOTA to explicitly recommend whether the proposed demonstration should be approved or toexplicitly conduct a political analysis on the need for rationing health care services. We feltthat at least one organization examin
ing the Oregon proposal should confine its examination
to technical critique and evaluation of potential consequences—both positive and negative--of the proposed demonstration. This is the approach OTA took. We hope that the resultingreport will therefore be not only useful to the Congress and others as they look at the Oregonplan but also relevant to States and other parties as they consider ways to reform the health
care system.
This OTA assessment was greatly assisted by an advisory panel, chaired by Lincoln
Moses, Professor of Statistics, Stanford University. In addition, a large number of individuals,
including many from the State of Oregon, provided information and reviewed drafts of the
report.
OTA gratefully acknowledges the contribution of each of these individuals. As with allOTA reports, the final responsibility for the content of the assessment rests with OTA.
u
JOHN H. GIBBONS
 Director 
,..
Ill

Activity (5)

You've already reviewed this. Edit your review.
1 hundred reads
1 thousand reads
nietoc liked this
nietoc liked this
mankuat liked this

You're Reading a Free Preview

Download
scribd
/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->