(The Oregon Health Plan . . . )
Insurance reform, aimed at making insurance company sales and pricing practices more equitable, has moved ahead not only in Oregon but at the federal level and in many other states. It could and should have happened with or without the Oregon Health Plan.
Rhetoric: Voters should pass the 1996 tobacco tax to fund maintenance and expansion of the Oregon Health Plan.
Reality: Only $20 million of the $160 million tobacco tax went to fund expansion of the Oregon Health Plan. That $20 million was dedicated to increasing Oregon Health Plan coverage to pregnant women and children under 12 with incomes up to 170% of the poverty level. $23 million was dedicated to a voucher program, aimed at giving working uninsured Oregonians with incomes below 200% of the poverty level a voucher to go out and buy insurance on the private market. This program, known as the Family Health Insurance Assistance Plan (FHIAP) has no limits on out-of-pocket costs, and no requirements for a comprehensive or even prevention-oriented package of health benefits. It is a far cry from what most Oregonians believe the Oregon Health Plan is about. Three-quarters of the tobacco tax was sucked into the general fund, supposedly dedicated to maintaining current benefits for current Oregon Health Plan enrollees.
The Promise of the Plan
Opponents of the Oregon Health Plan reading this article might have room to say: See I told you so ... its not working. But the truth is that the Oregon Health Plan has provided health coverage to 100,000 Oregonians who were previously uninsured. The problems we are seeing with access are more a result of managed care in general, not the Oregon Health Plan in particular. The fact that we have barely made a dent in the numbers of Oregons uninsured has a lot to do with an increasing part-time, temporary labor force, a shift in Oregons industry and the willingness or ability of employers to continue providing insurance coverage. It has less to do with the barriers the Oregon Health Plan has put up for people below poverty who should be eligible for the program. The vast majority of people below poverty now have insurance in Oregon! The Oregon Health Plan deserves our support. As a taxpayer supported program, it demands our vigilance. And as a promise of a better and healthier tomorrow, it requires our advocacy.
Advocacy opportunities abound for people interested in restoring the dream of the Oregon Health Plan. The Plan is being massaged, recrafted and reshaped even as you read this. The federal government, in a sweeping acknowledgement that the wealthiest nation and the most expensive health care system on earth cannot continue to leave people (particularly children) out in the cold, approved a $24 billion tobacco tax targeted at providing health coverage to children under 19 with incomes under 200% of the federal poverty level. Oregon will get $40 million a year for 5 years to implement that program. Decisions are being made about how to get the biggest bang for our buck.
The dream for universal coverage is not dead yet. We have a Governor who has stated clearly and repeatedly that that is Oregons goal. The dream that one day your health plan will give you access to every type of provider licensed or certified to practice in Oregon, and to preventive treatment in the truest sense of the word, must be kept alive.
To get an application for, and information about the Oregon Health Plan, call 1-800-359-9517.
Ellen Pinney is Director of the Oregon Health Action Campaign (OHAC). She can be reached at (503) 581-6830 or 1-800-789-1599.
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