Funding for this study was provided by the Office for Oregon Health Policy and Research (OHPR) through a Robert Wood Johnson Foundation State Coverage Initiatives Grant and by the Oregon Office of Medical Assistance Programs (OMAP).
Oregon Health Plan, Health insurance -- Oregon, Health Services Accessibility
In February 2003, in an effort to expand Medicaid coverage within tight fiscal constraints, the Oregon Health Plan (OHP) underwent a significant redesign of benefits, cost-sharing and premium structure. The OHP2 redesign resulted in two tiers of coverage, OHP Plus and OHP Standard, and a premium subsidy program. The OHP Plus benefit package and cost sharing structure is similar to the original OHP and serves the federally-mandated Medicaid populations: children and pregnant women, low-income elderly and individuals meeting the SSI definition of disability. OHP Standard, designed for Oregon’s expansion population,1 includes a reduced benefit package, expanded co-pays and increased premiums. Premium rules were also tightened for the OHP Standard group: individuals are now disqualified from benefits for non-payment of premiums and locked-out from OHP for six months following a disqualification. In addition, monthly premiums are no longer waived for certain groups.(e.g., homeless, zero income).
In order to assess the impact of recent program changes, a mail-return survey was conducted between November 2003 and February 2004 with a random sample of OHP beneficiaries who were enrolled as of February 2003, immediately before the program changes were implemented.
The survey assessed issues related to enrollment, health care access, health care use, and financial and health status and covered a six-month period following the OHP changes. A total of 2,783 individuals completed surveys, 1,405 individuals in OHP Plus and 1,378 in OHP Standard. This report presents descriptive survey results for the 1,378 OHP Standard enrollees and addresses the impact of recent program changes on 3 key outcomes: enrollment, health care access, and utilization.
Carlson, Matthew J. and Wright, Bill J., "The Impact of Program Changes on Enrollment, Access, and Utilization in the Oregon Health Plan Standard Population" (2005). Sociology Faculty Publications and Presentations. 14.