Brigette Courtot, Senior Health Policy Analyst

by Brigette Courtot, Policy Analyst
National Women’s Law Center

Yesterday’s Powerball lottery prize was a cool $133 million. Like lots of other people dreaming of winning big, I bought my ticket. No surprise that I didn’t win—despite a penchant for random drawings, I’m just not very lucky when it comes to lottery games. It’s a good thing, then, that I’m not a poor and uninsured Oregonian. If I were, a chance in the lottery could be my best and only option for getting health insurance.

You see, Oregon has recently reopened enrollment for its Oregon Health Plan (OHP) Standard component – this is the state’s Medicaid program for poor adults who aren’t otherwise eligible for public coverage (pregnant women, very poor custodial parents, and disabled people are covered under a different component of Medicaid, called OHP Plus). This is the first time that enrollment has opened in nearly four years. I could write an entire blog post about the misfortunes of OHP Standard, but here it is in a nutshell: Like many states, Oregon faced a serious budget deficit in 2002 and OHP Standard went to the chopping block. In the years that followed, the program was a favorite target for budget cuts. The state increased fees for program enrollees, cut benefits (including prescription drugs, mental health and dental services), put strict rules in place about premium payments, and eventually put an indefinite cap on enrollment. And the cumulative effect of all this? The OHP Standard enrollment crashed…big time. In 2002 there were approximately 102,000 people in the program, but by late 2003 (even before enrollment closed) enrollment had declined by 50 percent. Presently, around 19,000 people are covered through OHP Standard, but the program funds can support about 24,000 people.