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APHA Scientific Session and Event Listing

Roy M. Gabriel, PhD, Chandra Lewis, Kelly J. Vander Ley, PhD, Katherine E. Laws, BA, and Dennis D. Deck, PhD. RMC Research Corporation, 111 SW Columbia Street, Suite 1200, Portland, OR 97201-5843, 503-223-8248, rgabriel@rmccorp.com

In the 1990's, the Oregon Health Plan (OHP) was nationally known for its progressive and innovative approach to ensuring health care coverage for all of its citizens. Both substance abuse and mental health (SA/MH) care ranked highly on OHP's prioritized list of covered conditions. In 2003, the state's continuing financial crises moved the legislature to adopt cost-cutting measures that included eliminating the SA/MH benefit for the majority of the OHP population. Some 16 months later, these benefits were restored for those who had maintained their OHP enrollment. In the interim, however, nearly 50% of those who had lost the SA/MH benefit disenrolled from the OHP, and these were disproportionately the lowest income and most in need of health care of all kinds. This presentation, from a study funded by the Robert Wood Johnson Foundation, is of the results of highly structured interviews of over 200 OHP clients through these three policy-relevant periods, i.e., full SA/MH benefit (2000 – 2002), no benefit (2003 – 2004), and restored benefit (2004 – present). Results showed a decline in treatment service access for OHP members whether they had lost their SA/MH benefit in 2003 or not. Qualitative evidence noted a decline in overall system capacity to treat given the elimination of benefit coverage during this period. The restoration of the SA/MH benefit in 2004 saw an increase in services, but the increase failed to reach prior levels of service. Implications of short term savings on long term needs for care for this vulnerable population are discussed.

Learning Objectives:

Participants will
• Learn of the statewide health policy shifts in the Medicaid population of Oregon
• Recognize the effects of these policy changes on the Medicaid population in Oregon
• Recognize the trade-off between short term savings and long terms costs in health care for these vulnerable populations

Keywords: Health Disparities, Drug Injectors

Presenting author's disclosure statement:

Not Answered

Handout (.pdf format, 419.5 kb)