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Second opinion: Health plan diagnosed State expansion plan could mean adjustments ... and cuts By BILL KETTLER John Statler expects a spirited crowd Wednesday when Oregon Health Plan officials come to Medford to talk about reducing medical benefits for about 90,000 people statewide. "It should be a lively meeting," said Statler, who works with Project Equality, an organization that provides support for Health Plan members. "We have some pretty vocal people in Medford." In July, legislators approved an expansion plan that will bring health care to an additional 50,000 Oregonians. The expansion plan also cuts benefits for some 90,000 nondisabled adults currently enrolled in the plan. Legislators adopted the "two-tiered" plan as a way to expand the health plan without spending more money to do it. One of every seven Jackson County residents (about 23,000 people) receives medical care through the Oregon Health Plan. The Medford meeting is one of nine scheduled around the state to discuss which services the state should cut to implement the two-tiered plan. About three-fourths of the health plan's current enrollees will continue to receive the same medical benefits, said Darren Coffman, director of the state Health Services Committee. That group of 270,000 people includes children, pregnant women, elderly people, those with disabilities, and people who receive cash assistance from the state. "The vast majority (of enrollees) won't see their benefits change," Coffman said. Benefits that OHP considers "optional" will be cut for 90,000 people, mostly adults who are not disabled, he said. Those benefits include: prescription drugs, mental health counseling, vision service, medical equipment (such as wheelchairs), dental service and nonemergency medical transportation. Coffman said people who attend the meetings around the state will be asked to rank those optional benefits. They will also be asked to consider options that are commonly included in private sector health insurance. Those options could include paying a deductible amount before insurance benefits take effect, or making a co-payment for each doctor visit. Statler said cutting benefits for people who already have little or no discretionary income will just create more demand for services in other sectors. Cutting benefits "will be a personal problem for those people, but it'll be a community problem, too," he said. Eliminating prescription benefits could put more pressure on food banks, he said, if people have to buy medicines that are now covered by the OHP. "People will be forced to choose between medicine, or food or electricity," he said. Coffman said the Health Services Commission will use the opinions collected at the meetings to decide which benefits to cut in the two-tiered benefit system. He could not say how many additional Jackson County residents might be eligible for the health plan under the new system. The health plan debuted in 1994 with high hopes that it would bring better medical care to hundreds of thousands of Oregonians who had no private health insurance. The state contracted with health-insurance companies to provide HMO-style care to low-income people. Over the years, many insurance companies have dropped out of the plan in Southern Oregon, citing costs that exceeded their reimbursements from the state. One insurer, CareOregon, still carries contracts for about 3,100 OHP members in Jackson County. Three other insurers have contracts for an additional 600 Jackson County residents. Thousands of people are enrolled in the plan with "open cards." They see doctors who bill the health plan directly. Some doctors have declined to treat OHP "open-card" patients, saying state reimbursements fall short of their costs for providing services. Reach reporter Bill Kettler at 776-4492, or e-mail [email protected] Mail Tribune Home | Ottaway Newspapers, Inc. | Dow Jones & Co., Inc. | Privacy | Contact Us Copyright � 2001 Mail Tribune, Inc.