Swamped Phone Lines Evidence of Demand for Medical Coverage

The number of people we can enroll in Standard is small compared with the estimated 457,000 Oregon adults who lack medical coverage.

Photo courtesy: marsh.ca

(SALEM, Ore.) - The woman on the phone said she had no health insurance, and she wouldn’t be eligible for Medicare coverage for another couple of years. She said she takes good care of herself and is in good health, but her statement was nevertheless startling.

"I haven’t seen a doctor since 1995," she said.

Nearly one Oregonian in six lacks health insurance and, although some are healthy and believe they don’t need it, many are desperate for coverage.

The heavy response to the Oregon Health Plan reservation list for the Standard benefit package – more than 60,000 people put their names on the list in the first 13 days – is evidence of this. The woman who hasn’t seen a doctor in a dozen years is presumably among them.

This will be the first time since June 2004 the Standard plan has been open to new enrollment for low-income, uninsured people who don’t otherwise qualify for Medicaid coverage. To ensure as many Oregonians as possible know about this opportunity, the Oregon Department of Human Services has undertaken the most aggressive public awareness campaign in its history. This includes printing brochures and request forms in 10 languages.

After the reservation list closes February 29th, we will use a recognized computer program to randomly draw names of people to receive applications. Because demand is far greater than the few thousand adults we can enroll, we worked with stakeholders and developed a plan to do this in the fairest possible way.

People can get on the reservation list six different ways, among them by calling toll free 1-800-699-9075 weekdays between 7:00 AM and 7:00 PM, Pacific time; picking up a request form from any DHS office, county health department or major clinic or hospital; or going to the DHS Web site from which one can get on the reservation list electronically.

A person living in Scappoose, Shady Cove or Spray will have the same chance of receiving an application as someone in Salem or Portland. And the last person to put his or her name on the reservation list February 29th will have the same chance of receiving an application as the first caller on January 28th. If you believe you might qualify, I encourage you to get your name on the reservation list.

(The Oregon Health Plan’s separate Plus program is always open to people who are aged, blind, disabled, under age 19, pregnant or receiving Temporary Assistance for Needy Families benefits. To request an application, call 1-800-359-9517.)

The number of people we can enroll in Standard is small compared with the estimated 457,000 Oregon adults who lack medical coverage, 30 percent of whom are believed eligible for Standard. But some of Oregon’s best health-care minds are working on a solution.

Governor Ted Kulongoski appointed the Oregon Health Fund Board to craft recommendations to expand medical coverage to more Oregonians. The ideas will probably be debated by the 2009 Oregon Legislature.

Contributing to the debate will be the pent-up demand for health insurance; the fact the Oregon Health Plan attracts $1.50 in federal funds for every $1 the state invests; and the potential role the Health Plan can play in comprehensive health care reform.

The woman who hasn’t seen a doctor since 1995, and others without health insurance, will presumably want to watch – and perhaps participate in – that debate.

This guest opinion is by Jim Edge, state Medicaid director in the Oregon Department of Human Services. Jim Edge is state Medicaid director in the Oregon Department of Human Services. He can be contacted at jim.edge@state.or.us.

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