Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #108161

Roy M. Gabriel, PhD, Dennis D. Deck, PhD, Kelly Vander Ley, PhD, and Katherine E. Laws, BA. RMC Research Corporation, 522 S.W. Fifth Avenue, Suite 1407, Portland, OR 97204, 503-223-8248, roy_gabriel@rmccorp.com

A decade ago, 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. Despite published evidence of its success in terms of improved access to care and sustained improvement of clients served in the system, the state's financial crises moved the legislature to adopt cost-cutting measures that included eliminating the SA/MH benefit for the majority of the OHP population in 2003. 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, charts population-wide trends in OHP enrollment and participation in treatment since 2000, a time period encompassing the full range of this natural experiment, i.e., full SA/MH benefit (2000 – 2002), no benefit for the majority of the OHP population (2003 – 2004), and restored benefit for those who remained on OHP (2004 – present). Results presented here include those of statewide administrative data analysis, interviews with a sample of clients who lost their SA/MH benefits in 2003, and interviews with key stakeholders and policy makers on the intents and consequences of these massive policy changes.

Learning Objectives: At the conclusion of this session, participants will be able to

• Recognize the distinct statewide policy shifts in Medicaid coverage of substance abuse and mental heatlh care in Oregon since 2000.
• Describe the impacts the loss of benefits has had on the state's most vulnerable citizens
• Discuss the implications of such dramatic shifts in policy on the health and well-being of those afflicted with substance abuse and mental health disorders.

Keywords: Drug Abuse Treatment, Health Insurance

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.