Dr. Know: The Oregon Health Plan Returns

Anecdotal reports suggest adults are once again getting on the Oregon Health Plan, after several years of the plan only (or at least, mostly) being available to children and pregnant women. Given that the state is broke, how did the OHP make this comeback? —C.K. Dexter Haven

I heard it was the combined Wonder Twin powers of Barack Obama and John Kitzhaber. Didn't they touch their magic rings together and transform into an MRI machine made of ice and a marmoset with a medical degree, respectively, thereby solving our healthcare problems forever?

Actually, the plan that saved OHP was hatched way back in 2008. Obama was just a gleam in the Nobel committee's eye, and Kitzhaber was practically still governor. I won't keep you in suspense—it's a tax.  

"Thanks to a fee that hospitals agreed to pay during the 2009 session and federal funding," says Oregon DHS's Patty Wentz, "we're able to expand health care to some 35,000 adults." That still leaves 105,000 uninsured, but it's better than we were doing before. (Plus, three of them died while you were reading that sentence—universal coverage, here we come!)

What's unusual about this particular tax is that the folks it was levied on were largely for it: Since hospitals absorb most of the costs of providing care for the uninsured, it turns out to be cheaper for them to subsidize the OHP now than to eat the emergency room fees later. It's sort of like if all the relatives you might move in with chipped in now to buy you a one-way ticket to Bolivia—it actually saves them money in the long run.  

Of course, the hospitals pass the extra 4 percent on to us. But we're all insured, or else deadbeats, so nobody cares.

WWeek 2015

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