The Demise of Oregon's Medically Needy Program

In January 2003, there were 8,750 people who qualified for medical benefits through Oregon's Medically Needy program, but lost their coverage as a result of state budget shortfalls. This article describes the population who benefited from the program and examines how the loss of benefits affected their health and prescription drug use.

The program's coverage was limited to prescription drugs, some medical transportation, and partial mental health and chemical dependency treatments. Prescription drugs accounted for 88 percent of the program's expenditures. The researchers conducted a telephone survey of 439 participants (omitting those who had acquired Medicaid benefits) six months after the program's termination. The survey revealed that 75 percent of people who lost their benefits had already skipped or stopped taking medication, 60 percent had cut back on their food budget, 47 percent had borrowed money, and 49 percent had not paid other bills so they could afford their prescription drugs. There was no increase in emergency department visits but a significant decrease in hospitalizations. Over two-thirds of the people surveyed rated their current health as poor or fair, whereas only 2 percent rated it as excellent and 5 percent as very good. Participants in this program were vulnerable, very low-income people with multiple medical problems. The study concluded that losing prescription coverage resulted in decreased medication use and an increased financial burden.