OREGON PLAN FOR MEDICAID EXPANSION OK'D

                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: SATURDAY, March 20, 1993                   TAG: 9303200151
SECTION: NATIONAL/INTERNATIONAL                    PAGE: A-1   EDITION: METRO 
SOURCE: Associated Press
DATELINE: WASHINGTON                                LENGTH: Medium
OREGON PLAN FOR MEDICAID EXPANSION OK'D
In a move that may signal future changes in the nation's health-care system, the Clinton administration gave Oregon permission on Friday to provide Medicaid insurance for all its poor people by rationing the care they receive.
For the first time, everyone living in poverty in Oregon will be eligible for health insurance with a broad package of services, from preventive care to treating pneumonia to most organ transplants. The state will add about 120,000 people to the 239,000 residents already on its Medicaid rolls.
But their choice of doctors will be limited, and Oregon will no longer pay for dozens of procedures deemed too costly or ineffective, including aggressive treatment of terminal cancer or AIDS, simultaneous liver and kidney transplants, infertility therapy, scoliosis, and treatment of the common cold.
Health and Human Services Secretary Donna Shalala, who granted the federal Medicaid waiver necessary for Oregon to implement the plan, said the state had "significantly modified" the original plan rejected last August by the Bush administration on grounds it discriminated against the disabled.
President Clinton, as a candidate, had promised to give Oregon its waiver, and he assured governors last month he would give them the flexibility to run their own health-reform experiments.
Shalala imposed special conditions that Oregon must meet to ensure that it does not curtail essential services to the 239,000 state residents now on Medicaid. The Oregon program cost the federal and state governments $883 million in 1992.
Nationwide, Medicaid covers only about 47 percent of people living in poverty.
Oregon has drawn up a list of 688 medical conditions and treatments and proposed to pay only for 568 of them.
Shalala insisted that no one should draw "any conclusions about the health-reform proposal of the Clinton administration based on my decision on the Oregon waivers."
Both friends and foes of the Oregon experiment said it could set the stage for similar efforts to ration or prioritize care for all Americans.
"Sooner or later, the rest of America is going to come to what Oregon is trying," Sen. Bob Packwood, R-Ore., said. "We cannot, at public expense, provide health care for everyone in America with no limits."
Rep. Ron Wyden, D-Ore., called it "the first big step in the march for national-health reform."
Oregon Gov. Barbara Roberts has proposed imposing $100 million in taxes on health-care providers over two years to help pay for the Medicaid expansion.

by Archana Subramaniam by CNB