Portland State Magazine Winter 2009

AROUND THE PARK BLOCKS Health plan lottery provides unique study NINE MILLION DOLLARS and researchers from such places as MIT and Harvard are enabling Portland State and a local team of cientisrs to study an extraordinary policy experi– ment: the Oregon Health Plan lottery. This past year, Oregon's Medicaid agency drew names in a statewide lottery to fill approximately 10,000 open slots in the Oregon Health Plan. The names were randomly selected from a waiting list of nearly 100,000 uninsured Oregonians whose incomes are below the federal poverty level. Each received an application to be covered by the plan. Researchers are comparing data from those who were selected for coverage with data from people who were not to see what role health care coverage-----or the lack of it-plays in the lives of low-income adults. If, for example, the study shows that a lack of coverage is a big negative, then it may point to the need for wider coverage. Ir is the random lottery selection process that has researchers excited. Scientists on their own could never deny health cover– age to a group of people for study purposes. But the fact that the state initiated a lottery makes the study possible. "This research provides a rare chance to do work that can drive state and maybe even federal policy," says Matthew Carl– son, a P U sociologist and a principal investigator in the study. Phase 1 of the study involves surveying 70,000 low-income adults even ly divided between those who were randomly selected to receive Oregon Health Plan applications and rho e who were not. Carlson is convinced it is the largest, statewide Medicaid study ever undertaken. A collaborative effort, the study includes investigators from the Providence Center for Outcomes Research and Education, Oregon Health & Science University, the Oregon Office for Health Policy and Research, and the Division of Medical Assistance Programs. Although the Oregon Health Plan once served more than 100,000 people, budget cuts in 2003 reduced the number to about 17,000. Reopening the plan produced a dilemma for state officials. Should they enroll the sickest from the waiting list? Who is to decide? And what about children? The lottery was a small step toward fairness, says Jim Edge, state Medicaid director in the Oregon Department of Human Services. ■ WINTER 2009 PORTLAND STATE MAGAZINE 5