Senior Reporter Ben Botkin of The Lund Report went on Oregon Public Broadcasting’s noon public affairs show, Think Out Loud, on Jan. 26 to discuss his recent in-depth look at the growing criticisms in Oregon and around the country of how the state handles claims for treatment filed by low-income children.
The state program offering free health care to low-income people, called the Oregon Health Plan, has long operated under a waiver from federal Medicaid law allowing use of an evidence-based prioritized list of services and treatments. State officials use the advice of experts to set a line that in effect says what treatment will be paid for, and what will not.
When it comes to children however, that waiver and rationing system is more controversial. That's because federal Medicaid law requires that every other state in the country fund medically necessary care for low-income children, as a way to set them up for future success. In Oregon, children with certain health conditions face an extra hurdle to jump through: an appeals process that advocates say is often fruitless or takes years.
Botkin spoke with families, providers, and national experts. He obtained a letter from two pediatric physicians at Oregon Health & Science University calling the state’s approach “fundamentally racist” and “unacceptable.”
He also obtained internal Oregon Health Authority emails showing internal questions about the legality and propriety of Oregon’s practices.
One employee’s email quotes the “exact words” of a federal Medicaid official saying “‘I don’t know how Oregon got away with this for so long.’”
The answer, Botkin shows, goes back to the roots of how Oregon for so long enjoyed the reputation as a health care pioneer.
To find and listen to the 16-minute segment, click here.
You can reach Nick Budnick at [email protected] or via Twitter at @NickBudnick.