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Bates writes prescription for Oregon Health Plan

SALEM ' The Oregon Legislature's only physician is circulating a proposal for a user fee to help bail out the Oregon Health Plan.

Rep. Alan Bates, an Ashland Democrat, said the user fee on hospitals, pharmacists, long-term care facilities and possibly doctors would generate more state tax dollars that in turn would leverage additional Medicaid dollars ' &

36;2 for every &

36;1 spent by the state.

Bates said his plan has drawn mixed reactions, but has strong support from long-term care providers who are 75 percent funded by Medicaid. If we cut their funds back, they're dead, Bates commented.

He said hospitals are looking at the plan, but the initial reaction is split. Some are saying, no way in hell, he noted. Pharmacists are also skeptical of levying a &

36;1 to &

36;2 surcharge on each prescription.

Bates is an unabashed fan of the Oregon Health Plan, the brainchild of former Gov. John Kitzhaber, who is also a doctor.

Overall, looking at the big picture, it is one of the best Medicaid programs in the country. Many states look at us with envy, he said.

The problem, he said, is the negative reaction in Oregon. The perception is that it is out of control, Bates said. It's not. The program is running well.

Medicaid automatically covers people who are on welfare, are disabled, in foster care or blind. About 300,000 residents qualify. The Oregon Health Plan covers an additional 100,000 working Oregonians whose incomes fall below the poverty line.

During the mid-1990s when the economy was strong, eligibility was expanded, and natural population growth added to the rolls. But the economic slump that has hit the state hard will mean significant cuts to the program in 2003-05.

Gov. Ted Kulongoski has expressed support for the plan but said it is not economically sustainable in its current form. Meanwhile, at least five legislative committees are looking at it for a solution as the economy continues to sink and health care costs rise.

Bates said the Legislature has to ensure that only eligible people are entitled to coverage, and that the benefits package isn't better than what a person who pays for health insurance receives.

Currently, 22 states levy a surcharge on providers but that money goes to long-term providers to help them maximize federal funding.

How successful Bates will be remains uncertain. He has asked legislative counsel to review Medicaid regulations to see if his proposal could pass muster with the federal government.

It may die in two weeks, he said. But I think the Feds will say that we can do it.

Don Jepsen is a free-lance writer living in Salem