The demise of Oregon's Medically Needy program: effects of losing prescription drug coverage.
BACKGROUND
In January 2003, people covered by Oregon's Medically Needy program lost benefits owing to state budget shortfalls. The Medically Needy program is a federally matched optional Medicaid program. In Oregon, this program mainly provided prescription drug benefits.


OBJECTIVE
To describe the Medically Needy population and determine how benefit loss affected this population's health and prescription use.


METHODS
A 49-question telephone survey instrument created by the research team and administered by a research contractor.


METHODS
A random sample of 1,269 eligible enrollees in Oregon's Medically Needy Program. Response rate was 35% with 439 individuals, ages 21-91 and 64% women, completing the survey.


METHODS
Demographics, health information, and medication use at the time of the survey obtained from the interview. Medication use during the program obtained from administrative data.


RESULTS
In the 6 months after the Medically Needy program ended, 75% had skipped or stopped medications. Sixty percent of the respondents had cut back on their food budget, 47% had borrowed money, and 49% had skipped paying other bills to pay for medications. By self-report, there was no significant difference in emergency department visits, but a significant decrease in hospitalizations comparing 6 months before and after losing the program. Two-thirds of respondents rated their current health as poor or fair.


CONCLUSIONS
The Medically Needy program provided coverage for a low-income, chronically ill population. Since its termination, enrollees have decreased prescription drug use and increased financial burden. As states make program changes and Medicare Part D evolves, effects on vulnerable populations must be considered.
Zerzan
Judy
J
Seattle VA Health Services Research and Development, 1100 Olive Way, #1400, Seattle, WA 98101, USA. zerzanj@u.washington.edu
Edlund
Tina
T
Krois
Lisa
L
Smith
Jeanene
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003363:Cost Control; D003695:Delivery of Health Care / Q000191:economics*; D011307:Drug Prescriptions / Q000191:economics*; D005252:Fees, Pharmaceutical; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008484:Medicaid / Q000191:economics*; D008875:Middle Aged; D009922:Oregon; D010349:Patient Compliance; D011203:Poverty; D011306:Prescription Fees; D013221:State Health Plans / Q000191:economics*; D014481:United States