Higher Premiums, Cost-Sharing

eAlert 09d36dc1-63b3-4c26-97a7-fad6fd6df31d

<p>Like many other cash-strapped states, Oregon has enacted major changes to its Medicaid program in a bid to save money. In 2003, the state raised premiums, required copays for the first time, and imposed a six-month lockout for individuals missing premium payments, then rolled back some of these changes the next year. But Oregon's changes came at a steep price to many low-income residents, a new Commonwealth Fund–supported study finds.<br><br>
The report, <a href="/publications/fund-reports/2005/jul/impact-of-changes-to-premiums--cost-sharing--and-benefits-on-adult-medicaid-beneficiaries--results-f
">Impact of Changes to Premiums, Cost-Sharing, and Benefits on Adult Medicaid Beneficiaries: Results from an Ongoing Study of the Oregon Health Plan,</a> says nearly two-thirds of surveyed individuals lost their coverage after the initial premium and cost-sharing increases, many directly resulting from increased costs. Those who left because of higher premiums and cost-sharing reported worse access to care, reduced primary care utilization, and greater financial hardships than those who remained enrolled or left the Oregon Health Plan for other reasons. The ill effects of the changes were most serious for those remaining uninsured six months or longer, according to the report.<br><br>

As other states and the federal government move to increase premiums or cost-sharing as a way to control Medicaid expenditures, they will need to carefully consider the impact those changes might have, the authors say, on individuals' insurance coverage, access to needed care, and financial well-being.<br><br>

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