The Health Care Lottery

OPB | Jan. 28, 2008 9 a.m. | Updated: Sept. 10, 2013 8:39 p.m.

This Monday the Oregon Health Plan opens registration for applicants for the first time since the program froze enrollment in 2002. So if you’re a US citizen, over age 19, and earn less than $850 a month as an individual (or $1141 a month as a couple), you can put your name in the hat to get basic health coverage from the state. After a month-long registration period, a fancy computer system will randomly draw names of people to send applications to. At the end of the process, health plan administrators will probably insure about 5,000 more Oregonians through OHP.

To put this all in perspective, though, you can earn a full $10,201 a year and still not be eligible for the plan. And even after OHP’s current open registration is complete, according to the State Medicaid Office, Oregon will have something like 455,000 uninsured adults throughout the state.

All of which brings up a ton of questions. When money is limited, is the random assignment of health insurance — state services by lottery, in other words — the best way to determine who gets covered? In this busy election season, when healthcare is near the top of the domestic agenda, should presidential candidates be looking to Oregon as an example of how — or how not — to insure the uninsured? What do you think of the Oregon Health Plan?

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