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Voices of the Oregon Health Plan say 'No' to co-pays

If certain state legislators have their way, Oregon Health Plan consumers will be faced with mandatory co-pays for ambulatory and pharmaceutical expenses starting in January. A coalition of OHP consumers and advocacy organizations has been fighting to prevent this from happening, and to defend and empower "the poorest of the poor".
The Oregon Health Plan (OHP) is a program of the Oregon Department of Human Services intended to provide health care benefits to low income individuals and families. For many, it is the only affordable way to receive medical treatment. Unfortunately, like many social services in this cash-strapped state, it doesn't cover everyone who needs it, and fails to adequately provide for those who are enrolled. And it's about to get worse, if certain state legislators have their way.

Recently, a citizen activist campaign spearheaded by the Oregon Health Action Campaign (OHAC) turned back an effort in the Oregon Legislature to mandate co-payments for pharmaceutical and ambulatory care expenses for OHP recipients. Such co-pays would have had a deleterious effect on the lives of many low-income people. This victory was temporary, however, and the co-pays are scheduled to take effect in January 2003. OHAC is a coalition of businesses, community organizations, unions, and individuals whose mission is to empower consumer in the health care purchasing arena.

OHAC's "No co-pays" campaign has been active since August, 2001, when OHAC organizers first discovered that the proposed state budget included mandatory co-pays. OHAC and its allies have successfully delayed the co-pays several times now using a diversity of tactics: letter-writing, public demonstrations, and heavy-duty lobbying that has included attending hearings, sub-committee meetings, and one-on-one education of legislators. One result was that the legislature opened a set of hearings to investigate how changes to OHP would specifically affect seniors, the disabled population, and those living with incomes of less than 50% the poverty level. Central to all these efforts has been empowering OHP enrollees to tell their stories and reveal how changes to the system would affect them personally. This tactic not only puts a face on the consequences of bureaucratic decisions, it also empowers people to speak for themselves and fight for their rights. Video of a February 8 speak-out is available from OHAC.

OHAC and its allies, including OHP enrollees and others concerned about the plight of the poor in Oregon, gathered in Lownsdale Square at 4th & Salmon SW in downtown Portland on Wednesday, July 24, to call attention to this situation and ask fellow Oregonians to help them in their struggle. They also wanted to thank the legislators who helped turn back the mandated co-pays, namely Representative Bates (a Democrat) and Senator Hannon (a Republican [!]).

Representatives from several organizations were present, including Elders in Action, the Mental Health Association of Oregon, and Oregonians for Health Security, who all spoke against co-pays.

The fear is that, when faced with higher medical costs, people will be forced to make the choice between food and pharmaceuticals, or between calling an ambulance and paying the rent.

OHP enrollees talked about their personal situations. Ric, for example, has only $120 left every month after paying room and board. A monthly bus pass costs $16 and he buys food for his dog. He is also on many different pharmaceutical drugs, and co-payments on the required dosages every month would cost him an additional $50-60. That doesn't leave much to live on from an amount that isn't much to live on in the first place.

Debra would face many of the same stark choices. She would have to come up with the money for at least 18-20 co-pays a month. "The co-pays will cripple people," she said. "I'd like to know where their Christianity is when it comes to helping those in need."

Chris Frost is an organizer with Oregonians for Health Security, and she is a powerful speaker. "We need people in the state house who care about health care. We need to demand from candidates that they support health care. We need to make this happen in November so we don't have to have rallies here in December."

Speaker after speaker talked about how charging co-pays would be hitting up the "poorest of the poor" -- those least able to pay, and who are already struggling to survive.

Sarah works with Oregon Action, which works with seniors and is attempting to institute price controls for presecription drugs. Oregon Action is having a rally on July 30 at St. Andrew's church around these issues.

Charles is with Elders in Action, a group that wants a government that "does the right thing for people". While Elders in Action engagnes in advocacy for seniors, it also actively supports edutaction, health care and human services for everyone. Elders in Action is adamantly against mandatory co-pays for OHP enrollees. "It's outrageous that people say they don't want high taxes, but they will raise the rates on the poor," he said.

"Health care" in the U.S. is driven by profits, not people -- even government programs like OHP.

Costin is an OHP consumer who has been living with cancer since 1995. Hospital visits are common for him. He is afraid of what will happen if he has to undergo chemotherapy again, when you "lose your hair and lose your lunch". During such treatment he wouldn't be able to work, and the unpaid co-pays would pile up. Unlike other medical bills, these unpaid co-pays are debts that affect your credit rating, and can add an additional hassle to your life. Costin doesn't want to have to choose between chemotherapy and co-pays.

The folks who turned out for this demonstration don't match the stereotype of "activists".

But here they are, publicly making their demands, standing up for themselves, seeking better treatment of "the poorest of the poor", and being active. It's inspiring.

The corporate capitalist monster oppresses people in thousands of ways, some small and some large. I hadn't heard about the "No co-pays" issue until it was posted on the portland indymedia newswire here so I went to check it out. What I found was another situation in which this country is abusing people. Many people in the U.S. don't have health coverage at all, but here's what's happening to some of them who do.

Mandatory co-pays would definitely have a profound affect on many people. But stopping them is a winnable battle, as the work of OHAC and others have shown. Still, this is a campaign that would benefit from the efforts more people.

If you are interested in helping to defend and empower oppressed people regarding the co-pay issue, contact Elizabeth Byers, the Project Equality Coordinator for the Oregon Health Action Campaign, at 1-800-789-1599, voicemail box#14.

GREAT REPORT 25.Jul.2002 17:01


This is a super photo journalism story. I just forwarded it to Rich Rohde, our fearless Oregon Action leader here in S. Oregon. He and others will be glad to see it...

Jeremy, thanks for the report!

State of Jefferson

More information 25.Jul.2002 18:02


The announcement for this demo contains a short discussion of the no co-pays issue featuring personal testimonials added as comments. Check it out here: http://portland.indymedia.org:8081/front.php3?article_id=14924&group=webcast

Great report...thanks for doing it 25.Jul.2002 20:44


Thanks Jeremy for a very good story. The photo's are incredible. You really caputre the energy and people of this rally. Thanks Portland Indymedia for being here when we need you.

Photos by Bison 25.Jul.2002 21:35


Thanks for the props, Bridge. Note that the photos were taken by Bison, not me !!

CORRECTION 29.Jul.2002 18:58

Jeremy David Stolen fellowtraveler@riseup.net

Oops !! Got a fact wrong in the article above. The no co-pays campaign is being spearheaded by PROJECT EQUALITY, not the Oregon Health Action Campaign (OHAC). OHAC is the umbrella organization of Project Equality. Project Equality's campaigns do not necessarily reflect the opinions of OHAC.

I apologize for the error.