In Oregon, healthcare for the lucky

SEATTLE — Tens of thousands of Oregonians queued up quickly for a chance at the state's latest lottery, but this one is no game.

Officials began drawing names last week for a chance at some rare openings in the state's healthcare plan.

Announced in February, the lottery drew 91,675 hopefuls in 30 days. The winners will receive a postcard notifying them that they can apply for the Oregon Health Plan.

Like millions of people across the country, cash-strapped Oregonians bypass doctors, forgo prescription drugs and neglect basic healthcare when they can't afford health insurance. The state's Department of Human Services says at least 600,000 Oregonians live day to day without health insurance.

For some, life or death could hinge on the outcome of the unique insurance lottery.

Budget limitations capped the Oregon Health Plan standard benefit package in mid-2004. Now the plan has room for a few thousand people. The lottery winners will be the first new applicants since the cap was imposed.

Oregon's standard plan covers physician services, prescription drugs, mental health and chemical dependency services, emergency medical services, and limited dental, hospital and vision benefits. Premiums range from zero to $20.

When it was fully funded, it was considered a trailblazing program. In 1996, the benefit package enrolled five times as many people as are enrolled today, and only 10.7% of Oregon's population lacked insurance, compared with about 16% today.

Long odds of winning the healthcare lottery didn't deter Judith Padgett, a 55-year-old resident of Keizer, a suburb of Salem, the capital. She can't afford healthcare, avoids doctors, and goes without prescription drugs because they're too expensive. She is banking on the state-sponsored insurance lottery.

"I'm just hoping that I'm lucky," Padgett said. "I really do need it."

Padgett has a rare blood disorder that has killed relatives, she said, but cannot afford healthcare on her $500 monthly stipend in an Easter Seals job retraining program.

Healthcare advocates and policymakers can recite story after story of low-income adults who don't qualify for traditional Medicaid. Every day they see uninsured elderly, working-poor and young people trying to make ends meet with two or three low-wage jobs.

Oregon's largest newspaper, the Oregonian, called the lottery a "jarring reminder of just how broken the U.S. healthcare system really is."