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T he P ortland O bserver • A pril 0 6 , 199 4
Clinton’s Health Plan Could
Cover Illegal Aliens
Because o f gaps and loopholes in
president C lin to n ’ s health care pro­
posal, illegal aliens w ill be guaran­
teed medical coverage as long as they
are w orking. A fte r debating whether
or not to include illegal im m igrants in
the national health plan, the C linton
administration fin a lly decided that as
long as a person is w orking, legally or
ille ga lly, he or she w ill be included in
national coverage.
CLINTON’S DILEMMA
they are legally here, can receive free
health care.
Although W hite House officials
say they do not think it is fa ir for
illegal aliens to be covered by the
national plan, they also adm it that
there w ill be no extensive checks on
legal residency. In published news
reports, the plan’ s ch ie f architect, Ira
Magaziner, said the adm inistration is
concerned about immigrants, be they
F A IR has recommended that law­
makers tie the National Health Secu­
rity card to the cardholder by photo­
graph or some other physical in fo r­
mation to help prevent fraud and abuse
o f the health care system. T o obtain a
health card, F A IR also recommends
everyone be required to present a
afford to pay fo r the medical services.
FIXING THE PROBLEM
WHAT’S COVERED NOW
C urrently, illegal aliens
receive coverage fo r emer­
gency procedures and preg­
nancy-related treatment. The
costs are paid first by the states
which arc then reimbursed by
a partial subsidy from the fed­
eral government. But states
such as C alifornia, which is
swamped by ille g a l im m i­
grants crossing the border spe­
c ific a lly to get the free m edi­
cal care, say that the federal
government is fa llin g behind
These four states spend the most on illegal aliens' health care in the country. Prof. Ooncld Huddle of Rice
in its payments.
University estimates countrywide costs to be $2.5 billion o year.
C alifornia now has to pay
$ 1 b illio n a year in health care
costs for illegal immigrants because legal or illegal, com ing to the United social security card or valid im m i­
its health care o fficials are not al­ States specifically to take advantage grant documents that prove whether
lowed to check for legal residency. o f the health coverage. However, de­ or not they are legal residents.
The Im m igration Stabilization
State officials say, in some cases, signers o f C lin to n ’ s plan have done
A
ct,
which has been introduced in
legal residents could be denied the nothing to prevent this magnet.
both
the
House and the Senate, w ould
A llo w in g illegal aliens to be cov­
kind o f health care that illegal aliens
help
in
cutting
back on potential health
ered by national healthcare could
are receiving.
care
fraud.
I
f
the b ill is passed, a
Towns along the Mexican border bankrupt the system, said Dan Stein,
arc p articula rly hard hit. Thomas F A IR S ’s executive director. Perm it­ ta m p e r-p ro o f id e n tific a tio n card
Hospital in E l Paso, Texas, w rites o ff ting anyone other than legal U.S. w ould be issued to al U.S. citizens and
legal immigrants. This card w ill make
residents to be included in the health
about S3 m illio n a year in unpaid b ills
fo r illegal aliens, w hile at H o lly Cross plan is sim ply sending an advertise­ it easier to identify those entitled to
Hospital in Nogales, Arizona, one- ment to the w orld that anyone who w ork legally in the U nited States.
(Copley News Service, September 23,
third o f the emergency admissions can secure em ploym ent in the United
1993)
are Mexican nationals who cannot States, regardless o f whether or not
Annual State Medical Costs Per Illegal Alien
Caregivers Need To Meet
Their Own Needs
Estimates arc that 80% o f long-term care for the elderly is provided by
a fam ily member.
Increasingly, that is a grown child. A survey by Portland State
U niversity’ s Institute on Aging, fo r example, revealed thatofPortland-area
employees who responded to the survey, one in four had some eldercare
responsibilities.
Social w o rk e r Joella B u llo c k , a t K aiser Sunnyside M e d ic a l C enter
in C lackam as, advises those ca rin g fo r an aged relative to:
• Set lim its . Just because you’ ve agreed to care for someone doesn’ t entitle
him or her to demand instant obedience to every request.
• F in d a s u p p o rt group. Speaking w ith others who share the same
responsibilities can help you talk through common concerns, and get
insights into how others cope.
• Get help. I f you don’ t get time away from caregiving responsibilities
you’ ll burn out and risk your own health. D on’ t be afraid to ask siblings
or others to help.
• C onsider a lte rn a tive liv in g arrangem ents before you reach yo u r
b re a kin g p o in t. It can take a long tim e to find a placement option fo r an
elderly relative needing care, so don’ t w ait until you’ re at your w its ’ end
to start looking.
Oregon Health Plan Income
Eligibility Limits Rise April 1
The federal poverty level in O r­
egon rises on A p ril 1, meaning people
w ill be able to cam more money and
still q ualify for M edicaid insurance
under the Oregon Health Plan.
Jean Thom e, state M edicaid d i­
rector, said the federal poverty level
fo r a fam ily o f three would rise to
$1,027 a month from $991, an in ­
crease o f $36.
“ The federal poverty level is ad­
justed fo r in fla tio n each A p r il,”
Thorne said. “ Some people who were
close to qualifying before may want to
check the new income levels.”
A principal e lig ib ility criterion
for the health plan’ s Medicaidexpan-
sion is monthly household income
falling below the federal poverty level
in the month that a household applies
for coverage. (Other criteria include
being a U.S. citizen or legal alien and
livin g in Oregon.)
As a result of the increases,
these are the new federal poverty
levels for five sizes of Oregon house­
holds (with old guidelines in paren­
theses):
•
•
•
•
•
1 person: $613 (581)
2 people: $820 ($786)
3 people: $1,027 ($991)
4 people: $1,233 ($1,196)
5 people: $ 1,440 ($ 1,401)
Households may earn up to 133
percent o f the federal poverty level i f
one member is pregnant or is a child
under age 6, although only the woman
or child would qualify.
Increases in the federal poverty
arc based on inflationary increases.
Thome said the A p ril 1 incom e-eligi­
b ility increase was anticipated and,
therefore, was factored into the state’s
Medicaid budget.
An estimated 120,(XX) Orego­
nians are e lig ib le fo r the Oregon
Health Plan’ s M edicaid expansion.
Through March 25, more than
30,000 Oregonians had become new ly
eligible fo r M edicaid coverage under
the Oregon Health Plan. The M edic­
aid expansion differs from the old
Medicaid program w ith a p rio rity list
o f services that emphasizes preven­
tive care, early treatment, most-effec­
tive treatments and use o f managed
care plans to deliver medical and
dental services.
C om m unity outreach meetings
arc being conducted across the state
to answer questions about the health
plan and to help people complete
their applications. Inform ation about
meetings, as w ell as packets o f mate­
ria l about the health plan, arc a vail­
able by calling toll free: 1-800-359-
9517 (or T D D : 1 800 621-5260).
Thome said the toll-free linccon-
tinucs to receive more than 2,000
calls a day.
Prior to the health plan’ s Feb. 1
startup, the state estim ated that
479,000 Oregonians were w ithout
health insurance.
The M edicaid expansion is the
first major piece o f the health plan,
which beginning in 1997-98 is sched­
uled to require employers to provide
health insurance for their employees
w orking at least 17-1/2 hours a week.
Oregon
Receives A
Grade Of "Fair"
For Control Of
Tobacco Use
Oregon is one o f 16 states receiv­
ing a grade o f “ fa ir” in its efforts to
control tobacco use, the number one
preventable cause o f death in the na­
tion.
The grade comes from the from
the firs t report card on state govern­
ments’ tobacco control policies by the
C oalition on Smoking OR Health.
The C oalition is a jo in t e ffo rt o f the
national offices o f the Am erican Lung
Association, the American Cancer
Society, and the Am erican Heart As­
sociation.
The C oalition found that most
states need to improve their tobacco
control polices to protect nonsmokers
and to cut smoking rates. The grades
the coalition gave apply to actions
that have taken place in the 30 years
since the release o f the first U.S.
S urgeon general ’ s report on the health
hazards o f sm iling.
The report card was compiled by
tobacco control experts from the
Am erican L u n g A sso ciatio n, the
Am erican Cancer Society, and the
Am erican H eart Association. The
experts assigned each state o f the
fo llo w in g grades: outstanding, prom­
ising, fair, poor, or failing. Oregon’s
“ fa ir” grade was based on its perfor­
mance in three areas: restrictions on
sm iling in public places, cigarette
excise taxes, and sales o f tobacco to
m inors. The ranking incorporates
each state’ s 30-ycar performance in
all three tobacco control areas.
“ Oregon’s tobacco control p o li­
cies lack the teeth to take a bite out o f
smoking,” said Brenda N iblock, the
A m e ric a n L u n g A s s o c ia tio n o f
The C oalition on Smoking Or
Health has released the fo llo w in g rec­
ommendation fo r state governments:
Sales To M inors
States should enact strong en­
forcement procedures to ensure that
state laws against the sale o f tobacco
to minors arc enforced. Such proce­
dures should include a program to
ensure that retailers are licensed to
sell tobacco, and that they are penal­
ized fo r selling to minors. Other steps
should include bans on the distribu­
tion o f free tobacco samples (already
against the law in Oregon), and on
cigarette vending machines.
State Dealing With Oregon
Health Plan Dental Access
The smooth beginning o f the
Oregon Health Plan has encountered
an unexpected k in k - a lack o f par­
ticipating dentists in some areas -
that the state is trying to correct.
Hundreds o f Oregon Health Plan
enrollees have experienced d iffic u lty
obtaining dental appointments, par­
ticularly in rural Oregon, said Nancy
Hale, prepaid health plan coordinator
for the state M edicaid office, which is
managing the health plan’ s M edicaid
expansion.
“ A lthough many o f the dental
plans forecast wide acceptance, den­
tists’ actual participation rate has been
far less than anticipated,” Hale said.
Hale said no dentists are signed
up w ith managed care plans in Baker
and Douglas counties, for example,
although even there patients can re­
ceive fec-for-service care i f they can
find a dentist to take them. A number
o f areas outside o f tri-county m etro­
politan Portland have experienced
d iffic u lty , she said.
“ There is some concern that den­
tists may not take patients who have
serious dental problems because o f
years o f neglect and the dental re im ­
bursement rates offered by the state,”
Hale said.
She said the reasons that fewer
dentists than expected signed up to
treat Oregon Health Plan patients
include insufficient inform ation to
dentists, the dental plans’ reimburse­
ment rates, and the fast startup o f the
health plan. Dentists are also unac­
customed to government-financed
plans’ specific recordkeeping require­
ments, she said.
Hale said the state is scheduling
meetings w ith the Oregon Dental
Association and w ith selected dental
insurance plans to determine how to
meet Oregon Health Plan members’
dental needs.
“ Increased outreach to the dental
com m unity w ill begin im m ediately,”
Hale said, to provide inform ation
about the health plan and how to sign
up w ith a managed care plan.
“ W e are also considering such
options as paying non-plan dentists a
low m onthly fee per health plan pa­
tient, in addition to payment fo r ac­
tual treatment, to accept health plan
enrollees, “ Hale said.
“ W e w ill also discuss the feasi­
b ility o f establishing free-standing
dental clinics that w ould be run by
private dental plans to serve both
Oregon Health Plan members and
private patients.”
Hale said the state Medicaid o f­
fice w ill also w ork w ith dental plans
to review dental-fee schedules now in
place.
“ This is a problem that the state
cannot resolve by itself,” Hale said.
“ I t ’ s going to take the collaborative
efforts o f the dental plans and dental
com m unity to make it work.
“ W e need to fin d the ke y th a t
w ill open the d o o r to access to
dental care so we can keep o u r
c o m m itm e n t to the thousands o f
O reg on ian s w ho are lo o k in g to
the O reg on H ea lth Plan to m eet
th e ir h e a lth care needs.”
M ore than 30,000 Oregonians
are new ly enrolled in the Oregon
Health Plan since the medicaid ex­
pansion began taking applications on
Feb. 1. More than 2,000 calls a day
continue to be received on a toll-free
phone line - 1 (800) 359-9517 (T D D :
1 (800) 621-5260) - where people
can call fo r printed inform ation and
a p p lic a tio n s . T he T D D n um ber
should also be used by people w ith
hearing impairments w ho want to
request assistance at a com m unity
meeting.
An estimated 120,000 Orego­
nians are e ligible fo r the M edicaid
expansion under the health plan, and
a requirement that employers provide
health insurance to their employees is
scheduled to take effect during 1997-
98.
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