• Judy Zerzan, Tina Edlund, Lisa Krois, and Jeanene Smith.
• Seattle VA Health Services Research and Development, 1100 Olive Way, #1400, Seattle, WA 98101, USA. zerzanj@u.washington.edu
• J Gen Intern Med. 2007 Jun 1; 22 (6): 847851847-51.

BackgroundIn January 2003, people covered by Oregon's Medically Needy program lost benefits owing to state budget shortfalls. The Medically Needy program is a federally matched optional Medicaid program. In Oregon, this program mainly provided prescription drug benefits.ObjectiveTo describe the Medically Needy population and determine how benefit loss affected this population's health and prescription use.DesignA 49-question telephone survey instrument created by the research team and administered by a research contractor.ParticipantsA random sample of 1,269 eligible enrollees in Oregon's Medically Needy Program. Response rate was 35% with 439 individuals, ages 21-91 and 64% women, completing the survey.MeasurementsDemographics, health information, and medication use at the time of the survey obtained from the interview. Medication use during the program obtained from administrative data.ResultsIn the 6 months after the Medically Needy program ended, 75% had skipped or stopped medications. Sixty percent of the respondents had cut back on their food budget, 47% had borrowed money, and 49% had skipped paying other bills to pay for medications. By self-report, there was no significant difference in emergency department visits, but a significant decrease in hospitalizations comparing 6 months before and after losing the program. Two-thirds of respondents rated their current health as poor or fair.ConclusionsThe Medically Needy program provided coverage for a low-income, chronically ill population. Since its termination, enrollees have decreased prescription drug use and increased financial burden. As states make program changes and Medicare Part D evolves, effects on vulnerable populations must be considered.

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