Health policy in Oregon is like football in the Southeastern Conference: not only a contact sport but also a source of intense civic pride. In the early 1990s, under the leadership of its physician Governor John Kitzhaber, Oregon created a “first in the nation” state-run managed care plan for Medicaid, the Oregon Health Plan, expanding its covered population by nearly 50 percent. He funded the expansion in part by a controversial priority system for redesigning the benefit package, and instituted population-based payments to health insurers.
