In 1994, An Oregon state senator drafted legislation extending Medicaid beyond the welfare recipients who had previously qualified for it.

Results were good. In its first year, the Oregon Health Plan’s (OHP) enrollment climbed from 260,000 to 360,000, as 100,000 Oregonians who had depended on emergency rooms or charity clinics for their health care were covered by Medicaid.

Results were also not so good. By 2001, Medicaid spending had climbed from $1.1 billion to $2.5 billion. By 2008, the state was using a lottery, randomly selecting 10,000 winners from a waiting list of low-income Oregonians qualified for OHP coverage.

The state senator who conceived of the OHP is now Oregon’s governor, again looking for solutions to the high costs and limited accessibility that define health care in the United States.

As part of our “What Works” series, Sasha Abramsky profiles Oregon Governor John Kitzhaber, who understands that reform is a protracted process—and is open to genuine innovation in both health care and education.

See Sasha Abramsky’s full article here: Governor John Kitzhaber’s Second First Term.