Associated Press - December 14, 2003

"I knew there was this huge deficit and they were going to make budget cuts," he said. "But, to be honest, I didn't believe they would cut people off from lifesaving medications."

But they did.

The state returned the benefit two months later -- but now threatens to revoke it again if voters on Feb. 3 reject a $800 million tax package passed by the Legislature last summer.

A defeat of the tax increase may spell the demise of the already strained Oregon Health Plan, a program championed by former Gov. John Kitzhaber and once held up as a model health care system for the working poor.

It rationed care to provide coverage to a wider group, closing the gap of uninsured by several percentage points in the 1990s, but then reducing benefits for tens of thousands of Oregonians during the recession-caused budget crisis this year.

If the referendum in February overturns the tax increase, the Health Plan would lose a further $154 million, trimming the once-vaunted program close to the federal minimums common to all states.

Supporters of the cuts say they make state government more efficient, and that private charities and families can better care for some poor or disabled people.

In 2002, charity programs run by pharmaceutical companies provided prescription drugs for about 65,000 Oregonians, some of whom lost state benefits, protecting patients from gaps in their state-provided benefits.

The companies expect to see a wave of new applications if the tax hike fails in February, said Dianne Danowski-Smith, spokeswoman for the Oregon chapter of Pharmaceutical Research and Manufacturers of America.

But Danowski-Smith said charity cannot replace Medicaid permanently.

"These people can get the help they need without a strong Medicaid system in place, but only to fill the gap," she said.

The cuts already mandated by law if the referendum is successful would hit health care particularly hard.

On paper, public schools will take the biggest hit if voters reject the tax hike, with about $285 million in cuts.

The Department of Human Services is in second place with $188 million. Of that, the Health Plan would lose $154 million.

But the true cuts to health care will be far larger; Oregon loses about $1.50 in matching federal funds for every state dollar cut from health programs, said Jim Edge, assistant state Medicaid director with the Department of Human Services.

The total cuts to the Oregon Health Plan would thus total $385 million if the referendum overturns the tax hike, Edge said.

Last spring, while his state assistance was in limbo, Hancock received anti-viral AIDS drugs free from pharmaceutical companies; he got no help with medications to treat side effects and for a heart condition.

A typical trip to the pharmacy, he says, ends with a brown paper grocery bag bulging with pill bottles that can cost as much as $800 retail.

The uncertainty has proved particularly jarring for Hancock, who experienced the AIDS drugs as a second chance on life, and is distressed to see them repeatedly pulled out of reach now by the state's budget woes.

Infected with the HIV virus in 1985, Hancock succumbed to AIDS 10 years later, languished near death in an Oregon Health & Sciences University hospital bed for weeks, and then was sent to an AIDS hospice to die.

In 10 years of operation, no patients had left the hospice alive.

A week into his stay, he met his future partner, William Reed, said Hancock, a slender 48-year-old with close-cropped gray hair and rimless glasses.

The pair agreed to try a new anti-viral drug "cocktail" that doctors said might prove lethal -- but might help. Hancock made it into the first wave of treatments with the drugs that saved his life but are now bankrupting himself and the state.

Ten months later, Hancock and Reed became the first patients to leave the hospice alive. He recalls standing on the porch, as nurses cried and cheered, carrying a box of photographs and some clothes, and, inexplicably he says now, a television set. He had given everything else away before he entered the hospice.

"I'll never forget standing on the porch of Our House of Portland. The nursing staff was crying, it was a big scene. It was a question of what are we going to do now," he said.

They rented a house with their disability checks. They bought furniture, and spent days tending a lily pond in the back yard.

But this year, they lost the house because Hancock had to move into a subsidized apartment in Gresham, near a strip mall and fast-food joints, to afford copays on medications.

"At least I'm still alive, for now" he said.
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