PORTLAND, Ore. (AP) - Of the $1.27 billion Oregon is getting in federal stimulus money for health and human services, most of it - $833 million - is going to people whose medical benefits are paid by the Oregon Health Plan.

The stimulus money has made it possible for Oregon to meet unprecedented increases in demand for health care services at a time when state revenues were falling, said Dr. Bruce Goldberg, director of the Oregon Department of Human Services.

The American Recovery and Reinvestment Act funding has boosted the number of people on the plan to about 460,000 and allowed the state to handle a caseload that has increased about 15 percent without reducing benefits to existing patients.

"Without it we would not have been able to maintain the health plan, and we would have had to slash it by huge amounts," said state Sen. Alan Bates, a doctor and a leader in state health care reform.

That's good for people on the Oregon Health Plan, the state's version of Medicaid, and it takes pressure off the state.

But officials are worried about what's going to happen when the stimulus money runs out in 2011.

Unless the economy improves substantially in 2010, Bates said, serious cutbacks may be necessary in state programs.

"We're looking at a real crisis here, and I think it's about a year to a year and a half away," the Ashland Democrat said.

The Oregon Department of Human Services said the other big share of the federal stimulus money the agency manages went to food stamps, about $343 million, to keep up with a more than 30 percent increase in demand from last year.

Some of that share also went to child care assistance. For the remainder, nearly $35 million went to public health and about $17 million for job training.

The other major spending on health care was for medical research, with more than $51 million in stimulus dollars going to Oregon Health and Science University.

Jillian Schoene, spokeswoman for Gov. Ted Kulongoski, says the long and slow recovery that economists are predicting means there will be heavy pressure on Congress to extend funding for health care and Medicaid programs "to keep the safety net intact."

"We need those dollars," Schoene said. "The cliff people are talking about is really out there."

But right now, there are no assurances that's going to happen.

Mary Stenzel Poore, associate dean for basic science at Oregon Health and Science University, says leaders of research projects there are already on the hunt for replacement funding in order to maintain the level of research.

"We're trying to deal with it proactively so we're not hanging off the proverbial cliff," Poore said.

She said researchers hope that President Barack Obama can make good on his promise to boost funding for basic scientific research "after we've been flatlined for eight years with the Bush administration."

Without that boost, the loss of federal stimulus money means "difficult, difficult times," Poore said.

Geoff Sugerman, spokesman for Oregon House Speaker Dave Hunt,said the upcoming legislative session in February will deal mostly with the results of a Jan. 24 special election on a pair of tax measures aimed at boosting revenue by $733 million with increases on big corporations and wealthy Oregonians.

If the measures fail, lawmakers are going to have to look for ways to cut back, Sugerman said.

"The February session is definitely going to be more about getting us through the rest of the recession," he said.

The Oregon Health Plan, created by former Gov. John Kitzhaber in the early 1990s, was aimed at improving access to health care.

At the time, nearly one in five Oregonians had no medical coverage because they did not qualify for public assistance under Medicaid, were not insured by an employer or could not afford individual coverage.

Despite improvements under the health plan that have reduced the number of uninsured to about one in six people statewide, more than 600,000 Oregonians still lack health coverage.

Goldberg says the larger problem is ever-increasing health care costs. He worries that further improvements in health care will be difficult even with increased funding.

Bates agrees, saying the national debate over health care often misses the point.

"They seem to think that just getting everybody insured is going to solve this problem, and that's not the problem," Bates said. "It's just a symptom. The real problem is the cost of providing health care in this country is completely out of  control."
     
(Copyright 2009 by The Associated Press.  All Rights Reserved.)