In 2003, Oregon implemented changes to its Medicaid program to cope with budget shortfalls. In addition to reducing benefits, increasing premiums, and implementing copays for a substantial portion of enrollees, the Oregon Health Plan (OHP) also eliminated premium exemptions and instituted a six-month lockout for individuals missing premium payments. In 2004, OHP rolled back some of these policies. An ongoing study of the impact of OHP’s program changes finds that, after the initial cost-sharing increases and benefit reductions, nearly two-thirds of individuals surveyed had lost their coverage, many directly resulting from increased costs. Those who left because of premiums and cost-sharing reported worse access to care, less primary care utilization, and greater financial hardships than those who remained enrolled or left OHP for other reasons. Many also reported a decline in health status. Analysis suggests that these negative impacts may be reduced considerably if coverage is restored within three to six months.