The widely publicized Oregon Health Plan (OHP) was established in 1989 to provide the residents of Oregon with universal access to health insurance. The OHP encompassed provisions to reform Medicaid, which included relaxing eligibility requirements and requiring Medicaid beneficiaries to enroll in managed care plans. To date, the OHP has improved access to health care facilitated the efficient use of healthcare services. However, problems with the program exist--failure of Medicaid beneficiaries to choose a health plan and primary care physician, inadequate education of the enrollee population, and frequent enrollee turnover, for example. These problems offer lessons to the rest of the nation as Medicaid managed care plans proliferate.