What federal law says
Oregon's Death with Dignity Act (ORS 127.800 to 127.897) has allowed a terminally ill adult to request a prescription for medication to end their life since 1997. The same year, Congress passed the Assisted Suicide Funding Restriction Act. Its key section, 42 U.S.C. 14402, says federal health care funds may not be used:
- to provide any item or service for the purpose of causing, or assisting in causing, a death;
- to pay for such an item or service, including related expenses; or
- to pay for health coverage that includes such an item or service.
The law applies to Medicare (Title XVIII of the Social Security Act) and Medicaid (Title XIX), among other programs.
What Medicare still covers
The same statute lists what it does not affect, and that leaves the rest of end-of-life care in place:
- Withholding or withdrawing medical treatment, nutrition or hydration.
- Drugs or care to relieve pain or discomfort, even if they may increase the risk of death, as long as they aren't given to cause death.
So Medicare keeps covering hospice, palliative care, pain control and treatment of other conditions. Under the Act, the attending doctor must tell the patient about feasible alternatives, including comfort care, hospice and pain control.
Who pays instead
The Oregon Health Authority says the Act doesn't specify who must pay; individual insurers decide whether it's covered under their policies. People on Medicare usually pay out of pocket or through other private coverage. Under ORS 127.875, making a request or taking the medication can't affect a life, health or accident insurance or annuity policy.
Oregon facts
OHA's 2025 data summary, released April 2, 2026, reports 637 prescriptions written in 2025 and 400 deaths from the medication so far (the count may rise as death certificates arrive). Ninety-two percent of those who died were enrolled in hospice. Since 2023, patients don't have to be Oregon residents. Doctors and health systems don't have to participate, and some don't. For Medicare coverage questions, call 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048). More in our guide to Death with Dignity and Medicare.
Related questions
Can I use Death with Dignity while on hospice?
How hospice fits in.
Does Medicare cover hospice in Oregon?
What's covered and what you pay.
What is a POLST form in Oregon?
Orders for life-sustaining treatment.
Sources
- 42 U.S.C. 14402 — Restriction on use of federal funds
- Oregon Health Authority — Death with Dignity Act FAQs
- Oregon Health Authority — Death with Dignity Act prescriptions continued to rise in 2025
- Oregon Legislature — ORS chapter 127
More questions in this guide
- Can I use Death with Dignity while on hospice in Oregon?
- Does Medicare cover hospice care in Oregon?
- How do I make an advance directive in Oregon?
- What is a POLST form in Oregon?
Part of the guide: End-of-Life Medicare in Oregon · All questions
Frequently asked questions
Does a Medicare Advantage plan pay for it?
No. Medicare Advantage plans are paid with federal Medicare funds, and 42 U.S.C. 14402 also bars federal funds for health coverage that includes these services.
Does OHP pay for Death with Dignity?
OHP is jointly funded by Oregon and the federal government. Federal Medicaid dollars can't be used; ask OHA or your CCO how the state handles coverage.
Will using the Act affect my Medicare hospice coverage?
Federal law lets Medicare keep paying for care that relieves pain and discomfort. Hospice coverage depends on Medicare's hospice rules, not on whether you make a request under the Act.
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