Oregon is now among the top tier of states with the highest percentage of residents with health care coverage, according to a newly released federal study. Since 2010 Oregon has improved its position from 37th in the nation to 19th in the ranking of states with the highest percentages of residents who have health insurance.

According to the Census Bureau’s American Community Survey (ACS), the uninsurance rate for Oregon is 7 percent, down from 9.7 percent in 2014. The national average of uninsured Americans is 9.4 percent.

Oregon’s improvements follow the state’s decision to expand coverage under the Oregon Health Plan (OHP). Under the federal Affordable Care Act (ACA), states had the option to provide Medicaid coverage to individuals and families who earn 138 percent of the federal poverty level (FPL). Oregon is one of 32 states nationwide to expand Medicaid coverage. As a result of Medicaid expansion and coverage through the marketplace:

• Insured rate rises: Approximately 3.64 million Oregonians have insurance, while 204,000 Oregonians continue to lack coverage.
• OHP enrollment increases: Over the past three years, more than 400,000 people were added to the Oregon Health Plan, which now covers one in four Oregonians.
• Fewer young adults lack coverage: The uninsured rate for adults 18-34 has been cut in half to less than 20 percent, from above 40 percent in 2011.
• OHP covers working families: At least one adult works in 74 percent of households with OHP coverage where members are below retirement age.

To learn more about insurance coverage in Oregon, see the Oregon Health Insurance Survey site.

A new report to the Legislature shows the state’s health reform strategy has increased health coverage, improved health outcomes and contained health care costs in the state’s Medicaid program.

“Oregon’s Health System Transformation Quarterly Legislative Report” also shows that coordinated care organizations (CCOs) are financially stable, with operating margins remaining healthy even as the state has adjusted rates. CCOs are health plans that serve most Oregon Health Plan members. They are key parts of Oregon’s health reform strategy.

The report found that CCOs helped Oregon meet quality of care and financial goals:

• Quality of care: Avoidable emergency visits for OHP members have dropped 50 percent since 2011. CCOs have improved access to primary and preventive care.
• Cost containment: Oregon held cost growth in its Medicaid program to 3.4 percent since 2013, saving taxpayers $1.3 billion. Oregon’s growth is below the 4.4 to 5.4 percent Medicaid increase other states are experiencing.
• Most OHP members are served through CCOs: Nearly nine out of 10 OHP members are enrolled in a CCO.
  
  

In July Oregon filed for renewal of its Medicaid waiver from the federal government. Under Oregon’s renewal application, Oregon’s waiver would extend to 2020 and the state would receive $250 million per year in federal funds (if approved). The waiver would accelerate Oregon’s health transformation strategy and maintain the state’s commitment to hold health costs to a 3.4 percent growth limit.

Last week, the federal Centers for Medicare & Medicaid Services (CMS) issued a letter affirming its commitment to “continue the state’s innovative work to transform the delivery of health care” and address key issues related to Oregon’s waiver renewal application this fall. Eliot Fishman, director of CMS’ state demonstration group, wrote:

“I am excited about the progress Oregon has made over the past four years and look forward to partnering with the state on a renewal to maintain Oregon’s momentum to transform the Medicaid delivery system. CMS is supportive of Oregon’s health system transformation and we have viewed Oregon efforts as a promising model. … We are committed to working through the major policy questions in the waiver by the end of the year.”