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August 16, 2023
Media Contact: Amy Bacher, 503-405-5403, amy.bacher2@oha.oregon.gov
The state’s efforts to keep people covered has resulted in historically low uninsured rates for children and adults
SALEM, Ore. – Oregon’s efforts to ensure greater access to health care coverage are making a big difference for hundreds of thousands of people in Oregon who face possible disenrollment. Thanks to considerable steps taken by the state to extend and maintain Oregon Health Plan (OHP) benefits, Oregon's low Medicaid disenrollment rate runs counter to national trends in which 40% of people on Medicaid are losing coverage across the nation.
OHP is the state’s Medicaid plan, which provides free or low-cost health care to people of all ages with limited income and resources. It helps people and families access medical, dental, behavioral health and other services, including long-term services and supports. In many rural and frontier counties, more than four in 10 residents are covered by OHP.
In March 2020, the federal government began allowing states to maintain continuous Medicaid eligibility for beneficiaries throughout the federal COVID-19 health emergency so they could have access to care during the pandemic.
Since the emergency declaration in March 2020, more than 400,000 people in Oregon have enrolled in OHP coverage, an increase of 37%, which brought Oregon’s uninsured rate down from 6% to 4.6%. There are currently 1.5 million OHP members, more than one in three people in the state.
Now that the federal health emergency is over, states are reviewing eligibility for all Medicaid enrollees. To date, approximately 4 million people across the U.S. have lost Medicaid coverage since the COVID-19 health emergency ended, which includes nearly four in 10 adults and one in three children.
Oregon is taking a different approach. Based on national data, Oregon is among the top three states with the lowest termination rates of benefits. In less than five months, Oregon has reviewed eligibility for approximately one-third of all OHP members. Of the more than 600,000 OHP members evaluated so far, benefits have been renewed for more than 85%.
At the National Academy for State Health Policy (NASHP) conference today, interim director of Oregon Health Authority (OHA) Dave Baden addressed an audience of other state Medicaid policy experts about Oregon’s effective strategies to keep people covered.
“In Oregon, we’re doing everything we can to preserve health coverage for economically and medically vulnerable people and families,” said Baden. “Expanding health care coverage is one of the most important steps we can take to eliminate health inequity and allow for better outcomes in people’s lives.”
In an effort to keep people covered after the end of the public health emergency, Oregon applied for Section 1115 demonstration waivers via the federal government to expand what kinds of benefits people receive and allow more people to be eligible.
“I’m proud to partner with Oregon to improve quality and access, reduce health disparities, and improve health equity for those who need it most,” said Centers of Medicare and Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure in a statement when CMS approved the state’s Medicaid section 1115 demonstration initiative. “For the first time ever, children with Medicaid coverage in Oregon will be able to keep their coverage until the age of 6 — ensuring they can get the care they need during their formative years. We applaud Oregon for helping us use every tool available to protect and expand access to high-quality, comprehensive, affordable health care coverage.”
The federal waivers and legislative action approved for Oregon will specifically allow the state to:
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Keep kids covered. Children who qualify for OHP can now be covered from birth to age 6, regardless of changes to their household circumstances or income. This means that kids will have consistent access to health, dental and behavioral health care in key developmental years. Oregon is the only state that offers this.
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Guarantee benefits for a longer period of time. Most people ages 6 and older will keep their OHP benefits for two years, regardless of household changes, including income. Continuous coverage will make it easier for people to plan health care in advance, avoid costly and disruptive changes in coverage, treat chronic conditions, and improve health outcomes.
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Expand eligibility to adults with higher incomes. During the pandemic unwinding, adults with incomes between 138 – 200% of the Federal Poverty Level (FPL) will receive a temporary extension of their OHP coverage. That translates to a maximum income of $29,160 for an individual and $60,000 for a family of four. The temporary expansion will keep these people covered until Oregon launches a Basic Health Program serving people in that income range in July 2024. This expansion is estimated to cover more than 55,000 people who would otherwise lose their Medicaid benefits.
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Provide access to care, regardless of immigration status. Oregon extended full OHP coverage through a state-funded program called Healthier Oregon, as of July 1. Full benefits are now available to people of any age or immigration status who meet all other criteria. When more people have access to affordable health coverage it helps all Oregon communities, along with our workforce, education systems, and many other sectors of the economy.
According to the Commonwealth Fund, Medicaid expansion and other coverages in the Affordable Care Act (ACA) led to “historic reductions in racial disparities in access to health care.” The Public Health Emergency’s continuous eligibility gave more people a chance to get the care they needed, especially people in priority communities.
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