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Sept. 12, 2023
Media Contact: Amy Bacher, 503-405-5403, amy.bacher2@oha.oregon.gov
Oregon receives state approval for Basic Health Program
BHP will provide affordable health coverage for adults who have gone without health insurance at higher rates
SALEM, Ore. – A proposal for Oregon’s Basic Health Program (BHP), a plan that will provide comprehensive medical, mental health and dental care to more than 100,000 Oregonians with lower incomes, moved a pivotal step forward to providing affordable health care for more people in the state. The Oregon Health Policy Board today approved a blueprint for the BHP, and the draft plan is headed to the federal government for final review.
BHP coverage will be similar to what is offered by the Oregon Health Plan (OHP) and be available to adults in the state with household earnings between 138% - 200% of the federal poverty level (FPL). The eligible FPL income range for an individual is $20,120 – $29,160 per year and $41,400 – $60,000 for a family of four.
“People in Oregon within these income brackets have historically gone without health coverage at higher rates – more than any other income group in the state,” said Dave Baden, interim director at Oregon Health Authority (OHA). “The Basic Health Program will mean that coverage, and subsequently care, is within reach to more adults and families in our state.”
In addition to providing greater access to care, establishing a BHP will reduce health coverage disruptions that happen when people disenroll and re-enroll in OHP due to income changes in a relatively short timeframe. The state found that 34% of people enrolling in OHP were returning less than one year after disenrolling; 25% returned within six months. The diminished “churn” on and off OHP will improve continuity of care, which makes it easier for people to manage chronic health conditions or seek treatment for health issues before they become more serious.
In 2022, the state legislature directed OHA via House Bill 4035 to establish the BHP and mandated that the Oregon Health Policy Board vote to allow the BHP to move forward. OHA convened a task force to inform development of this program, including a study of the economic impacts before implementation of the program. An open comment period earlier this year garnered more than 30 supportive comments from community organizations and health centers across the state.
Some insurance providers have voiced concern that BHP will move their customers from Marketplace coverage and cautioned that Marketplace premiums could increase. OHA commissioned an actuarial analysis to assess how the creation of the BHP will impact premiums for consumers that remain on the Marketplace and found that increases for most consumers would be on par with regular Marketplace fluctuations—$25 or less per month starting in 2025—if the state takes no further action. OHA is working with carriers to explore state-funded or other “stopgap” solutions to prevent premium increases, until Oregon moves to a State-Based Marketplace for plan year 2027.
BHP will be almost entirely federally funded. States that operate a BHP receive federal funding equal to 95% of premium tax credits for BHP enrolled members. Federal funding will fully cover BHP benefits, and the state will cover the cost of running the program. For each $1 the state invests in the BHP, Oregon will receive more than $500 in federal funds.
Oregon secured a waiver from the federal government that expands OHP to people in Oregon with income from 138% – 200% of the federal poverty level for 14 months following the expiration of the federal public health emergency.
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