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January 31, 2023

Media contacts:

Erica Heartquist, Oregon Health Authority, Erica.J.Heartquist@oha.oregon.gov, 503-871-8843

Jake Sunderland, Oregon Department of Human Services,  Jake.Sunderland@odhs.oregon.gov, 503-877-0170

Latest data shows Oregon leads in keeping people covered

More than one million people are keeping their Oregon Health Plan benefits due to Oregon’s efforts to expand coverage options

SALEM, Ore. — With nearly 84 percent of the state’s 1.5 million renewals complete, more than 5 out of 6 Oregonians are keeping their Oregon Health Plan (OHP) or other Medicaid benefits.

Oregon’s 85 percent renewal rate is second highest in a national comparison of state renewal rates by KFF, a nonpartisan health policy organization. KFF analysis shows Oregon also has saved more people from unnecessary paperwork than any other state via the automated renewal process. Oregon’s high renewal rates are also due to proactive efforts by the state to keep people covered.

Members who have not received a renewal yet should:

• Keep their address and contact information up to date.
• Check their mail or online ONE account for their renewal letter.
• Do what the renewal letter asks as soon as possible.

Anyone concerned they missed their letter should get help with their renewal via one of the ways to find help listed below.

Although most people are keeping coverage, approximately 180,000 people will lose or have reduced benefits and need to consider other coverage options.

• People who do not have coverage through an employer or Medicare may be able to enroll through the Oregon Health Insurance Marketplace and get financial help. Most people who enroll through HealthCare.gov qualify for financial assistance. The Oregon Health Insurance Marketplace is sending information to people who are no longer eligible for OHP benefits, advising of potential coverage options through the Marketplace. People who have recently lost OHP benefits can enroll anytime until July 31, 2024 or within 60 days of their benefits ending. For more information and ways to get help signing up for Marketplace, Medicare, or employer coverage, see “What to do if OHP is ending” below.

During the COVID-19 pandemic, the federal government allowed states to keep people on Medicaid and did not require annual eligibility renewals. This ended when the public health emergency ended, and Oregon is currently making sure everyone on OHP is still eligible.

Over the course of the pandemic, Oregon saw a 30 percent increase in Medicaid coverage, bringing the total number of OHP members to over 1.5 million people. Oregon started processing eligibility reviews on April 1, 2023.

Extended unwinding schedule

Oregon has not started renewals for over 100,000 people. Many of these renewals were affected by previously reported renewal issues. These included a federal request for more than 30 states to review automated renewal processes, and restorations of Oregon Supplemental Income Program Medical (OSIPM) benefits. Oregon is currently seeking federal approval of an amended timeline for these renewals. A May 2024 update to Oregon’s automated renewal process and federal approval of the new timeline will enable Oregon to use the new process for the remaining renewals.

Oregon is proposing to stagger those renewals over four months. Renewals letters would be sent to members in four waves between June and September. Members would still receive 90 days to respond, and 60 days’ advance notice before any termination or reduction in benefits. This would mean the final responses would be due in December 2024, and the final closures would happen in February 2025.

Oregon will share more information about these renewals after federal approval. In the meantime, data about these renewals does not appear in the Medical Redeterminations Dashboard. For consistency, data below continues to use the December total number of members affected by unwinding.

December OHP renewal data

As of Jan. 27, 2024, 1,221,363 people have completed the renewal process. This represents 83.9 percent of all OHP and Medicaid members.

• 1,029,057 people (84.9 percent) were renewed and kept their benefits.
• 167,082 people (13.7 percent) were found ineligible.
• 14,924 people (1.2 percent) had a reduction in their benefits. Most of these members lost full OHP but were able to continue Medicare Savings Programs that help pay their Medicare costs.

In December, renewal letters were sent to an additional 171,781 people. 

• 73 percent were renewed without any action needed.
• 20 percent were asked to provide some information to renew. The most common requests are for income-related proof such as paystubs, or forms of identification such as a government identification or birth certificate.
• 5 percent were asked to fill out a renewal form.
• 3 percent had previously reported that they no longer met income limits or other requirements and received a notice that their benefits will end in 60 days.

Find help renewing your benefits

1. Learn more about how to renew your Oregon Health Plan medical coverage.
2. Call the ONE Customer Service Center at 800-699-9075. All relay calls are accepted, and help is available in multiple languages. Wait times are lowest between 7 and 8 a.m.
3. Visit or call a local Oregon Department of Human Services office. People can find their local office at https://www.oregon.gov/odhs/Pages/office-finder.aspx.
4. Visit a community partner for free in-person help. To find one near you visit OregonHealthCare.gov/GetHelp(English) or orhim.info/ayuda(Spanish).

The large number of OHP renewals, along with renewals of long-term services and supports, may cause greater wait times, delays, and possible interruptions to people’s OHP benefits. The fastest way members can provide an update is by going to benefits.oregon.gov and logging into their ONE online account.

What to do if your OHP is ending:

• First, review the case summary in your letter to make sure the information used to make the decision was correct. If that information has changed, notify the state. You can call the ONE Customer Service Center at 800-699-9075 (toll-free, all relay calls accepted) or find other options to connect at benefits.oregon.gov. If the information on file for you is correct and you disagree with the decision, you can request a hearing. Learn more about hearings.
• Explore options through an employer. If you, your spouse, or a parent are working, you may be eligible for health coverage through that employer. Talk to your manager or Human Resources department to see if you qualify. You will have a special enrollment period to enroll mid-year due to loss of OHP benefits.
• If you have or are eligible for Medicare: For help understanding and choosing the right Medicare options, go to https://OregonHealthcare.gov/GetHelp to find an insurance agent or a counselor at the Senior Health Insurance Benefits Assistance Program (SHIBA). You can also call SHIBA at 800-722-4134.

If you need to sign up for Medicare for the first time, contact the Social Security Administration (SSA) at 800-772-1213 to enroll by phone or find a local office. You can also enroll in Medicare online at ssa.gov/medicare/sign-up.

• Nearly 80 percent of Oregonians qualify for financial help through the Oregon Health Insurance Marketplace. Visit https://OregonHealthCare.gov/WindowShop to answer a few quick questions, find out how much you can save and find out how much coverage may cost you. You can also call the Marketplace Transition Help Center at 833-699-6850 (toll-free, all relay calls accepted).
• Need free local help finding other coverage? Visit https://OregonHealthCare.gov/GetHelp to find professional help near you.

The Oregon Health Authority (OHA) and Oregon Department of Human Services (ODHS) are committed to transparency and will continue to send monthly information about medical coverage among Oregonians as the agencies continue to track the programs. Check our ONE Eligibility Operations Dashboards for more frequent updates on medical renewal data and wait times for callers to the ONE Customer Service Center.

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