State-based Marketplace Project Updates for January 2026

Senate Bill 972 (2023) requires the Oregon Health Authority (OHA) to transition the Marketplace from a state-based marketplace using the federal platform (SBM-FP) to a state-based marketplace (SBM) in time for open enrollment for plan year 2027. Specifically, OHA is required to procure and administer an information technology platform or service and consumer assistance center, separate from the federal platform and call center, to provide electronic access to the health insurance exchange in this state by November 1, 2026.

The Oregon Health Insurance Marketplace helps people in Oregon access affordable, high-quality health insurance through enrollment in private health insurance and federal subsidies during annual open enrollment and special enrollment periods. A state-based marketplace will give the Marketplace more flexibility to make open enrollment fit the unique needs and budgets of people across Oregon while also allowing for community input into process and procedure changes.

OHA is also dedicated to eliminating health inequities in Oregon by 2030. Below you will find some ways this change to the Marketplace will better serve communities of focus:

• Allows access to real-time data and evidence to tailor outreach and be more intentional about efforts to enroll disproportionately uninsured people, including people of color and rural residents.
• Collection of data, particularly on race and ethnicity, will facilitate our understanding of enrollment disparities.
• Additional and more reliable data will allow Oregon to refine its outreach and communication strategies, both overall and in real time to reach targeted communities.
• Immigrants and non-native English speakers may be more likely to enroll if additional translation and interpretation services are available to help them complete the application or to communicate effectively with navigators, agents and brokers, or the call center.

Final Open Enrollment on HealthCare.gov Complete

Open Enrollment for plan year 2026 concluded on January 15 with 118,372 people in Oregon signed up for a Marketplace plan. During this cycle, the state successfully supported partners as they provided direct services to consumers through plan selection and enrollment while continuing critical readiness activities for the transition to a state-based marketplace. Outreach, consumer assistance, and coordination with federal partners remained strong through the close of the open enrollment period, ensuring continuity for current enrollees and access for new consumers. With Open Enrollment complete, the project team is now fully focused on post-enrollment activities and implementation milestones to support a smooth launch of the state-based marketplace for the upcoming plan year.

Since the last update in November 2025, the SBM Project completed a variety of deliverables including:

• Continuation of collaboration with Marketplace carriers, insurance agents, and community partners. See additional details in the Partner Engagement section.
• Product orientation sessions for agency staff began and will be completed in February 2026.
• Project initiation meetings and execution of an information exchange agreement with the Centers for Medicare & Medicaid Services.
• Presentation to Senate Health Care Committee (info/4rZVL8R) on Nov. 18, 2025.
  • Monthly - October 2025: info/3L3trBN, November 2025: orhim.info/4jGdvSM
  • Quarterly (July-Sept. 2025): orhim.info/4aO1MiH

The Marketplace continues to place an emphasis on the importance of partner engagement, with continued activities through the third quarter of 2025:

The table below contains a comprehensive list of deliverables and milestones, along with their corresponding start dates, due dates, and current status.

• Visit orhim.info/SBMtransition
• Email marketplace.sbmproject@odhsoha.oregon.gov