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There’s a health program gap at the Federal Level

Oregon advances plan to preserve coverage gains when public health emergency ends

Legislation directs OHA to explore creating an option for low income families that don’t qualify for Medicaid coverage

With the passage of HB 4035 by the Oregon Legislature today, Oregon has taken a significant step towards preserving health care coverage for people in Oregon when the public health emergency ends. HB 4035 directs resources towards creating an orderly transition for the estimated 300,000 Oregonians who may no longer qualify for Medicaid, also known as the Oregon Health Plan (OHP). Like other states, Oregon was asked early in the pandemic by the federal government to keep people from losing OHP coverage. OHP membership has risen from just over 1.1 million members before the pandemic to 1.4 million today. The federal government has told states that when the PHE ends, they have 12 months to determine who is eligible to stay on Medicaid and who must leave.  HB 4035 sets up a process for OHA to potentially create a ‘bridge health plan’ which could be offered to low income Oregonians who do not qualify for Medicaid because they earn slightly too much.

“Every Oregonian deserves access to quality health care. Throughout the pandemic, we worked to ensure Oregonians did not lose their health coverage––and we must ensure they stay covered,” said Governor Kate Brown. “The disparities in our health systems mean that Black, Indigenous, Latino, Latina, Latinx, Asian, Pacific Islander, Tribal, and people of color are disproportionately impacted by inequitable health care coverage. We must develop a process to ensure everyone has access to quality health care coverage. I’d like to thank the Legislature for putting forward this pathway to create options for families with low incomes to maintain the health care coverage they need.”

Oregon recently released health insurance survey data which showed that some of the largest jumps in coverage during the pandemic were among Black/African/African American Oregonians along with other minority groups. Many legislators cited this data as a key reason for focusing resources and efforts to maintain coverage in the wake of the pandemic.

“Eliminating ‘churn’ and extending continuous coverage to the people who earn slightly too much for Medicaid is the natural next step in health transformation,” said Senator Elizabeth Steiner Hayward, Co-Chair of the Joint Committee on Ways and Means. “I’m proud to live in a state that is tackling this problem in a proactive and creative manner. We know that the more we simplify the system for people and make it affordable, the healthier they are, which in turn is great for Oregon’s economy. Creating a bridge plan could be a monumental step forward for Oregon.”

“I am proud to have led the effort to develop a roadmap that keeps our fellow Oregonians covered following the end of the public health emergency,” said Representative Rachel Prusak, Chair of the House Committee on Health Care. “In passing HB 4035 we demonstrated our commitment to preserving the coverage gains we saw during the pandemic. Stable, affordable care is vital to the health of our state, and I’m grateful we prioritized the protection of our lower-income families and individuals.”

“Oregon currently has the highest rate of health insurance we’ve ever seen and with that we have closed some very troubling health equity gaps,” said Jeremy Vandehey, Director of the Health Policy and Analytics Division of OHA. “We cannot afford to move backwards on these gains. We are appreciative of the responsibility the Legislature has given us to make sure that as the public health emergency ends, our state keeps everyone covered.”

HB 4035 directs OHA to set up a task force to focus on options for a bridge plan for Oregonians who no longer qualify for OHP but also cannot afford Marketplace plans. This group, which could number around 55,000, has historically ‘churned’ on and off OHP. Data shows that during the PHE very few people in this group left and rejoined OHP, but instead stayed covered throughout – contributing to stability in health care access for them.

A bridge plan could resemble New York or Minnesota’s “Basic Health Plan,” in which the federal government gives the state the Marketplace tax subsidies that the population qualifies for and directs that state to provide coverage instead through their managed care organizations. Oregon would need permission from the federal government to set up such a plan and need permission to keep the population covered until the program is set up. However, the plan would come at no additional cost to Oregon’s budget. OHA has begun talks with the federal government to understand the possibilities around this sort of a plan.

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