Thousands of people on Medicaid in Central Oregon — and hundreds of thousands more across the state — are getting notices this fall about new requirements for the Oregon Health Plan, mandated by the federal government. That could bump some people off Medicaid coverage, and be a struggle for others, which has local organizations working to fill the gaps.
New requirements are the result of H.R.1, or the One Big Beautiful Bill Act, which rolled back social welfare programs and extended tax cuts. The changes require some people on Medicaid to provide proof of work, school or activity for at least 80 hours a month, and create more frequent renewal requirements. The Oregon Health Authority says it started sending notices in September to about 600,000 people across the state who will have to comply. Those notices are a federal requirement, and don’t mean coverage is ending immediately, the agency said.
“We want to be clear: We know the vast majority of people who are on Medicaid who can work are already working,” said Max Sprague, communications director with the Oregon Health Authority at a Sept. 21 media briefing. “We know from other states that when people lose Medicaid or the Oregon Health Plan because of these rules, it isn’t because they’re not working or they’re not contributing. It is because of administrative churn.”
According to the state’s health agency, most people will keep their benefits under the changes. The new requirements won’t apply to children and youth under 19 years of age, people over 65 or people who qualify based on disability, pregnancy or other factors, according to the health authority.
H.R.1 also rolls back Medicaid for non-citizens, including refugees and asylum seekers. But the state’s health agency says about 7,000 people will switch in October to a program called Healthier Oregon, which provides Oregon Health Plan benefits to people regardless of immigration status.
Mosaic Community Health announced Sept. 24 it’s been preparing by adding staff and doing trainings to provide free, one-on-one to help people navigate the changes.
“Mosaic team members have been preparing for months so that our community can have local support during this transition period, and so that no one loses health insurance coverage simply because a form or a deadline felt confusing,” said Cy Erickson, patient access manager at Mosaic Community Health, in an announcement. “We want everyone in Central Oregon to know that our help is free and available to anyone in the community, not just Mosaic patients.”
About half of the community health center’s patients rely on the Oregon Health Plan for coverage, or about 17,000 people, the release said.
The plan, which is subsidized by the federal government, provides free health care for people in Oregon who make below a certain income. The plan covers doctor’s appointments, hospital care, behavioral and mental health services, oral health, prescriptions and more. It generally covers individuals who make around $22,000 or less per year, or about $45,000 for a family of four, said Vivian Levy, interim Medicaid director with the Oregon Health Authority.
One in three people in Oregon are covered by Medicaid, Levy said Sept. 21. Rural counties typically have higher enrollment, she said.
With the changes at the federal level, Levy said the agency, “knew that keeping people covered would become more difficult.
“When people can’t afford health insurance or are uninsured, they delay care until a situation becomes urgent,” Levy said. “If they do seek treatment, our health care providers and hospitals aren’t reimbursed, which increases overall health care costs for everyone.”
Many vulnerable populations might struggle to jump through additional hoops to stay on the Oregon Health Plan, which puts them at risk of losing insurance, said Holly Harris, director with Deschutes County Public Health, in an email.
Harris said the changes will have an impact on the County’s direct service programs like behavioral health, in which a majority of clients are on the Oregon Health Plan. The new requirement that people re-enroll every six months could cause some disruption, Harris said.
The health department is also making sure there are enough people to assist those who need to enroll or re-enroll in the Oregon Health Plan, Harris said.
Harris said the department is “doing everything we can to educate, outreach and support people in staying connected to their health insurance.”
“It’s a big lift, without any additional resources to help do that work, but we are committed as a community to do everything we can to support people through the process,” Harris wrote.
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