Oregon pioneers continuous Medicaid coverage for children

Oregon is the first state in the nation that will allow children with Medicaid coverage to remain continuously enrolled through their sixth birthday.

This means low-income families won't have to re-enroll every year to keep their kids insured.

Gov. Kate Brown made the announcement Wednesday morning, alongside federal officials from the Centers for Medicare & Medicaid Services.

"Keeping young people continuously enrolled in Medicaid up to the age of 6, to prevent gaps in coverage, regardless of changes in their financial circumstances is a paradigm shift," Brown said.

More than 1 in 3 children in Oregon is covered by the Oregon Health Plan.

In another change, Oregon and Massachusetts will become the first states to use the federal health insurance program to fund rental assistance and food aid to some state health plan enrollees who qualify.

In Oregon's case, the state will receive a major infusion of new federal funding for housing and food assistance: $1.1 billion over the five years the program is in effect. Oregon will be required to contribute $88 million of state funding in the final year of the program.

Oregon's new Medicaid spending on health-related social needs will also include a program targeting the health impacts of climate emergencies.

Oregon Health Plan enrollees who have a demonstrated medical need can qualify for a benefit that will directly cover the cost of things like air conditioners, air filters, or temporary shelter during wildfires or other declared emergencies.

The state applied for and received the changes through a five-year waiver process.

The federal government allows states to use the waivers to bend the typical rules that govern Medicaid. The waivers encourage innovation and are supposed to be cost-neutral.

Washington, New Mexico and California are considering similar proposals to make children eligible for more continuous Medicaid coverage.

In Oregon, the shift toward more continuous enrollment isn't limited to the youngest children. Children 6 and up and adults on Medicaid will be able to stay enrolled for two years at a time.

Medicaid eligibility checks have been suspended during the COVID-19 pandemic, but they will resume when the federal government's declaration of emergency expires - a date yet to be announced.

That's when Oregon's new enrollment policies are expected to kick in.

The policies will reduce the number of people kicked off Medicaid and add to the number of enrollees, increasing the costs of the program. The cost over the next five years, according to the Oregon Health Authority, will be $850 million in federal dollars and $409 million in state dollars.

Not all Oregon Health Plan enrollees will qualify for housing and food aid. The program is designed to support the health of Medicaid enrollees in transition, a group that includes youth in foster care, people who are homeless or at risk of homelessness, and low-income older adults, according to the health authority.

Rent assistance through Medicaid will be available for up to six months. Other services could last longer.