Oregon starts review of 1.5 million people on Medicaid to determine who qualifies for free coverage

The Oregon Health Authority starts a months-long review of the state’s 1.5 million Medicaid members this week to determine who still qualifies for the health insurance.

Normally, states review the financial eligibility of members annually, but during the pandemic, the federal government expanded benefits to states that kept members insured. Medicaid, known as the Oregon Health Plan in Oregon, provides free medical, behavioral health and dental coverage. The extra federal benefits ended Friday, forcing all states to review the income of their Medicaid members.

In most states, Medicaid is limited to those who earn 138% of the federal poverty level, but Oregon recently obtained federal approval to raise the ceiling to 200% of the federal poverty level. That means a single person in Oregon can earn up to $29,160 in gross income, with up to $60,000 allowed for a family of four.

Raising the ceiling will enable about 25,000 more people to stay on Medicaid, the health authority said in a statement. But it expects up to 300,000 people could lose their benefits because they earn too much. Nationwide, as many as 14 million could lose the insurance, according to the Kaiser Family Foundation.

Oregon will launch a new insurance plan, with the same benefits as Medicaid, in July 2024. State officials expect it to eventually serve 100,000 for those earning between 138% of the federal poverty level, now about $20,000 annually, and 200%.

The Medicaid review is expected to last a year.

“We want to do everything we can to make sure Oregon Health Plan members stay covered as long as they are eligible,” Dana Hittle, the state’s Medicaid director, said in a statement.

All households on Medicaid will receive a renewal notice over the next 10 months. The notice will inform members of any action they have to take. Hittle advised members to keep their contact information up to date and respond to any requests in a timely fashion.

“We know this process can be stressful for many members. We don’t want anyone to lose health coverage because of a missed notice,” Hittle said.

Those who no longer qualify for coverage will have 60 days before their benefits end. During that time, they’ll receive information from the Oregon Health Insurance Marketplace about buying coverage. The marketplace is the only way to receive federal subsidies for health insurance.

A transition team will be available starting April 13 to explain coverage and options to those who lose their Medicaid insurance, state officials said.

“We are committed to helping eligible Oregon Health Plan members maintain their coverage,” said Hittle. “We don’t want anyone to fall through the cracks. We want to protect and expand health coverage so more children and adults have access to the health care they need.”