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300,000 Oregonians at risk of losing state health insurance. Here’s why.

An estimated 300,000 Oregonians could lose health insurance in the next 16 months because they no longer qualify for state coverage that was made more widely available during the COVID-19 pandemic.

All of the roughly 1.5 million people who receive coverage through the state will soon have to prove they qualify financially, something they haven’t had to do in three years under an emergency reprieve from the federal government.

That deferral ends soon, giving state officials just over a year to make sure everyone who qualifies for coverage keeps it.

“Our real goal is to make sure we preserve all the benefits we can,” Oregon Health Authority interim director James Schroeder said in a presentation to lawmakers Tuesday. “But at the end of the day, people will either be eligible or not.”

Under federal rules put in place shortly after the pandemic began, Oregonians do not have to prove financial hardship or work status to qualify for Medicaid coverage, which in Oregon is called the Oregon Health Plan. Coverage has expanded dramatically over the past three years, from about 1,080,000 Oregonians before the pandemic to about 1,470,000 today, according to state data.

But on April 1, Oregon will begin a 14-month process to verify that people don’t make too much money to qualify for the low-income health insurance program and meet other requirements.

The Oregon Department of Human Services, which is responsible for checking eligibility for its own programs and for the health authority, called the amount of work ahead “historic.”

“We’re serving the highest caseload we’ve ever had in the history of our state,” said Nate Singer, who oversees the eligibility program. “There are currently more individuals receiving benefits in the state of Oregon than we have ever served on these programs.”

Health officials said they now have to contact and hear back from those enrolled in the Oregon Health Plan and ask for proof of eligibility, as was the practice once a year before the pandemic.

Unless the state already has proof by other means, eligible people who fail to respond could lose coverage.

“It’s something that I think we all find unconscionable, and we want to prevent,” Interim Medicaid Director Dana Hittle said Tuesday.

Medicaid traditionally serves people who may be hard to reach because of linguistic or cultural barriers or because they lack stable housing, officials said, making it especially important to make extra efforts to contact them.

With that in mind, Schroeder and Hittle urged lawmakers to tell their constituents how important it is to them to ensure the state’s contact information is up-to-date. The health authority can also now use the addresses that patients give to their health care providers, which the agency said it could not do before.

The plan is tentatively to pass the Medicaid renewal process in 14 months, starting with people the state expects will find it easy to re-enroll. A person who gets a notice from the state will have 90 days to respond, up from 30 days before the pandemic. If they don’t, the state will try to contact them again, giving the person another 60 days before they lose coverage.

“Despite all the planning and the work we do to plan for all the eventual issues that may happen, it’s not going to be a pretty, graceful process,” Hittle said. “It’s an incredibly challenging piece of work.”

In addition to the expected drop in state-funded health care coverage, about 426,000 Oregonians next month will lose supplemental food benefits that were extended during the pandemic because federal funding ends. The program, which has been available since April 2020, came on top of regular benefits from the Supplemental Nutrition Assistance Program, formerly known as food stamps.

The program awarded about $70 million in extra cash last month, or an average of $167 per eligible person.

Fedor Zarkhin

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