Latest monthly data show nearly 70 percent of Oregonians have kept medical benefits as state reviews eligibility
SALEM, Ore. – The most recent eligibility review data show that nearly 7 in 10 Oregonians whose eligibility for the Oregon Health Plan (OHP) and other state Medicaid programs has been reviewed in recent months have maintained health coverage. Fewer than 1 in 18 people lost coverage. In the remaining cases, state eligibility workers are seeking more information or documentation. Many of those OHP members are likely to retain their coverage once they respond.
The renewed eligibility figures include people whose cases were determined to be eligible through automated reviews of income and other factors, as well as people who were required to file full renewal applications.
Background
When the COVID-19 pandemic began, the federal government allowed states to keep people on Medicaid once they became eligible and did not require annual eligibility renewals. During the historic health emergency, the Oregon Health Plan (OHP) membership, Oregon’s Medicaid program, grew to nearly 1.5 million people.
Three months ago, Oregon began the process of making sure everyone on OHP is still eligible. While most people will continue to qualify for existing benefits, OHA is required to renew all OHP and Medicare Savings Program (MSP) members by mid-2024. Initial data for April, May and June shows that so far, at least 64.3 percent of people will keep their benefits without needing to provide additional information. These numbers will rise as more people complete the renewal process; response data will become available in late June.
OHP Renewals
In April, Oregon began renewing all 1.5 million members receiving OHP and other Medicaid-funded services and supports. The federal government requires Oregon to disenroll any members who are no longer eligible or fail to respond to renewal notices.
All OHP households will receive a renewal notice over the next several months.
Oregon will be able to process many renewals automatically. This means that we can make a decision a response from the member. Other members will need to submit documents such as paystubs, so we know whether or not they are still eligible or complete a longer renewal packet similar to the application they filled out when they signed up for OHP. Every OHP member will receive a renewal notice, and the notice will explain whether the member needs to provide additional information or take action to keep their coverage.
OHP members encouraged to respond quickly
Although the state has taken many steps to prepare, the large number of OHP renewals, along with renewals of long-term services and supports, is expected to cause greater wait times and delays. OHP members are encouraged to respond as quickly as possible after they receive a renewal notice to avoid any interruptions to their OHP benefits.
Members losing OHP have other coverage options and will receive at least 60 days advance notice. Many people will be eligible to enroll in health plans with financial help through the Oregon Health Insurance Marketplace (OHIM). Other people will be eligible for Medicare or employer coverage.
- To learn more about the marketplace, visit OregonHealthCare.gov or call 833-699-6850 (toll-free, all relay calls accepted).
- To sign up for Medicare, call the Social Security Administration at 800-772-1213 or go to ssa.gov/medicare/sign-up
May OHP renewals data
In May:
- 164,873 people came up for renewal and 108,343 people had their benefits renewed without needing action from the member.
- So far, 450,047 people have come up for renewal.
- 289,481 people (64.3%) were fully renewed without action needed.
- 24,357 individuals, (5.4%) were found ineligible and received 60-day notices of termination. The first losses of coverage will occur at the end of June.
Members losing coverage should report changes to their income or household information immediately if any of the information used to make the decision is inaccurate. Otherwise, they should apply for other health coverage as soon as they know their coverage ending date to prevent a gap in coverage.
Data dashboard expanded to reflect demographic data
When Oregon began redetermining eligibility for all Medicaid members in April 2023, a new data dashboard was created. The dashboard has information about people who are OHP members or receive other Medicaid benefits and are having their eligibility redetermined. The dashboard was recently expanded to include demographic and county-level data.
The dashboard now includes:
- Progress in completing medical renewals by the number of individuals and cases.
- Renewals by stage: Not started, initiated and completed.
- Demographic information including ethnicity, disability status, gender identity, housing status, race and written language preference.
- Data by county.
The dashboard is updated daily. More data about medical renewal outcomes and will be added in phases this year.
Extending health coverage
To get help, people can:
- Learn more about how to renew your Oregon Health Plan medical coverage.
- Call the ONE Customer Service Center: 800-699-9075 (all relay calls are accepted, and help is available in multiple languages).
- Stop by a local office. People can find their local office at: https://www.oregon.gov/dhs/Offices/Pages/one-services.aspxm
- Visit a community partner for free, in-person help. To find one near you visit https://oregonhealthcare.gov/GetHelp (English) or orhim.info/ayuda (Spanish).
Get help finding other health coverage at OregonHealthCare.gov/GetHelp.
The Oregon Health Authority (OHA) and Oregon Department of Human Services (ODHS) are committed to transparency and will continue to send monthly information about medical coverage among Oregonians as the agencies continue to track the state’s progress in renewing eligibility for medical programs.