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

An estimated 300,000 Oregonians could lose health insurance over the next 16 months because they are no longer eligible for state coverage that became more widely available during the COVID-19 pandemic.

All of the roughly 1.5 million people who get coverage from the state will soon have to be able to prove they meet the financial requirements, something they haven’t had to do for three years under an emergency reprieve from the federal government.

That moratorium soon expires, giving state officials just over a year to make sure everyone eligible for coverage is in compliance.

“Our real goal is to make sure we retain 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 are either going to be eligible or they’re not.”

Under federal rules put in place soon after the pandemic began, Oregonians did 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 make sure 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 verifying eligibility for its own programs and for health authorities, called the amount of work ahead “historic.”

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

Health officials said they will now have to reach out and contact 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 through other means, eligible people who fail to respond could lose coverage.

“This is something that I think all of us find unconscionable and want to prevent,” Interim Medicaid Director Dana Hittle said Tuesday.

Medicaid has traditionally served people who may be hard to reach because of language or cultural barriers or because they lack stable housing, officials said, making it especially important to make an extra effort to reach them.

To that end, Schroeder and Hittle urged lawmakers to tell their constituents how important it is for them to ensure the state’s contact information is up-to-date. Health authorities 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 for now is to stagger the Medicaid renewal process by 14 months, starting with people the state expects will be easy to re-enroll. A person who receives 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 losing coverage.

“Despite all the planning and the work we do to plan for all the potential problems that could happen, it’s not going to be a pretty, graceful process,” Hittle said. “It’s incredibly challenging work.”

In addition to expected declines in state-funded health care, about 426,000 Oregonians next month will lose supplemental food assistance extended during the pandemic as federal funding ends. The program, available starting in April 2020, came in addition to the regular benefits of the Supplemental Nutrition Assistance Program, formerly known as food stamps.

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

Fedor Zarkhin

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