Oregon has the highest rate in the nation for Medicaid renewals since the lifting of the COVID-related continuous enrollment requirement in March 2023, according to a Georgetown study.
With 92 percent of the state’s nearly 1.5 million renewals complete, more than four out of five Oregonians are keeping their Oregon Health Plan (OHP) or other Medicaid benefits.
Six reasons Oregon is doing well with Medicaid renewals
OHP Bridge
OHP Bridge, a new category of OHP with higher income limits, launched July 1. Since the unwinding of the pandemic emergency began, people likely to be eligible for OHP Bridge kept their OHP. To date, 22,784 people have moved to OHP Bridge.
Sequencing
Oregon intentionally scheduled renewals for people who were more likely to keep benefits and needed minimal support to complete the process upfront. State employees put certain renewals such as likely OHP Bridge members later in the schedule and spread more complex renewals throughout the process to ensure support was consistently available.
Longer timelines
Oregon gave people longer to respond before closing benefits than any other state in the nation. In Oregon, people have up to 90 days to respond and 60 days’ advance notice of any closure. People who did not respond can also reopen their case up to 90 days after closing.
Outreach
Oregon has a robust network of community partners across the state, and tools like earned media and paid advertising were used to spread awareness of the renewal process.
Maximizing automating renewals
When members’ eligibility information can be verified using federal data matching sources without needing the member to respond, they can be automatically renewed. This minimizes the chances for closures due to nonresponse, reduces the paperwork burden on members and preserves staff capacity to help the remaining people. To date, Oregon’s monthly news release on renewals has used KFF data, which continues to show Oregon in third place. The KFF ranking for Oregon being among the top states reduces paperwork in the process.
Rules protecting coverage between renewals
Oregon is unique in giving most adults a two-year continuous eligibility period where they will keep their medical benefits until their next renewal, even if something like income changes would no longer qualify them for benefits. Oregon also offers young children benefits until their sixth birthday. These rules do not directly affect renewal rate but prevent “churn” on and off benefits between renewals.
July OHP renewal data
As of July 19, 1,347,208 people have completed the renewal process. This represents around 92.7 percent of all OHP and Medicaid members.
- 1,114,627 people (82.7 percent) were renewed and kept their benefits.
- 221,260 people (16.4 percent) were found ineligible.
- 11,321 people (0.8 percent) had a reduction in their benefits. Most of these members lost full OHP but were able to continue Medicare Savings Programs that help pay their Medicare costs.
Although most people are keeping coverage during the post-pandemic medical renewals, approximately 232,000 people have or will need to consider other coverage options due to lost or reduced benefits.
- People who do not have coverage through an employer or Medicare may be able to enroll through the Oregon Health Insurance Marketplace and get financial help. Most people who enroll through HealthCare.gov qualify for this help.
- The Marketplace is sending information to people who are no longer eligible for OHP benefits, advising of other potential coverage options.
- People who have recently lost OHP benefits can enroll anytime until Nov. 30, 2024, or within 60 days of their benefits ending.
- For more information and ways to get help signing up for Marketplace, Medicare or employer coverage, see “What to do if OHP is ending” below.
Need help renewing your benefits?
- Learn more about how to renew your OHP coverage. You can log into your ONE Online account and complete your renewal at benefits.oregon.gov.
- Call the ONE Customer Service Center at 800-699-9075. All relay calls are accepted, and help is available in multiple languages. Wait times are lowest between 7 and 8 a.m., Pacific Time.
- Visit or call a local Oregon Department of Human Services (ODHS) office. People can find their local office at https://www.oregon.gov/odhs/Pages/office-finder.aspx.
- Visit a community partner for free, in-person help. To find one near you visit OregonHealthCare.gov/GetHelp (English) or orhim.info/ayuda(Spanish).
- Download the Oregon ONE Mobile app via the app store to keep track of your renewal, find a local office, or upload a document.
What to do if your OHP is ending:
- First, review the case summary in your letter to make sure the information used to make the decision was correct. If that information has changed, notify the state via one of the options above. If the information on file for you is correct and you disagree with the decision, you can request a hearing. Learn more about hearings.
- Explore options through an employer. If you, your spouse or a parent are working, you may be eligible for health coverage through that employer. Talk to your manager or Human Resources department to see if you qualify. You will have a special enrollment period to enroll mid-year due to loss of OHP benefits.
- If you have or are eligible for Medicare: For help understanding and choosing the right Medicare options, go to https://OregonHealthcare.gov/GetHelp to find an insurance agent or a counselor at the Senior Health Insurance Benefits Assistance Program (SHIBA). You can also call SHIBA at 800-722-4134.
If you need to sign up for Medicare for the first time, contact the Social Security Administration (SSA) at 800-772-1213 to enroll by phone or find a local office. You can also enroll in Medicare online at ssa.gov/medicare/sign-up.
- Nearly 80 percent of Oregonians qualify for financial help through the Oregon Health Insurance Marketplace. Visit OregonHealthCare.gov/WindowShop to answer a few quick questions, find out how much you can save and find out how much coverage may cost you. You can also call the Marketplace Transition Help Center at 833-699-6850 (toll-free, all relay calls accepted).
- Need free local help finding other coverage? Visit OregonHealthCare.gov/GetHelp to find professional help near you.
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. Check our ONE Eligibility Operations Dashboards for more frequent updates on medical renewal data and wait times for callers to the ONE Customer Service Center.
Source: Oregon Health Authority