Medicaid Enrollment In Oregon Continues To Swell

Oregon Health Plan membership has swelled by more than 100,000 since the start of the COVID-19 pandemic. But the state said it is getting enough extra money from the federal government to cover the increased cost to the state until the end of the year and perhaps beyond.

The number of members in the government-funded health plan grew by more than 4,000 last week, taking the total to 1.18 million. That’s an increase of 101,000 new members since the March 8 declaration of a pandemic emergency by Gov. Kate Brown.

The health plan’s membership had been expected to grow, but no one has been sure by how much and how fast. Oregon residents left without jobs and job-provided health insurance in the pandemic-induced economic slump have flocked to the free government coverage.

Some observers had expected a rapid and large increase in Medicaid enrollment. But Oregon Health Authority officials have said the increase so far has been steady and moderate, in part because many companies have continued to provide workers with health insurance, even while they are furloughed and counted as unemployed. Also, some state officials speculate that laid off workers are focusing on getting unemployment benefits and trying to find new jobs, and not bothering to sign up for the Oregon Health Plan until they experience health problems.

The increased OHP membership is costly to taxpayers. Each member costs about $6,000 or more to insure. The federal government pays about 75% of that and the state funds the rest. Recognizing there would likely be an increase in demand for Medicaid coverage during the pandemic, the federal government bumped up its payments to states in March by 6.2% through the end of the year. That’s an extra $215 million for Oregon, the state has said, enough to cover expected increased enrollment.

“This 6.2% increase in federal Medicaid matching funds has covered and is projected to cover Oregon’s enrollment increases through the end of the year,” the state said in a news release Monday.

Two factors are boosting the number of Oregon Health Plan members. One is the enrollment of new people, with 75% adults and 25% children, the state said. The Oregon Health Authority is not verifying new members’ incomes during the pandemic. Applicants can simply attest to their earnings instead of submitting a pay stub or other documentation.

The other factor that’s boosted the numbers is existing members are staying on longer than they did before the pandemic, the state said. Typically,  about 20,000 people a month left the plan, either dropping it or being booted off because their income had risen above the plan limits, or other factors. But without the state conducting annual income verifications, people are dropped from the plan only if they voluntarily terminate or leave the state, a condition that was set by the federal government as part of the extra funding for states. The bottom line: Currently, only about 5,000 people a month are exiting the plan.

To help keep the plan solvent, the Oregon Health Authority has cut by 2% the amount per member that it pays to coordinated care organizations to manage Oregon Health Plan members.  

You can reach Christian Wihtol at [email protected].


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