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Oregon Senate Passes Bill that Studies Dental Care for COFA Community

Low-income COFA Islanders are shut out of the Oregon Health Plan because of federal funding restrictions, so the Legislature created a special private insurance plan for them. But it didn’t include dental care. Now, the Department of Consumer and Business Services may be ordered to study the feasibility of including this service in the COFA insurance program.
March 28, 2017

Oregon’s Pacific Islander community won a special health insurance program last year that provides basic health insurance at no cost to low-income islanders, but it came with one serious shortcoming -- it doesn’t cover dental care.

On Monday, the Oregon Senate took a step toward correcting that oversight, unanimously passing Senate Bill 147, which directs the Department of Consumer & Business Services to form an advisory group to find ways to expand the program to include dental care.

“The only thing wrong with this bill is that it doesn’t provide for the service now,” said Sen. Lee Beyer, D-Springfield, who carried SB 147 on the floor with chief sponsor Sen. Fred Girod, R-Stayton, a dentist. “What we did to these island nations when they were under the protectorate, we ought to be ashamed.”

The Pacific Islander premium program, and any potential dental plan, is limited to the so-called COFA islands governed by the Compact of Free Association -- Micronesia, Palau, and the Marshall Islands. After World War II, the three nations became colonial protectorates of the United States, which used some of the islands as nuclear bombing ranges.

Coverage for dental care varies by insurance type. While the Oregon Health Plan started covering basic adult dental services in 2014, almost all private individual health insurance plans sold on the Obamacare exchanges do not, forcing individuals to buy a separate, stand-alone dental plan, which cannot receive subsidies to reduce costs.

“The Medicaid people in Oregon can get dental but the COFA people cannot,” said Loyd Henion, a lobbyist for the COFA Alliance Network. “That’s unfair.”

The compact signed after the three nations were granted independence allows them to travel and live in the United States, but they aren’t technically immigrants and retain their citizenship with their home countries. President Clinton’s 1996 welfare reform law stripped them of the ability to receive Medicaid.

Thousands of people simply went without health insurance access in the ensuing two decades, and they were again left out by the Affordable Care Act.

An innovative Oregon law, however, allows the state to draw down federal exchange subsidies to offer low-income Islanders free private health plans, which also come with a debit card for copayments and coinsurance. The premium program is only available to people with low enough incomes to qualify for Medicaid. People with higher incomes can shop and receive the regular subsidies on the federal exchange.

The Department of Consumer & Business Services may have been able to study the dental option even without the bill, but advocates said SB 147 keeps the marginalized COFA Islander community in the consciousness of the Oregon Legislature and gives senators another chance to affirm their support for the community.

“The study will determine if federal subsidies are available,” said Shane Jackson, another COFA lobbyist.

A tiny fraction of federal exchange plans do voluntarily include adult dental among the covered benefits, making it likely that a COFA-specific plan would get this service subsidized if Oregon health insurers designed a plan that includes the benefit.

Chris can be reached at [email protected].