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Updated: Emma Sandoe named as next director of Oregon's Medicaid program

Sandoe hails from North Carolina's program where Oregon Health Authority Director Sejal Hathi also had worked for a time. Sandoe will bring a national reputation while heading the $28-billion Oregon Health Plan providing free health care to 1.4 million low-income people.
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Emma Sandoe will head the state program providing free health care to 1 in 3 Oregonians. | OREGON HEALTH AUTHORITY
May 23, 2024
This article has been updated to incorporate additional reporting.

Emma Sandoe has been named director of Oregon’s version of Medicaid and will take over the program providing free care to 1.4 million low-income Oregonians in July.

Formerly the deputy director of medicaid policy for North Carolina, Sandoe was chosen to oversee Oregon's version of the federal program following a national search. Her starting annual salary will be $171,312.

Sandoe will take over direction of the Oregon Health Plan at a fraught time. The agency has been racked by several high-level departures — including that of her well-regarded predecessor, Dana Hittle. That's left key positions filled with people serving on an interim basis.  Oregon last year won federal approval for revisions to the program, but there's been concern even at top levels of the agency about whether the changes would succeed. And rollout of the changes has been rocky at times. 

Meanwhile, the agency is nearing 2030, the date by which it has a goal of eliminating health inequities — a major focus of Hathi's.

Sandoe's obtained her bachelor's degree from the University of California, San Diego in 2008, and a master's in public health from the George Washington University School of Medicine and Health Sciences in 2010. She took a job as a press secretary at Centers for Medicare & Medicaid Services during the Obama administration, then left to earn a doctoral degree at Harvard in health policy analysis. There, her dissertation looked at Medicaid history in states including Oregon. Other work looked at how certain decision points in the history of Medicaid led to reinforcing racial and ethnic disparities, rather than reducing them.

In 2019, she joined North Carolina's Department of Health and Human Services, where over time she worked on numerous revisions to the state's Medicaid program, including expansion to cover 450,000 additional residents. Having faced earlier resistance from Republicans, that decision occurred nearly a decade after Oregon expanded its own program. 

According to Oregon's announcement of her hiring, Sandoe worked in North Carolina with federal Medicaid officials and also led efforts to improve health equity in the program. She also became the program's liaison to Tribal nations in the state. She also worked on efforts to expand the health care workforce and efforts to address food and housing insecurity.

“Dr. Sandoe brings a track record of expertise, innovation and experience putting health equity into practice in vital Medicaid programs,” Hathi said in the state's press release. “She brings both vision and pragmatism to this role, as well as strong relationships with our federal partners, which will enable Oregon to continue to set the pace in implementing vanguard Medicaid coverage and benefits that address the major health issues facing our communities, such as homelessness and climate change. I’m excited to welcome Dr. Sandoe to Oregon.”

Sandoe's background, acquaintances and history shows that she has a lot in common with her new boss. 

Like Hathi, Sandoe's national profile grew in part through being very active on social media in health policy matters — sharing information on the history of Medicaid policy development and health equity, among other things. Hathi also served as a clinical fellow and resident physician at Harvard Medical School even as Sandoe worked there as a teaching fellow as well as research assistant studying responses to the opioid epidemic. They worked with some of the same professors.

They both started working in North Carolina in 2019. That's when Hathi took time out of her residency to serve as a special assistant to  the state's then-Secretary of Health and Human Services, Mandy Cohen. Cohen, a friend of Hathi, last year was appointed by President Joe Biden to be director of the Centers for Disease Control and Prevention. 

In North Carolina, like Sandoe, Hathi worked on the state's Medicaid changes. State employees thanked the two of them for their feedback on a paper published in the prestigious journal Health Affairs about the state's “Buy Health” program intended to reduce waste .

Sandoe will take over from interim director Vivian Levy. 

In a statement included in the state's press release, Sandoe said “I’m delighted to come to Oregon, a state that's always been at the forefront of health policy. I’m excited to collaborate with Medicaid staff and partners to expand access to care, improve peoples' lives and eliminate health inequity.”

Correction: An earlier version of this article mischaracterized Sandoe's starting position at North Carolina Medicaid. We regret the error.

You can reach Nick Budnick at [email protected] or via at @NickBudnick