medicaid

Quick Look: Oregon Health Authority Policy Keeps Medicaid Members from CCOs

Only 15 percent of Oregon Health Plan income-based members have seamless coverage at renewal time. Rep. Cedric Hayden wants to pull enrollment from OHA and give it to DHS, and require that lapsed members be put immediately back into the CCO that was serving them.

Medicaid members must renew each year.

OHA Routinely Keeping Medicaid Members out of CCOs

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As they jump through a difficult re-enrollment process, 147,000 Medicaid members have been caught outside coordinated care organizations with little access to care, which could cause the state and CCOs to lose $200 million per year in Medicaid funding, mostly from federal sources.

The Oregon Health Authority’s Medicaid renewal plan is marooning recipients for weeks or months in a separate system outside the state’s coordinated care organizations, limiting members access to care and keeping funds away from the local CCOs

Oregon Health Authority Disputes Auditor’s Allegations It Misused Medicaid Funds

An audit by the Oregon Secretary of State’s office found that health officials may not have adequately checked to see if people met Medicaid requirements before enrolling them in health plans. But the health authority says the audit missed key context, including a federal waiver governing Medicaid renewals.

Two powerful Oregon agencies are butting heads over whether the state is using federal Medicaid dollars correctly.

Medicaid Expansion Too Big, Too Successful and Too Politically Disruptive to Gut

Oregon’s innovative Medicaid expansion under the CCOs faces big tests with Congress and President-elect Donald Trump promising to repeal the Affordable Care Act while Oregon faces a $1.7 billion budget deficit.

For 10 years, Mel Rader, executive director of Upstream Public Health, didn’t have access to health insurance – and he was sick for more than three of those years. His experience convinces him it’s a “moral imperative to provide health insurance for those who cannot afford it.”

Wyden Says Trump Administration Could Derail Oregon's Medicaid Waiver

At the same time, Wyden is fairly certain the federal government will sign off on the waiver before President Obama leaves office.

While Governor Kate Brown and the Oregon Health Authority are urging the Centers for Medicare & Medicaid Services to approve Oregon’s multi-year waiver before President-elect Trump takes office, there still could be trouble ahead, according to U.S. Senator Ron Wyden, D-OR.

State May Seek More Straight-Forward Medicaid Waiver to Bolster CCOs

By pulling back on the Medicaid waiver, Oregon may be able to be assured that the reforms launched in 2012 can get approved before President Obama leaves office.

The governor’s top healthcare policy advisor told a state panel Wednesday morning that the state may seek a straightforward renewal of its Medicaid waiver while President Obama was still in office, and pull back on more aggressive innovations to use medical dollars for social determinants of heal

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