Oregon Health Plan safety net catching more people during pandemic
Federal and state officials have boosted access to Oregon Health Plan insurance in response to the COVID-19 crisis.
Low-income Oregonians, people who’ve lost their jobs and those who’ve seen their incomes take a nosedive can more easily qualify for the health insurance.
To see if you qualify for OHP and to apply at any time of the year, visit one.oregon.gov or call 1-800-699-9075. Phone call wait times may be long.
“The COVID-19 pandemic requires us to act quickly to support the needs of our communities,” said Patrick Allen, director of the Oregon Health Authority. “This added flexibility in our Medicaid program is going to allow us to more quickly get people access to health care and expand our health system to meet the challenges of this public health emergency.”
OHP is the state’s version of Medicaid, which primarily covers low-income kids and adults.
It covers more than 1 million Oregonians — or about one in four residents.
New rules mean individuals can sign up for OHP without having to verify their income through documents such as pay stubs.
Officials said they will be able to self-attest, which will help Oregonians get access to OHP coverage more quickly.
Federal stimulus payments to people and increased unemployment payments will not affect OHP eligibility. They will not be counted during the application process or when members report a change in their household, officials said.
All members who are currently enrolled in OHP will not lose their coverage during the COVID-19 crisis, officials said.
This month, Congress and President Donald Trump approved a new bill that boosts federal funding for Medicaid programs.
Federal and state governments together cover the costs of the government-subsidized health insurance.
The bill requires that all insurers and government-provided insurance like Medicaid and Medicare fully cover COVID-19 testing and related services.
Extra funding for OHP means the coordinated care organizations that manage benefits for Oregonians can better respond to the crisis, said AllCare Health Vice President of Government Relations and Health Policy Josh Balloch.
AllCare Health and Jackson Care Connect serve Southern Oregon residents.
“The more funding that we’re getting now allows us to act quickly, come up with creative solutions and not let financial considerations be a roadblock to what needs to be done — because we are going to have to expand access and infrastructure to be able to deal with what potentially could be a lot of people getting sick,” Balloch said.
Compared to some states, Oregon has a high proportion of insured residents. It embraced the 2010 Affordable Care Act, which expanded eligibility for government-subsidized health insurance, including OHP.
Oregon reduced its uninsured rate to approximately 6% of the population following passage of the act, according to Jackson Care Connect.
Long before the COVID-19 pandemic, Republicans in Congress and the Trump Administration tried to gut the ACA but failed in the effort.
Of the 1 million Oregonians with OHP coverage, about 368,000 have that health insurance thanks to expanded eligibility from the Affordable Care Act, Balloch said.
The COVID-19 crisis could lead to a surge in demand for OHP as people lose employer-provided health insurance.
Oregon will lose 257,000 jobs by July through layoffs and furloughs, pushing the state’s jobless rate to 15.5 percent from its pre-virus record low of 3.3 percent, the nonpartisan Economic Policy Institute estimated in a report released Wednesday.
Under the current OHP system, the state spends on average about $6,000 a year insuring the health of each of its members. Adding, for example, 150,000 members could cost the state an extra $900 million a year, the health news service The Lund Report estimated.
The federal government normally covers about 75% of OHP costs, with the state of Oregon paying the rest. The federal government has already increased its payouts to states by 6.2%, The Lund Report said.
It’s not clear yet what the financial fallout will be on Oregon and its system of coordinated care organizations, which are companies and nonprofit groups that manage OHP physical, mental and dental benefits.
The CCO model was launched in Oregon after passage of the Affordable Care Act. It emphasizes preventive care to keep people healthy and out of high-cost medical settings such as hospital beds and emergency rooms.
Several years of data show the approach has improved the quality of care, increased patient satisfaction and cut emergency room use. While the amount of money spent on health care continues to rise in Oregon and across the nation, Oregon’s rate of spending increases are lower than the national average.
Balloch said the CCOs’ efforts to keep OHP patients healthy overall could help during the pandemic.
“We’re trying to do everything in our power right now to keep people healthy, stabilized and in their homes,” he said. “Every hospital bed that they’re not using is a hospital bed that can then be used by somebody who may be infected with COVID-19.”
Jackson Care Connect said it’s working with its network of doctors and other health care providers to boost access to telehealth services so patients don’t have to visit with providers in person and risk catching or spreading COVID-19. The CCO is also reducing administrative burdens as much as possible.
In addition to prioritizing preventive care, the CCOs partner with community groups to tackle problems such as inadequate and unaffordable housing, lack of access to food, and addiction — all of which can harm people’s health.
Balloch said those partnerships are more important than ever.
“It’s a very interconnected web, and we in Oregon are lucky we actually do have a lot of people doing a lot of good work on the front end and the back end to try to make this work,” he said. “This is a scary time, but I do have a lot of hope because we have a lot of really smart, capable people and systems in place to try and navigate this even better than a lot of other states.”