Task force considers federal funding options to support health insurance plan for Oregonians

A new task force discussed federal funding options for supporting a health insurance plan for low-income Oregonians Tuesday.

 

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Oregon’s Bridge Health Care Program Task Force was formed after the passage of House Bill 4035 during the last legislative session. Members are working to create a bridge program to offer coverage to people leaving the Oregon Health Plan (OHP) when the public health emergency ends.

The task force will focus on providing coverage for people up to 200 percent of the federal poverty level who do not qualify for the OHP. Approximately 300,000 people will no longer be enrolled in the Medicaid program when the public health emergency ends, which is currently slated for July 15, though that could change.

The number of insured Oregonians increased during the COVID-19 pandemic. In 2019, prior to the pandemic, 94 percent of residents had coverage. Jeremy Vandehey, Director of the Oregon Health Authority’s Health Policy and Analytics Division, said that number went up to 95.4 percent in 2021. The number of insured among the state’s Black population increased from 92 to 95 percent during that time, he said.

“Large coverage gains were made among low-income adults as fewer people reported being uninsured,” Vandehey said. “We’ve seen some significant equity gaps close. As we approach this public health emergency [end date], we’re trying not to go backwards.”

Manatt Health Managing Director Joel Ario presented three federal waivers for task force members to consider for coverage options:

  • Section 1115 of the Social Security Act gives the Secretary of Health and Human Services authority to approve experimental, pilot, or demonstration projects likely to assist in promoting the objectives of the Medicaid program.
  • The Affordable Care Act’s (ACA) Section 1331 gives states the option of creating a basic health program, which gives states the ability to provide more affordable coverage for low-income residents and improve continuity of care for people whose income fluctuates above and below Medicaid and Children’s health Insurance Program levels.
  • The ACA’s Section 1332 permits a state to apply for a state innovation waiver to pursue innovative strategies for providing residents with access to high quality, affordable health insurance while retaining the basic protections of the ACA.

“These are the three basic pathways to access federal money,” Ario said.

Task force member discussion largely centered on Sections 1331 and 1332, and the likelihood that the implementation of 1332 would take longer to roll out.

“It’s becoming clearer that the 1331 path is a quicker expedited path than 1332,” Vandehey said.

Task force members considered the idea of utilizing 1331 as a stopgap to address immediate concerns while working to implement 1332. But Ario said the Centers for Medicare & Medicaid Services (CMS)which released a rule creating the 1331 basic health program in 2014may not cooperate in implementation purposes if the intention is for the program to be used temporarily.

“The signals coming out of CMS is that the 1331 program is designed to be permanent,” Ario said. “We don’t think that transition is viable. At the federal level for 1331, they’ll say we have to be committed to it.”

Task force members will continue to weigh their options during their next meeting on May 24. They are expected to make a final decision on June 14.