5 Things Oregon: 2022 health policy, Medicaid redetermination, Market oversight program


Emily Boerger


We were honored to host the 2021 Oregon State of Reform Health Policy Conference two weeks ago. It was a day filled with dynamic conversations, cross-sector collaborations, and forward-looking dialogue.

In this edition of “5 Things We’re Watching” we feature some of the conversations and stories that took place at the event. For those who registered for the conference, you can still access the videos of the two keynotes and all 16 sessions using your participant link!

Emily Boerger
Managing Editor
State of Reform


1. Keynote video: Legislative leadership

Rep. Rachel Prusak, chair of the House Interim Committee on Health Care, says her committee will continue to frame policy conversations around equity, access, cost, and public health in the upcoming session. Her comments came during our “four corner” legislative keynote at the State of Reform Conference which we have available in full here.

During the conversation, the four leaders discussed the issues they’ve been focused on in the interim, the future of the state safety net, efforts to lower health care costs, and a preview of the issues they will prioritize in the coming session. Supporting the health care workforce, both in urban and rural areas, is top of mind for all four leaders, as is investing in upstream, preventive health care. This was a particularly insightful and forward-looking conversation which is well worth a listen.

2. State leaders prepare for Medicaid redetermination

State leaders are preparing for the impending end of the federal public health emergency (PHE) declaration, which will instigate a lengthy eligibility redetermination process for Oregonians who currently benefit from Medicaid. Since March 2020, over 267,000 new individuals (+24.8%) have enrolled in the Oregon Health Plan, and OHA estimates as many as 300,000 may be taken off the program once the PHE ends.

OHA Director Pat Allen says it will be important to support smooth transitions to other health coverage options for those found to be ineligible for Medicaid. “If we do things the way they ordinarily get done, we’ll have a bunch of people found to be ineligible for Medicaid. And without any kind of a system of support or coordination, they will likely end up uninsured … What we’d really like to do is make sure people who are eligible are on the system so that they can benefit from that heavy investment in upstream and primary care spending.”


3. Draft rules for “Health Care Market Oversight Program”

OHA last week released its latest draft rules for implementation of House Bill 2362 – the bill passed this year requiring health care entities to obtain approval from OHA for certain mergers, acquisitions, or affiliation transactions. The 29-page document details the types of transactions requiring approval, the list of entities subject to the rules, and the approval process for transaction approval.

As part of its review process, OHA may choose to convene a community review board which will consider if the transaction may result in a loss of essential services, if it will have an impact on a large number of residents, and if it will result in a significant change in market share. OHA will file its proposed rules at the end of November, and the public comment period is expected to run from Dec. 1 through Dec. 21. The program’s effective date is March 1, 2022.

4. Health priorities for the 2022 session

Over the course of two separate breakout sessions during the State of Reform Conference, seven legislators offered a preview of the health policy they will prioritize in the 2022 legislative session. The Democratic leadership panel highlighted health care affordability, community connections, school-based care, and health equity.

Legislators on the Republican leadership panel said general behavioral health, youth mental health, access and efficiency in the health care sector, and rural access to medications will be top of mind. A rundown of both panels’ comments is available here.


5. Video: DEI work & the social determinants

Three experts came together at the conference last month to talk through diversity, equity, and inclusion investments and their impacts on the social determinants of health. The panel reviewed efforts underway to collect better data around the social determinants of health, create a more inclusive health care workforce, and connect with underserved communities.

CareOregon Chief of Staff Jeremiah Rigsby says its important to “pull each lever available” to try to move the needle on DEI work. This might mean supporting better data collection, better data utilization, and investments in upstream services. “Within the CCO space it’s important for us to be adaptable to what’s available in the community, what the resources are, and make sure we get our members the right access at the right time.”