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OHP Work or Activity and Federal Changes to Oregon Health Plan

Stay Connected, Stay Covered

Last updated Sept. 18, 2026

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What You Need to Know

The federal government requires changes to Oregon Health Plan (OHP), also known as Medicaid. This is due to House Resolution 1 (HR1), a federal law passed by Congress. 

Most members will keep their benefits

Renewals will be more frequent, some adults will need to meet work or activity rules, and ther will be coverage changes for some non-citizens. These changes will start in late 2026 and through 2028. For durrent OHP members, what changes appy to you will vary. Click to learn more about each change:

OHP Work of Activity Rules
More Frequent Renewals
Changes for Non-Citizens
Less Time for Help with Bills
Fees for Some Services in 2028

How to Get Help

Please keep your contact information up to date so OHP can reach you. Tell us if your mailing address, email, and phone number, or other information changes.

OHP will send you notices when it is time to renew.

For questions or to report changes to your contact information:

OHP Work or Activity Rules

Starting in 2027, some adults ages 19-64 will need to meet work or activity rules when they apply for or renew OHP.

People age 19-64 who:

  • Are not pregnant
  • Don't have Medicare
  • Don't get Supplemental Security Income (SSI)
  • Don't qualify for OHP programs based on disability or certain other factors

Work or activity rules will not apply to many OHP members, including:

  • Children and youth under 19
  • Adults who are age 65 and older
  • OHP members with Medicare, or who qualify for an OHP program based on disability, pregnancy, or certain other factors

People may also qualify for exemptions that mean they do not need to meet the rules, such as serious medical conditions or caring for children under 14 years old. Learn more below.​


If you're an OHP member and the rules apply to you, you will get a notice about the rules in September 2026.

  • Sample Notice – English
  • Sample Notice – Spanish

Oregon is required to send this notice to everyone who will be subject to the new rules. This includes people who may be exempt, such as parents of a child under 14 years old. In addition to the September notice, members will get a notice before their next renewal that will tell them if any information is needed and by what date.

You will not get this notice if you are American Indian/Alaska Native, or on categories of OHP based on disability, pregnancy, or other factors the rules do not apply to. ​


If you qualify for an exemption, it means you have a reason you don't need to meet the work or activity rules. There are many exemptions. 

You may need to provide proof of exemptions.

  • In 2027, you can tell us you have an exemption. You don't need to give proof.
  • In 2028, proof will be required for more exemptions. We will share more about proof that will be accepted in 2028 after the federal government provides more guidance.
  • Learn more about exemptions and how to qualify below or in the Exemptions Explainer.
​
​​Exemption Does this describe you? How to show you qualify
SNAP work rulesYou get Supplemental Nutrition Assistance Program (SNAP) food benefits and must meet SNAP's work rules. Meeting SNAP work rules counts for OHP too. You don't need to separately meet OHP's rules. However, if you are exempt from SNAP work rules, you still need to meet OHP's work or activity rules or qualify for a different exemption.You do not need to tell us about this or provide documents. We check using existing records.
TANF work rulesYou get Temporary Assistance for Needy Families (TANF) cash assistance and already meet TANF's work rules.You do not need to tell us about this or provide documents. We check using existing records.
Under age 19You are 18 years old or younger.You do not need to tell us about this or provide documents. We check using existing records.
Former Foster YouthYou were in foster care when you turned 18 and are now 19–26.You do not need to tell us about this or provide documents. We check using existing records.
Covered by another OHP programYou qualify for OHP in a program that doesn't require work or activity rules.You do not need to tell us about this or provide documents. We check using existing records.
Live in a high-unemployment countyYou live in a county with a high unemployment rate. We will tell you if this applies to you.You do not need to tell us about this or provide documents. We check using existing records.
Live in a disaster areaYou live in a county the federal government has declared a disaster area.You do not need to tell us about this or provide documents. We check using existing records.
American Indian/ Alaska Native

You're an enrolled member of a federally recognized tribe (or your parent or grandparent is) or a shareholder in an Alaska Native Corporation.

This also covers people who get care from Indian Health Services or a Tribal or Urb​an Indian clinic.

Tell us this applies.
Pregnant or recently pregnantYou're pregnant, recently became pregnant, or you had OHP coverage while pregnant sometime in the last 12 months.Tell us this applies, especially if you recently became pregnant. That way we'll know this exemption applies to you.
Recently released from jail or prisonYou were released from jail or prison within the last 4 months if you are a new applicant or the last 9 months if you are renewing.Tell us this applies.
Have MedicareYou have Medicare Part A or Part B, or you qualify for Medicare.We can usually verify this automatically. If we ask for proof, you can give us a Medicare card, Medicare letter, or any document that shows your Medicare coverage.
Certain serious or
disabling health conditions

You are receiving care for a serious or disabling health condition that prevents you from working at least part time. Many types of conditions that require medical care or services may qualify, including things like:

  • Temporary conditions: Recovering from major surgery (like cardiac bypass); a serious injury (like fractures); pneumonia; or a hospital or care-facility stay for a complex condition.
  • Serious or long-term conditions: Cancer requiring chemotherapy or radiation, dialysis, Crohn's disease, chronic obstructive pulmonary disease (COPD), major depressive disorder, or a substance use disorder.
  • Conditions requiring frequent monitoring or treatment: Diabetes with complications or cystic fibrosis.
  • Life-long conditions: Down syndrome (trisomy 21), cerebral palsy, blindness, or another major physical, intellectual, or developmental disability.
  • Social Security benefits: Receiving Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

Tell us this applies. You do not need a statement from a medical provider in 2027. 

Visit your primary care provider at least once a year and attend follow up appointments. If you are regularly receiving care, your medical records may be enough for us to verify an exemption.

If we ask for proof (starting in 2028), we may need a statement from a medical provider.

Veteran with total disability ratingThe Department of Veterans Affairs (VA) has assigned you a 100% disability rating. If we ask for proof, you can give us a copy of your VA award letter. If your rating isn't permanent, you need to confirm your disability rating status every 12 months.
Caring for a child under 14You're the parent, guardian, or caregiver who regularly takes care of a child 13 or younger.

Tell us this applies and your relationship to the child.

If we ask for proof (starting in 2028), give us a calendar, schedule, or other document showing your caregiving hours.

Caring for a person with a disability
or serious or disabling health condition		You regularly care for a family member or someone else with a disability or a serious or disabling health condition. This includes people you're not related to or don't live with as long as you provide at least 80 hours of care a month.

Tell us this applies and your relationship to the person.

If we ask for proof (starting in 2028), give us a calendar, schedule, or other document showing your caregiving hours.

In drug or alcohol treatmentYou currently participate in or participated in services or supports to treat a drug or alcohol use disorder within the past 5 years.

Tell us this applies.

If we ask for proof (starting in 2028), give us a bill or document from your provider or counselor showing treatment dates.

Getting inpatient or residential careYou spent at least one night as a patient in a hospital, nursing facility, behavioral or mental health facility, or similar place.

Tell us this applies.

If we ask for proof (starting in 2028), give us a bill, discharge papers, or a document from your provider.

Traveling for medical careYou (or your child or tax dependent) were away from home for seven or more days out of a month to get medical care, or you missed work, school, or job activities to help that person.

Tell us this applies.

In 2028, give us discharge papers or a document from your provider.

If the new rules apply to you, we'll review your case each time you apply or renew. This review is to see if you

1. Meet the work or act​​ivity rules through:

  • Income: You earn more than $580 per month of household income before taxes and deductions.
  • School: You are enrolled in school at least half-time. This includes high school or a GED program.
  • Hours: You do at least 80 hours a month of some mix of work, volunteering, caregiving, school, or a training or work program. This includes unpaid work, seasonal work, and self-employment.
  • What counts for volunteering: Volunteer hours must be part of an organized program with a public agency or nonprofit that keeps track of your hours and can confirm them if asked. Political or partisan activities don't count.

​OR​​

2. Qualify for an exemption, which ​​means you don't need to meet the work or activity rules. Check the Exemptions section.​

If you don't meet the rules or qualify for an exemption:

  • Your OHP could end.
  • You can re-apply for OHP at any time. When you re-apply, we check if you met the work or activity rules in the prior month.
  • If you no longer qualify for OHP because you do not meet work or activity rules, you may be eligible for coverage through the Marketplace, but you may not qualify for financial help called premium tax credits or cost-sharing reductions. The only way to know if you qualify for financial help is to apply. Visit OregonHealthCare.gov to learn more.

If you need help finding a job or volunteer work, visit https://OHP.Oregon.gov/Resources.​

You may need to give us proof to show you meet the rules or qualify for an exemption. Your notice will tell you what we need and when.

Timing: We'll check if you meet the rules or qualify for an exemption:

If you're a new applicant: One month before your application month. In some instances, we will check during your application month. We may also need proof for other months if you ask for help with bills or services for past months.

If you're renewing: In at least one month during the six months before your renewal date.

Ways to Meet the Rules How​ to Prove It
Income: $580 in monthly household incomePay stubs, statements from your employer or financial institution, personal records for self-employment, tax forms, or other documents that verify your income per month. If you had seasonal income, you can send proof that shows an average household income of at least $580 over six months.
Education: Enrolled at least part-timeClass schedule, financial award letter, or a statement from your school or program.
Hours: 80 hours a month of activitiesTimesheets, activity logs, statements from employers, schools, or volunteer organizations
ExemptionsVaries. Check the Exemptions Section.

More Frequent Renewals

OHP and Medicare Savings Program members will need to renew more frequently starting in late 2027. When this change applies to you depends on when your household renews.

Six-month renewals will only apply to adults who:

  • Are between the ages of 19 and 64.
  • Do not have Medicare or an OHP program based on a disability, pregnancy, or certain other factors.
  • Are not American Indian/Alaska Native.

All other OHP members, including children, will need to renew once per year.

Currently, most OHP members renew every two years, and children under 6 don't need to renew until their sixth birthday. This will end in late 2027.

To learn more, read the fact sheet​


Changes for Non-Citizens

The federal government will require some changes to OHP for many noncitizens in late 2026 and 2027.

In Oregon (unlike other states), this does not mean people will lose OHP. Oregon has a program called Healthier Oregon that provides full OHP benefits regardless of immigration status.

In October 2026, about 7,000 OHP members will move to Healthier Oregon. Healthier Oregon is an OHP program and has the same benefits. This will affect adults with these immigration statuses that include:

  • Refugees
  • Asylees
  • Survivors of domestic violence or human trafficking
  • Some humanitarian parolees, including from Afghanistan and Ukraine
  • Amerasian-Vietnamese
  • Canadian-born First Nations, and enrolled members of a US Indian tribe born outside the United States who do not have Lawful Permanent Resident (LPR) status 

These changes will not affect children, or adults with these statuses who qualify for OHP Bridge.

To learn more, read the fact sheet.

Members who have OHP through Healthier Oregon will move to OHP Open Card in January 2027.

  • This affects adults with statuses including nonimmigrant visas, refugee or asylum statuses, most adults with permanent resident status for less than 5 years, and adults and children who do not have an immigration status that qualifies for other OHP programs.
  • If you are affected by this change, you will get a notice in October.

OHP Open Card is a type of OHP for members who are not in a coordinated care organization (CCO). CCOs are a group of health care providers that care for OHP members in their area.

OHP Open Card has the same OHP benefits. The health care providers you can see through OHP Open Card may differ.

Ask your current health care providers if they accept OHP Open Card. If they do not, use the search tool at OHPopencard.org. After January 1 you can also call 800-562-4620 for help finding providers.

To learn more about this change, read the fact sheet or visit Oregon.gov/HealthierOregon.​


Members who have coverage through Healthier Oregon may be affected by other changes, including more frequent renewals and work or activity rules for some adults.​​

Less Time for Help with Bills

Starting Jan. 1, 2027, OHP will cover recent medical bills from a shorter time period for new members and people who re-apply after losing benefits. Currently, new members can get help with up to three months of medical bills. This will change in 2027.

  • Only one month of past bills for most adults ages 19 – 64 who do not qualify for OHP programs based on disability, pregnancy, or certain other factors. 
  • Up to two months for all other members, including children, people over 65, and anyone pregnant or on OHP programs based on disability.

Fees for Some Services in Late 2028

Starting in October 2028, some adults will need to pay a small fee for certain types of health care. This is called a “copayment" or “copay".

  • These fees will not apply to adults who have Medicare or OHP based on a disability.
  • Members with incomes under $15,000 a year will not need to pay the fees.
  • Members will not need to pay fees for checkups, emergency care, or mental health care.
  • These fees will not apply to prenatal care, substance use treatment, or care at community health clinics

Oregon is still awaiting more federal guidance about this change. This page will share more information as we get closer to 2028.