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Oregon's Medicaid Waivers

What Is a Medicaid Waiver?

Every state must operate according to rules set by the federal government. But states can ask the federal government for permission to not follow some rules. To do this, states must apply for a waiver.

Approved waivers are also called Section 1115 Medicaid Demonstrations. Demonstrations are a way for states to test new ways to:

  • Cover more people,
  • Cover benefits,
  • Pay for covered services, or
  • Deliver care.

Oregon's Waiver History

​1994: Established the Oregon Health Plan (OHP). This made most people living in poverty eligible for Medicaid, regardless of age, disability or family status. It also based coverage on the Prioritized List of Health Services. This list defines the health condition and treatment pairs that OHP covers in priority order.

1997: Gave Children's Health Insurance Program (CHIP) members the same benefits and delivery system as Medicaid members.

2002: Established OHP Plus and OHP Standard benefits. Added the Family Health Insurance Assistance Program.

2007 and 2009: Expanded CHIP and established the Healthy Kids program.

2012-2017: Established the coordinated care model and initiated Health System Transformation. Read the Evaluation of Oregon's 2012-2017 Medicaid Waiver.​

​​​The 2017-2022 OHP 1115 Medicaid Demonstration ran from Jan. 12, 2017, through Sept. 30, 2022. It continued and expanded all elements of the 2012 waiver, particularly around integration of behavioral, physical and oral health integration, and include a focus on social determinants of health, population health, and health care quality. 

It promotes a performance-driven system to improve health outcomes and bend the cost curve. It includes:

  1. An expanded focus on the integration of physical, behavioral, and oral health care.

  2. A strong focus on social determinants of health and health equity to improve population health outcomes for all low-income Oregonians.

  3. A commitment to an ongoing sustainable rate of growth. The 2-percent test puts the federal investment at risk for not meeting that target. CCO payment and contracting protocols promote increased investments in health-related services and use of value-based payments.

  4. Expanding the coordinated care model with innovative strategies for ensuring better outcomes for members eligible for both Medicare and Medicaid.

2017-2022​​ waiver approval

2017-2022 waiver evaluation

Public input for the 2017-2022 waiver application

​​OHA accepted written comments through June 1, 2016. To collect written comments, OHA:

  • Sent newsletters, emails, and public meeting notices to Tribes and partners. 

  • Published notices on the OHA and Secretary of State websites.

  • Offered an online survey to submit comments.

OHA also held many meetings and public hearings with partners, Tribal government leaders and the public.


OHA public notices: