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Helping Oregonians Maintain Coverage after the Public Health Emergency Ends

Oregon is committed to helping Oregon Health Plan (OHP) members helping maintain coverage. Continuous enrollment policies during the Public Health Emergency (PHE) have allowed more people to maintain coverage, and Oregon has been working on several policies to ensure continuous enrollment once the PHE ends.

Provisions under House Bill 4035 (2022)

Legislative Reports

Creating a “Bridge Program”

House Bill (HB) 4035 requires Oregon Health Authority (OHA) to create a new “bridge program.” The program would provide an affordable, comprehensive source of health coverage to adults in Oregon with income between 138 and 200 percent of the Federal Poverty Level (FPL). Implementing this program will prevent coverage loss among some people who would otherwise lose OHP during the unwinding of the federal Public Health Emergency. It will also improve coverage continuity by reducing instances of "churn" due to small and/or temporary income gains among OHP members.


About the Joint Task Force on the Bridge Health Care Program

HB 4035 directs OHA to work with the Legislative Policy and Research Office (LPRO) to convene a Task Force to inform development of this program. Oregon will seek Centers for Medicare & Medicaid Services (CMS) approval before implementation of the program.

Click here for membership details, upcoming meeting dates and times, and links to meeting recordings.

SUD 1115 Waiver Bridge to the Bridge Amendment - Application and Public Comment

OHA developed the draft application with proposals for changes to OHP as part of the PHE ending. The public is invited to submit written and verbal comments on the draft application from Aug. 1, 2022, through Sept. 7, 2022.

PLEASE NOTE: The 90-day review period has officially begun as of November 15.

Oregon SUD 1115 Amendment Application and Notice

CMS Approval

Oregon received CMS approval of the 1115 Waiver Bridge to the Bridge Amendment on April 20, 2023. Please find the formal approval below.

CMS Approval for the Oregon 1115 Amendment

Section 1331 Basic Health Program Blueprint - Application and Public Comment

The public comment period for the Section 1331 Basic Health Program has been extended, and will now end July 1, 2023.

OHA has developed a draft Basic Health Program Blueprint. The blueprint proposes to establish a new program that will provide comprehensive, no-cost coverage to adults in Oregon with income between 138 and 200 percent of the FPL. The public is invited to submit written and verbal comments on the draft application from May 1, 2023, through July 1, 2023.

Meeting Information and Resources
Date
PurposeMaterials
May 31, 2023
9 a.m. to noon
Section 1331 Basic Health Program Blueprint Public Hearing (Medicaid Advisory Committee)
Join this meeting to learn more about the draft blueprint and provide your input.
Public Notice
Draft Blueprint
Slide Deck
Video of meeting
May 9, 2023
1 to 2 p.m.
Section 1331 Basic Health Program Blueprint Public Hearing (Standalone Meeting)
Join this meeting to learn more about the draft blueprint and provide your input
Public Notice
Draft Blueprint
Aug. 31, 2022
9 a.m. to noon
SUD 1115 Waiver Bridge to the Bridge Amendment Public Hearing (Medicaid Advisory Committee)
Join this meeting to learn more about the draft amendment and provide your input.

Public Notice
Draft Application
Slide Deck
Video of Meeting
Aug. 24, 2022
10 to 11 a.m.
SUD 1115 Waiver Bridge to the Bridge Amendment Public Hearing (Standalone Meeting)
Join this meeting to learn more about the draft amendment and provide your input
July 21, 2022
5 to 7 p.m.
Hear from consumers, particularly individuals who have experienced churn between coverage provided by OHP and other health insurance or no insurance based on changes in income. Questions of specific interest to the Task Force and registration details will be provided at least a week in advance of the meeting.
Listening Session - English
Listening Session - Spanish

Outreach and Communication Strategies with Community Partners


OHA Welcomes Input on Rules for OHP Bridge - Basic Health Program

OHP Bridge – Basic Health program is a new health insurance program that expands Oregon Health Plan (OHP) to cover adults with income just above the OHP income limit. Adults with income between 138 and 200 percent of the federal poverty level (FPL) will have access to quality health coverage through OHP Bridge, provided by the same Coordinated Care Organizations (CCOs) that serve OHP members. OHP Bridge benefits are just like OHP benefits. OHP Bridge will not have monthly premiums or member costs, like copays or deductibles.

The Oregon Health Authority is currently drafting administrative rules for OHP Bridge – Basic Health Program. These rules are laws that the Oregon Health Authority, CCOs, and OHP Bridge – Basic Health Program providers must follow when delivering this new program.

We would love to have your input. We want these rules to reflect the needs of future OHP Bridge – Basic Health Program members, and the providers and CCOs that deliver the program. We are looking for interested community members and partners to provide thoughts and feedback. There are a few ways to do this:

  • Participate in our Rules Advisory Committee (RAC) that is taking place over Zoom on February 6th and 7th, 2024 from 2-4 pm each day. OHA will present the draft rules and talk through proposed changes with participants to gather thoughts and feedback. The RAC will be held in English, Spanish and ASL with other languages available upon request.
  • Set up time to meet with OHP Bridge – Basic Health Program staff between January 15th and February 9th, 2024. We can meet just with you or your organization. Or we can set up a group listening session at a time that works best for your community.
  • Provide input through the public comment process . The public comment period for the OHP Bridge – Basic Health Program rules will open on March 1st and close on April 19th. There will be a public hearing on March 21st.

Interested in attending the RAC, scheduling a meeting with us, have a question on need materials in an alternate format? Send us an email at: ohpbridge@oha.oregon.gov and let us know.

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Draft OHP Bridge rules can be found here

OHP Bridge Rules: Community Events

OHA held a Rules Advisory Committee on February 6 & 7, 2024 and an OHP Bridge Rules Webinar on February 13, 2024 in order to gather community input on the draft OHP Bridge Rules. Recordings of these events can be found below:

OHP Bridge Rules Advisory Committee Day 1

OHP Bridge Rules Advisory Committee Day 2

OHP Bridge Rules Webinar

About the Community and Partner Workgroup

As established in HB 4035, the Community and Partner Workgroup (CPWG) advises OHA, Oregon Department of Human Services and Department of Consumer and Business Services on the development of outreach and enrollment assistance and communications strategies to communicate and assist medical assistance program members in navigating the redetermination process and any transitions to coverage through the health insurance exchange. This work has the dual goals of:

  1. Maintaining the most individuals covered possible so that benefits are not lost, and
  2. Ensuring additional protective measures for identified vulnerable populations, priority populations, and populations and individuals facing health inequities during this transition and process.

Read the charter

Read the final recommendations

Read OHA's update on recommendations to support members

Members

The CPWG brings together representatives from impacted health systems, community partners, organized labor, individuals enrolled in medical assistance programs, and members of Oregon’s Medicaid Advisory and Health Insurance Exchange Advisory committees.

Members were selected based on their availability and willingness to attend CPWG sessions, lived experience and subject matter expertise, and in a manner to ensure diversity of perspective and representation of the state. Members representing intersecting identities and Oregon’s priority populations were given preference.

Provisions in the 1115 Demonstration Waiver

Oregon’s renewed 2022-2027 Medicaid 1115 Demonstration Waiver, approved by CMS on Sept. 28, 2022, is the largest expansion of continuous Medicaid eligibility in the country. For children under the age of six, Oregon will provide continuous eligibility from the time of a child’s enrollment through the end of the month in which their sixth birthday falls. For children six and up and adults, the waiver will provide two-year continuous eligibility. These changes will double the current period of continuous eligibility for beneficiaries ages 6-18 and offer continuous eligibility for the first time to adult beneficiaries in Oregon.

State Plan Amendment for Postpartum Individuals

Oregon’s request to expand Medicaid and Children’s Health Insurance Program (CHIP) coverage, known as Oregon Health Plan (OHP), to one year postpartum was approved by CMS in May of 2022. The change will allow individuals to maintain continuous OHP coverage and access medically necessary physical, oral and behavioral health services for 12 months after childbirth.

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