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About three-quarters of Oregonians retain Medicaid coverage during review

Rhonda Capello, a Medicaid member, shows Dr. Nat Fondell a photo of her new prosthetic legs at La Clinica in Medford.
La Clinica
Rhonda Capello, a Medicaid member, shows Dr. Nat Fondell a photo of her new prosthetic legs at La Clinica in Medford.

So far, more than three-fourths of the Oregonians reviewed for eligibility on the Oregon Health Plan have kept their benefits since the state started reviewing the status of the nearly 1.5 million people on Medicaid.

This is the first time the Oregon Health Authority has checked the eligibility status since the pandemic hit when annual reviews were suspended. That policy allowed thousands of Oregonians to stay on Medicaid, regardless of their income status.

The program provides free medical, dental and mental health benefits to participants with low incomes.

The data released this week shows more than three of four Oregonians successfully renewed their benefits since the reviews started in April.

The results represent a portion of the Oregonians on the plan. Since April, about 543,000 people have come up for renewal, which is 37% of all participants in the plan.

For this initial group, the results are:

  • 77.3%, nearly 420,000 people, fully renewed their benefits. 
  • 7.3% – almost 40,000 people – are no longer eligible and have received 60-day notices they will lose their coverage.
  • 2% – about 11,000 people – have reduced benefits but moved to the Medicare Savings Programs, which helps people cover Medicare premium costs. Medicare recipients are usually over 65 years old or disabled.
  • 9% – nearly 49,000 people – have responded to their renewals and are waiting for the state to process their paperwork or the state has asked for more information.
  • 4.4% – almost 24,000 people – have not responded to the state yet.

The work will continue into next year. People will receive a notice by mid-2024 that will explain what they need to do to renew their coverage. In some cases, the state may ask for additional information, such as pay stubs, or give them a renewal form to review and sign.

To qualify for the program, most residents can earn up to 138% of the federal poverty level, or about $20,000 a year for an individual or about $41,500 for a family of four. Oregon also has opened up benefits to those earning up to 200% of the federal poverty level to reduce the so-called churn population who fall off and on Medicaid, depending on changes to their income. As a result, individuals earning up to about $29,000 a year or a family of four earning up to $60,000 a year will receive the free coverage. The state estimated that would add about 25,000 more people to the Medicaid program.

Steps to stay covered

State officials advised those on the Oregon Health Plan to take these steps:

  • If you receive a renewal, review the information for accuracy. If anything is wrong, call the state’s customer service center at 800-699-9075. 
  • Go here for more information about how to renew your coverage.

Other coverage options

  • Explore options through an employer if you, your spouse or a parent has a job. 
  • To find out if you are eligible for Medicare,  go here. You also can call 800-722-4134.
  • Go here if you need help navigating your options and finding the right coverage.
  • For Spanish-speaking services, go here.

The Oregon Capital Chronicle is a professional, nonprofit news organization. We are an affiliate of States Newsroom, a national 501(c)(3) nonprofit supported by grants and a coalition of donors and readers. The Capital Chronicle retains full editorial independence, meaning decisions about news and coverage are made by Oregonians for Oregonians.

Ben Botkin covers justice, health and social services issues for the Oregon Capital Chronicle. Ben Botkin has been a reporter since 2003, when he drove from his Midwest locale to Idaho for his first journalism job. He has written extensively about politics and state agencies in Idaho, Nevada and Oregon.