Task Force Examines Federal Funding Options to Support Oregonians’ Medicare – State of Reform
A new task force discussed federal funding options on Tuesday to support a health insurance plan for low-income Oregonians.
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Oregon Bridge Healthcare Program Task Force was formed after the passage of House Bill 4035 during the last legislative session. Members are working to create a bridging program to provide coverage for people leaving the Oregon Health Plan (OHP) when the end of public health emergency.
The task force will focus on coverage for people up to 200% of the federal poverty level who are not eligible for OHP. About 300,000 people will no longer be enrolled in the Medicaid program when the public health emergency ends, which is currently scheduled for July 15, although that may change.
The number of insured Oregonians has increased during the COVID-19 pandemic. In 2019, before the pandemic, 94% of residents were covered. Jeremy Vandehey, director of the Oregon Health Authority’s health policy and analysis division, said that number rose to 95.4% in 2021. The number of insured among the state’s black population is rose from 92 to 95 percent during that time, he said.
“Big coverage gains were made among low-income adults, as fewer people reported being uninsured,” Vandehey said. “We have seen some significant capital gaps closing. As we approach this public health emergency [end date]we try not to go back.
Manatt Health Chief Executive Joel Ario outlined three federal waivers for task force members to consider for coverage options:
- Item 1115 of the Social Security Act gives the Secretary of Health and Human Services the authority to approve experimental, pilot, or demonstration projects that may help promote the goals of the Medicaid program.
- The Affordable Care Act (ACA) Section 1331 gives states the ability to create a basic health care program, allowing states to provide more affordable coverage to low-income residents and improve continuity of care for people whose income fluctuates above and below below Medicaid and Children’s Medicare levels.
- ACAs Section 1332 allows a state to apply for a state innovation waiver to pursue innovative strategies to provide residents with access to affordable, high-quality health insurance while maintaining basic ACA protections.
“Those are the three basic routes to accessing federal money,” Ario said.
The working group members’ discussions largely focused on Sections 1331 and 1332, and the likelihood that the implementation of 1332 would take longer to roll out.
“It’s becoming clearer that path 1331 is a faster accelerated path than 1332,” Vandehey said.
Task force members considered the idea of using 1331 as a stopgap to address immediate concerns while working to implement 1332. But Ario said the Centers for Medicare & Medicaid Services (CMS)—which issued a regulation creating the 1331 Basic Health Program in 2014—cannot cooperate for purposes of implementation if the intention is that the program be used temporarily.
“The signals coming out of CMS are that the 1331 program is designed to be permanent,” Ario said. “We don’t think the transition is viable. At the federal level for 1331, they will say that we have to commit to it.
Task force members will continue to weigh their options at their next meeting on May 24. They are expected to make a final decision on June 14.