Oregon embarks on ‘bridge’ health insurance plan for people facing Medicaid expansion sunset

Oregonians who make a little too much to qualify for Medicaid could be getting a new government health insurance plan, following a bill passed in the final days of this winter’s legislative session.

The bill creates a task force to look into options to create a so-called “bridge plan.”

It would provide basic health and dental coverage for people who get disenrolled from the Oregon Health Plan — the state’s Medicaid program — when their earnings go up.

In Oregon, Medicaid is available for adults who earn up to 138% of the federal poverty line and pregnant women who make up to 185% of the federal poverty line.

The bridge plan would be for people making between 138% and 200% of the poverty line.

That includes individuals making between about $19,000 and $27,000 per year — such as cashiers, gig workers, or Oregonians who may be employed part-time.

The Oregon Health Authority says people at that income level tend to cycle on and off health insurance frequently because some years they earn too much to qualify for Medicaid but still don’t have employer-provided insurance.

For that population, the bridge plan would be an alternative — or potentially a replacement — to buying insurance on the private market established by the Affordable Care Act and trying to qualify for a rebate.

During the pandemic, as part of the federal public health emergency, the federal government halted the process of removing people from Medicaid if their income changed or they were otherwise disqualified. States were awarded additional Medicaid funding to cover the cost.

That expansion during the pandemic has led to a record-high number of people with insurance — OHP membership has risen from just over 1.1 million members before the pandemic to 1.4 million today.

Health leaders in Oregon want the bridge plan in place before it has to start kicking people off Medicaid again when the federal pandemic aid dollars run out, so the bill sets an aggressive timeline for developing a proposal.

The task force must have its first meeting by March 31.

Its proposal is supposed to be complete by September 1, 2022, at the latest.

In the House, three Republicans joined the Democratic majority and voted for the bridge plan bill: Rep. Cedric Hayden, R-Roseburg; Rep. James Hieb, R-Salem; and Rep. Greg Smith, R-Heppner.

In the Senate, it passed along party lines.

The bridge plan idea was supported by labor unions and a number of physicians’ advocacy groups.

Some health insurance providers warned that creating a bridge plan could undermine the existing private health insurance marketplace.