Income test for Oregon Health Plan to be reinstated as pandemic wanes

By GARY A. WARNER
Oregon Capital Bureau

The official end of the COVID-19 pandemic emergency will mean major changes this month, including public health care coverage, masking requirements and cutbacks in pandemic data collection.

The Oregon Health Authority on Saturday began to winnow the ranks of the 1.5 million people covered by the Oregon Health Plan, the state’s version of federal low-income Medicaid.

On Tuesday, a statewide masking requirement in healthcare settings will be lifted, with each facility or provider able to continue or end a requirement for face coverings.

OHA said Thursday it was streamlining COVID-19 data reports, with an end to updating whether newly infected cases were vaccinated or not.

President Joe Biden announced at the end of January that he planned on allowing the current COVID-19 state of emergency to lapse on May 11. 

The moves come as COVID-19 has settled into a pattern of infection from highly-contagious but individually less virulent omicron subvariants.

The biggest impact of the COVID-19-related changes will be the reinstatement of income eligibility reviews to qualify for the Oregon Health Plan.

The federal Public Health Emergency officially ended Friday, including rules that gave each state wide latitude in deciding qualification for Medicaid programs. 

OHA allowed anyone on the Oregon Health Plan to stay in the program indefinitely regardless of a change in their income. A spike in unemployment at the onset of the pandemic swelled the program and once enrolled, the state did not require proof of a change in income status even as employment swung back up.

Today, one out of three Oregonians is covered.

With the end of the federal emergency expected, OHA announced Feb. 13 that the pandemic pause on income verification would end on April 1. 

OHA began sending notices on the change and will seek to retain as many residents in the low-cost program as possible.

“We want to do everything we can to make sure Oregon Health Plan members stay covered as long as they are eligible,” OHA Medicaid Director Dana Hittle said in a statement released Friday.

Oregon’s plan going forward is to allow children to automatically stay on OHP until age six. All other recipients would receive up to two years of eligibility regardless of changes in income and without having to reapply. Hittle said no other state provides more than one year of guaranteed eligibility.

OHA will also allow individuals with incomes below about $29,000 to retain coverage. That’s twice the federal poverty level.

Hittle said “most” residents on OHP continue to qualify, but changes to enrollment could begin by mid-April. All households of OHP recipients will receive notices over the next 10 months regarding their status and any actions necessary to remain in the program.

Those who do not respond to the notices risk losing their benefits. If deemed no longer eligible for OHP, recipients have 60 days to enroll in other insurance plans or find plans through the Oregon Health Insurance Marketplace, the program created under the federal Affordable Care Act. If they do not enroll in a plan, they will receive a second notice that they are being terminated from the OHP plan in 30 days.

OHA said the major work required to process redeterminations likely means slower response times on new enrollments and other OHP inquiries or requests. 

OHP eligibility is just one of the new impacts of changes in the federal and state emergency status put in place over the past three years.

OHA announced last month that a requirement that face masks be worn in hospitals and other health care settings including urgent care facilities, school nurses’ offices, and dentists’ offices would end on Monday, April 3. The notice was given for health providers to decide whether they wanted to continue a mask requirement, which the state allows.

OHA has also announced Thursday it has ended updates to its COVID-19 Cases by Vaccination Status chart on the agency’s “dashboard” of pandemic statistics. It was last updated in February.

Stating there was no significant difference in Oregon from national trends, the CDC’s website would be the reference point in the future to judge what percentage of new infections are in people who are vaccinated or unvaccinated.

“These data paint a much more useful and accurate picture than Oregon’s data,” OHA said in a statement. “As a result, we can actually learn more about Oregon’s COVID-19 disease and death rates by looking at national data than by looking at our own state’s data.”

OHA spokesman Afiq Hisham said OHA plans to make more changes in the near future to “streamline” COVID-19 data reporting. In recent months, Oregon has followed the example of other states and cut back on the number and frequency or reports on COVID-19, saying resources were being reassigned to other public health issues.

The CDC reports that 16.5% of eligible Americans have been vaccinated and received the full bivalent booster course. In Oregon, 25.2% of eligible residents have been vaccinated and received boosters.

Canada and Britain have recently approved an additional bivalent booster, but U.S. officials have said they want to wait until autumn unless trends show a need for earlier intervention with another round of inoculations.

OHA’s latest tally, released March 29, shows 986,791 infections and 9,470 deaths since the virus first appeared in the state in February 2020, two months after its discovery in Wuhan, China.

COVID-19 has claimed over 1.15 million lives in the U.S. since January 2020, according to the Centers for Disease Control and Prevention.

With the widespread availability of vaccines for those who want them, current CDC projections show a new spike in cases unlikely unless a variant of higher virulence appears.

The latest OHA report on COVID-19 showed 1,750 reported new infections and 25 deaths in Oregon over the previous week.

Hospitals reported 200 patients statewide who tested positive for COVID-19, though not all patients came to the hospital because of COVID-19 health-related complaints. There are 30 COVID-19 positive patients in hospital intensive care units around the state.

The most recent COVID-19 forecast from the Oregon Health & Science University projects that by late May, fewer than 100 people who have COVID-19 will be in Oregon hospitals.

For more information, go to OregonHealthCare.gov/GetHelp or call 1-800-699-9075.