Oregon Center for Public Policy
By Janet Bauer
March 17, 2017
A Republican proposal to cut Medicaid recently unveiled in a congressional committee led by U.S. Rep. Greg Walden (OR) would likely cause hundreds of thousands of Oregonians to lose health insurance, undermine coverage for many more, and harm the state’s economy. The impacts of the plan, which inevitably would fall on the nearly one million Oregonians relying on the Oregon Health Plan, would be particularly harsh for Oregon and rural residents of the state.
375,000 Oregonians would likely lose coverage; Oregon hit particularly hard
The GOP-proposed American Health Care Act introduced in the U.S. House Energy and Commerce Committee proposes to end the federal matching funds that since 2014 have enabled states, including Oregon, to extend Medicaid insurance to more low-income residents. More than 375,000 Oregonians in this expansion group are insured through the Oregon Health Plan (OHP), our state’s Medicaid program.[1] The expansion has made it possible for these Oregonians to get preventive and primary care, as well as acute care. Most in the group work, but their job does not come with health insurance.[2]
The House GOP plan phases out the additional federal matching dollars for the expansion group, starting in 2020. Effective that year, there would be no additional federal money for new applicants. Funds would continue for those in the expansion group already covered by OHP, but only for as long as they remained enrolled without interruption. Changes in income among the expansion group are common; people cycle on and off the program when their job hours increase or decrease, for instance.[3] It would not take long for attrition to decimate the extra federal funds that largely finance coverage for the expansion group.
The funding hit to Oregon would undoubtedly have catastrophic consequences for the expansion group. To make up the lost federal dollars, Oregon would need to nearly quadruple its contribution toward insuring the group.[4] Given the magnitude of the shortfall and the challenge Oregon would face to make up the difference, the GOP proposal would effectively end OHP coverage for the expansion group. Thus, the GOP plan would likely take away health coverage for more than 375,000 Oregonians. That is more people than live in Eugene, Bend, Medford, and Grants Pass, combined.[5]
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