Oregon Health Plan faces new Medicaid requirements

New federal requirements are introducing changes to the Oregon Health Plan (OHP), affecting approximately 600,000 members statewide. Under the One Big Beautiful Bill Act (H.R. 1), certain adults aged 19 to 64 will be required to demonstrate proof of work, school, or other activities for at least 80 hours per month when applying for or renewing coverage. These rules are set to take effect on January 1, 2027.

The Oregon Health Authority (OHA) has begun mailing informational notices to members. While the agency notes that most people are expected to retain their benefits, officials warned that coverage loss often occurs due to ‘administrative churn’ rather than a lack of eligibility. Exemptions to the new requirements include children under 19, individuals over 65, those with disabilities, pregnant individuals, and others meeting specific qualifying criteria.

In Central Oregon, Mosaic Community Health has expanded its enrollment team and trained community health workers to provide free, one-on-one assistance to residents navigating these transitions. The organization notes that roughly 17,000 of its patients rely on OHP. Additionally, while H.R. 1 rolls back Medicaid for non-citizens, approximately 7,000 people in Oregon are expected to transition to the Healthier Oregon program, which provides benefits regardless of immigration status.