Did Oregon children eligible for Medicaid lose coverage? 

State health officials are checking to see whether kids in the state have been wrongly kicked off the free health care as they have been elsewhere

By: - September 29, 2023 5:45 am

Calli Ross tends to her disabled 8-year-old son, Tensy, after watching the Oregon Senate in the Capitol on Friday, June 23, 2023. Having a disability can qualify children for Medicaid. (Ben Botkin/Oregon Capitol Chronicle)

A month ago, federal health officials announced that millions of children nationwide might have been booted from Medicaid in recent months even though they qualified for the free health care.

The disenrollments can happen when states automatically renew memberships, federal officials said, citing a few examples. Those examples did not apply to Oregon, said Erica Heartquist, a spokeswoman for the Oregon Health Authority, so the agency figured all was well with its review of Medicaid members and did not pursue the issue further.

Since April, states have been reviewing the eligibility of all members – in Oregon, they numbered 1.5 million – and kicking off those whose income had risen beyond the allowed limit or otherwise no longer qualified. During the pandemic, everyone who got on Medicaid stayed on, regardless of income changes.

Then last week, the Centers for Disease Control and Prevention said that 500,000 children in 30 states had been wrongly kicked off Medicaid or the Children’s Health Insurance Program, a program for children whose families are low income but earn too much to qualify for Medicaid.

Oregon was not among the 30 states, but Oregon children might have been kicked off. Heartquist told the Capital Chronicle that a vendor involved in the renewal process had informed the health authority that “there are some technical exceptions in the system that could cause individuals” to be dropped.

Get help

In Oregon, 472,000 children qualify for Oregon Health Plan benefits, including about 8,400 who lack residency documents. Oregon has extended those benefits to undocumented immigrants through a state program – Healthier Oregon Program, or HOP, that uses federal and state funds.

The federal agency called on states to stop their automatic renewal process, which checks information from reliable data sources, like state wage data, to determine eligibility. Medicaid sets different income eligibility levels. Adults earning up to 138% of the federal poverty level – $20,120 a year for one person and $41,400 for a family of four – qualify, as do children in households earning up to 305% of the federal poverty level, or $91,500 a year.

Health authority officials were due to meet with their federal counterparts this week to find out whether Oregon had indeed dumped children from Medicaid. 

State data shows that nearly 59,000 people have lost coverage since the state started the “redetermination” process, with people getting booted at the end of the month. A data dashboard that breaks those numbers down by demographics does not include information about those 19 or younger.

Heartquist said it was premature to say what the health authority would do if children had been wrongly disenrolled.

We will not know this until we know if there is an affected population and how large it is,” she said in a statement.

But she said the state would take “immediate action” to prevent any additional children from losing coverage during the renewal process and restore coverage for those who wrongly lost it.

She also said the state would “develop a plan” for any required changes to prevent future problems.

GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX

Our stories may be republished online or in print under Creative Commons license CC BY-NC-ND 4.0. We ask that you edit only for style or to shorten, provide proper attribution and link to our web site.

Lynne Terry
Lynne Terry

Lynne Terry, who has more than 30 years of journalism experience, is Oregon Capital Chronicle's editor-in-chief. She previously was editor of The Lund Report, a highly regarded health news site; reported on health in her 18 years at The Oregonian, was a senior producer at Oregon Public Broadcasting and Paris correspondent for National Public Radio.

MORE FROM AUTHOR