Oregon health and housing leaders prepare for Medicaid expansion

One year from now, the Oregon Health Authority plans to launch housing benefits for people on Medicaid who are at risk of losing their housing.

The benefits are part of the state’s five-year Medicaid program, which received federal approval to spend tax dollars on housing, food and climate-related needs, like air conditioners, in addiction to the traditional medical and dental benefits. The federal government will give Oregon an extra $1.1 billion to fund so-called social determinants of health, like housing and food, which affect a person’s health status.

The expansion, which involves a waiver of traditional Medicaid benefits, is one of the first in the nation.

State officials have decided first to help those most at risk of ending up on the streets. They could be in a variety of situations, such as a behavioral health crisis, hospitalized with a long-term illness or pregnant and in need of resources.

Thousands of Oregonians could benefit from the program. An estimated 125,000 people are potentially eligible, state officials said during a legislative meeting on Tuesday. They’re among the 1.5 million people enrolled in Medicaid as of Oct. 1, state data show.

The benefits will be phased in, with the first housing assistance starting next November. State health and housing officials are meeting with providers and housing agencies to prepare for the new program.

“These are disciplines that do talk to each other,” Dave Baden, interim director of the Oregon Health Authority, said in a presentation to the House Committee on Housing and Homelessness. “We’re spending a lot more time than maybe we have in the past, which is great.”

The housing assistance could take different forms, such as a one-time payment to help a client put down a security deposit or cover rent and utilities for up to six months. But state officials say six months isn’t enough time for everyone to get back on their feet. They want to find other programs to cover needs beyond that. 

“We know that there’s going to have to be a part two, that’s going to come behind that six-month rental assistance for most members,” said Andrea Bell, director of Oregon Housing and Community Services.

Baden said the project is complex and will take time, enrolling people gradually. It will require coordination among medical providers, housing services and patients. 

After the launch, they hope to provide food assistance starting in January 2025. Later that year, officials plan to widen the eligibility for housing, including helping those who are homeless. That date is not yet set.