AllCare CCO, one of two coordinated care organization for Southern Oregon residents insured through the Oregon Health Plan, saw its enrollment numbers largely hold steady through the first round of post-pandemic eligibility reviews.
“We’ve been actually incredibly surprised at how few people have been getting pulled off the plan thus far,” said Josh Balloch, AllCare vice president of government relations and health policy. “It’s been below our expectations.”
Balloch estimates that AllCare — which insures about 61,000 people in Jackson, Josephine and Curry counties, plus a southern swath of Douglas County — saw a net gain of about 50 members between April and July.
“Just by a hair, but, yeah — we’ve increased in enrollment,” he said.
Membership numbers will likely decrease with the second round. “End of September, I think we’re going to see a drop,” Balloch said.
For the first tranche of redeterminations, the health authority focused on people whose insurance was likely to be renewed and whose information was easiest to verify, Balloch said.
“We haven’t done it in three years,” he said, “so it was like, ‘Hey, let’s get people training wheels here.’”
Last month, the Oregon Capital Chronicle reported that roughly three-fourths of residents insured through OHP had kept their coverage.
Oregon gave people up to 90 days to submit their paperwork, and the clock is winding down for a larger and larger group. As OHP enrollees don’t meet the deadline, “you’re going to start to see more people coming off the plan,” Balloch said.
Roughly nine in 10 AllCare members will remain insured if they turn in the required forms, he estimated.
Jackson Care Connect — Jackson County’s other CCO, which covers about 70,000 people — has lost over 1,700 members since redeterminations began, according to Sara King Cole, a spokesperson for the organization. However, the CCO “can’t verify that all of these were due to redetermination, as some members could be losing coverage for other reasons,” she said in an email.
Cole said that more than a third of Jackson Care Connect members have been renewed so far.
Like AllCare, Jackson Care Connect also saw a net gain in enrollments — due, Cole said, to “the normal flow of members qualifying for OHP.”
It was also due to the Healthier Oregon program established by state House Bill 3352, she said. Starting last month, the program — formerly called “Cover All People” — allows residents of any immigration or citizenship status to enroll in OHP.
With the economic upheaval caused by COVID-19, the state saw hundreds of thousands of new OHP enrollments. The federal government mandated that the state keep members on the plan while the public health emergency played out. In exchange, Oregon received a higher rate of Medicaid reimbursements.
When the federal boost expired in March, Oregon — as well as other states that took the enhanced benefits — had to see who still qualified for Medicaid.
Of the roughly 1.5 million Oregonians on OHP, about 300,000 stand to lose their health insurance, the health authority estimated earlier this year.
The threshold to receive Medicaid is 138% of the federal poverty level. In 2023 figures, individuals with a gross income of $20,120, and families of four living on $41,400, qualify.
Oregon recently got a federal waiver to roll out the Bridge Plan, which allows people who make between that amount and 200% FPL — $29,160 for individuals, $60,000 for a family of four — to stay insured. The state is working on turning that plan into the Basic Health Program by mid-2024.
Those who get kicked off OHP can turn to the Oregon Health Insurance Marketplace, where most people can find financial help.
Cole urged Jackson Care Connect members to verify their contact information with the health authority and respond to the agency’s mail and requests for information.
“If members need help or have questions, they can reach out to OHA, or contact any of the local assisters,” she wrote. “You can find a list of local assisters on our website, under ‘OHP enrollment assisters.'”
Balloch said AllCare members who have questions or trouble updating their information can call the CCO, which extended its call-time hours, now stretching 8 a.m. to 8 p.m. every day.
“There is a lot more that we can do as CCOs than we traditionally have been able to do around enrollment,” he said, “because technically enrollment doesn’t happen with the CCO — it actually happens only inside of the state — but they’ve allowed us to be much more helpful than we’ve been able to be in the past.”
