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Did Oregon children eligible for Medicaid lose coverage?

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
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.

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.

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 鈥 in Oregon, they numbered 1.5 million 鈥 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鈥檚 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 鈥渢here are some technical exceptions in the system that could cause individuals鈥 to be dropped.

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 鈥 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 鈥 $20,120 a year for one person and $41,400 for a family of four 鈥 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 have lost coverage since the state started the 鈥渞edetermination鈥 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.

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

But she said the state would take 鈥渋mmediate action鈥 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 鈥渄evelop a plan鈥 for any required changes to prevent future problems.

Get help

  • Find out how to renew  medical coverage.\
  • Call the ONE Customer Service Center: 800-699-9075, which has service in multiple languages.
  • Visit a local office e. 
  • Find other health coverage at

The  is a professional, nonprofit news organization. We are an affiliate of , a national 501(c)(3) nonprofit supported by grants and a coalition of donors and readers. The Capital Chronicle retains full editorial independence, meaning decisions about news and coverage are made by Oregonians for Oregonians.

Lynne Terry is a reporter for the , a professional, nonprofit news organization and JPR news partner. The Oregon Capital Chronicle is an affiliate of , a national 501(c)(3) nonprofit supported by grants and a coalition of donors and readers. The Capital Chronicle retains full editorial independence, meaning decisions about news and coverage are made by Oregonians for Oregonians.