Oregon Governor Hopes to Expand Health Insurance Program for Low-income Residents
Although Oregon officials have proposed a plan to expand the Family Health Insurance Assistance Program -- a "small safety net" that helps cover the cost of health insurance premiums for the state's "working poor" -- they would have to "tap" Medicaid funds and cut benefits for Oregon Health Plan enrollees to fund the initiative, which has raised some concerns among advocacy groups, the Portland Oregonian reports. The proposal, which requires approval from state lawmakers and the federal government, would help "bridge a gap" for 136,000 low-income residents who "earn too much" to qualify for the state's health plan. The Oregon Health Plan, which serves adults who earn below 100% of the federal poverty level --$17,650 a year for a family of four or $8,590 for a single adult -- provides prescription drug coverage in addition to a "wide range" of medical and dental care. However, those earning more than 100% FPL often "find themselves without coverage." To combat the problem, Gov. John Kitzhaber (D) hopes to expand the Family Health Insurance Assistance Program, which currently covers up to 95% of insurance premiums for 5,000 families with annual incomes between 100% and 170% FPL, or up to about $30,000 for a family of four. The state currently finances the $11 million-a-year program with its share of the national tobacco settlement. "The overarching vision is to have a health care [system] that starts out with people who have nothing and continues until people can buy their own coverage or an employer will pay," Mark Gibson, Kitzhaber's health policy adviser, said.
Three Step Approach
Under Kitzhaber's three-step proposal, the state would:
- Limit Oregon Health Plan benefits for about 80,000 "less-needy" residents, specifically young singles and childless couples who otherwise would not be eligible for Medicaid. In addition, the state may add copayments, increase monthly premiums and reduce services "not mandated by Medicaid," such as adult dental and vision benefits. The reforms would likely save about $70 million per year;
- "Tap into" the state's CHIP program, which provides health coverage to children in households with incomes below 170% FPL, a move that would require federal approval. This strategy would provide the state with annual savings estimated at $30 million;
- Apply for an additional federal waiver that would allow the state to use more Medicaid funding and add another $15 million a year "to the subsidy pool."
