Oregon Health Insurance Marketplace Guide

You can buy a health plan through the Oregon exchange if:¹⁰

• You reside in Oregon.
• You are a U.S. citizen or national.
• You are not incarcerated.
• You are not already enrolled in Medicare.

To qualify for financial assistance (premium subsidies and cost-sharing reductions), you must meet additional requirements: 

• Your eligibility for premium subsidies depends on your income and how it compares with the cost of the second-lowest-cost Silver plan in your area. The cost of that Silver plan varies based on your age and location. 
• You must not have access to affordable health coverage offered by an employer. If your employer offers health insurance, but you feel it’s too expensive, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace. 
• You must not be eligible for Medicaid or CHIP.
• You must not be eligible for premium-free Medicare Part A.¹¹
• No one else can be able to claim you as a tax dependent.¹²
• If you’re married, you must file a joint tax return with your spouse.¹² (with very limited exceptions)¹³

In Oregon, open enrollment for 2027 ACA Marketplace/exchange individual and family health coverage runs from November 1, 2026 through January 15, 2027.¹⁴

Enrollments completed by December 31, 2026 will have coverage effective on January 1, 2027, and enrollments completed between January 1 and January 15 will have coverage effective February 1.¹⁴

OHP Bridge enrollment and Medicaid enrollment are both open year-round.

Enrolling in an exchange plan or changing your coverage outside of the open enrollment period is possible if you meet the criteria for a Special Enrollment Period (SEP).¹⁵ This typically means you must have a qualifying life event, such as losing your health insurance, getting married, or having a baby. But Native Americans can enroll or switch plans year-round.

Here are the main ways to enroll in a Marketplace health plan in Oregon:

• Online: For 2027 coverage, with enrollments beginning November 1, 2026, Oregon residents will use Explore Health rather than HealthCare.gov.¹⁶
  • If you already have Marketplace coverage in Oregon in 2026, your information will be migrated from HealthCare.gov to the Explore Health platform. You’ll receive information in early October explaining how to activate your account on the new state-run platform.¹⁷
  • Note: If you’re enrolling in a plan with a 2026 effective date (using a special enrollment period), you’ll use HealthCare.gov. 
• By Phone: Dial 855‑268‑3767  to enroll with a Marketplace representative.
  • If you’re enrolling in a plan with a 2026 effective date (using a special enrollment period), you’ll use the HealthCare.gov call center, at 1-800-318-2596 (TTY: 1-855-889-4325) 
    
• In-person: Enrollment assistance is also available from trained Navigators and assisters who can answer your questions. Go to OregonHealthCare.gov/GetHelp to find local help in your area.¹⁸

Assistance is available from local Navigators and brokers. For coverage effective in 2026, enrollments can also be completed via an approved enhanced direct enrollment (EDE) entity, using the EDE’s website.¹⁹ The EDE pathway will not be available once Oregon is running its own enrollment platform, but

Oregon’s ACA Marketplace (Explore Health, starting in November 2026) is a one-stop shop where individuals and families can find affordable health insurance coverage in Oregon. There are two types of financial assistance available through the Marketplace:

• Premium subsidies: You may qualify for income-based subsidies known as Advance Premium Tax Credits (APTC) that help lower your monthly premiums through the ACA Marketplace. About six out of 10 Oregon exchange enrollees qualified for premium subsidies in 2026, saving an average of $525 monthly. People who receive these subsidies pay an average monthly premium of $253 in 2026.²⁰

Source: CMS.gov²⁰

• Cost-sharing reductions: To be eligible for cost-sharing reductions (CSR), your income must be no more than 250% of the federal poverty level,²¹ and you must enroll in a Silver-level plan through the Oregon Marketplace. CSRs help lower your out-of-pocket costs, making coverage more affordable.²²

Oregon implemented a reinsurance program starting in 2018, using a 1332 waiver that allows the state to capture federal savings generated by the program.²³ Reinsurance is designed to keep unsubsidized (full-price) premiums lower than they would otherwise be. Although most enrollees do qualify for premium subsidies, the reinsurance program helps to minimize premiums for those who don’t.

Oregon also requires all state-regulated health plans, including Marketplace plans, to cover both female and male contraception (including vasectomies), as well as abortion, all without out-of-pocket costs.²⁴ (There is an exception for HSA-qualified high-deductible health plans, to ensure those plans don’t lose their HSA eligibility.)

Medicaid: Oregon residents may qualify for Medicaid coverage if eligible based on income. Medicaid in Oregon is called Oregon Health Plan, and has no monthly premiums.²⁵

Basic Health Program: Oregon has created a Basic Health Program — OHP Bridge —that became operational in July 2024.³ Federal approval for OHP Bridge was granted in June 2024.²⁶

Coverage under OHP Bridge is available to Oregon adults (under age 65) with income above 138% of the poverty level but not above 200% of the poverty level.²⁷ (Children at this income level were already eligible for OHP coverage, so OHP Bridge does not need to cover children.)

Short-term health insurance: If you’re not eligible for subsidies, Medicare, or Medicaid, short-term health insurance, available in Oregon with terms of up to three months, might be an affordable temporary solution. But note that these plans do not include ACA consumer protections, so they typically don’t cover pre-existing conditions and don’t include all of the essential health benefits.

Four insurers will offer plans through Oregon’s exchange for 2027:²

• BridgeSpan Health Company (available statewide)
• Kaiser Foundation Healthplan of the NW (available in 11 counties)
• Moda Health Plan, Inc. (available in all but 8 counties)
• Regence BlueCross BlueShield of Oregon (available statewide)

There were six participating insurers for 2026, but two of them — Providence²⁸ and PacificSource²⁹ — will no longer offer Marketplace plans after the end of 2026. Enrollees with these plans will need to select new coverage for 2027 during the open enrollment period that starts November 1, 2026. Learn more about what happens when your carrier exits the market.

The following average rate increases have been approved for Oregon’s Marketplace insurers for 2027, amounting to a weighted average rate increase of 21.6% before subsidies are applied.²

Source: Oregon Department of Consumer and Business Services²

The average rate changes apply to full-price premiums. However, 60% of Oregon Marketplace enrollees were receiving subsidies in 2026 – which means they did not pay the full rate.³⁰

Subsidy amounts are adjusted each year based on the cost of the second-lowest-priced Silver plan. But for 2026 and future years, subsidies cover a smaller portion of enrollees’ premiums than they did in 2025, because Congress allowed premium subsidy enhancements to expire at the end of 2025.

Because the subsidy enhancements expired:

• Only 60% of Oregon Marketplace enrollees qualified for subsidies for 2026,³¹
  down from 80% in 2025.³² Subsidies are no longer available to anyone with a household income above 400% of the federal poverty level.
• Average after-subsidy premiums grew to $426/month in 2026, up from $272/month in 2025.³³
• Marketplace enrollment dropped by more than 15% from 2025 to 2026.³³
• More people selected Bronze plans, which have lower premiums but higher out-of-pocket costs.

For perspective, here’s a summary of how average full-price (unsubsidized) premiums have changed in Oregon’s individual market over the years:

• 2015: Average decrease of 5%.³⁴
• 2016: Average increase of 24.2%.³⁵
• 2017: Average increase of 26.5%.³⁶
• 2018: Average increase of 15.7%.³⁷ (reinsurance took effect;³⁸ Federal CSR funding eliminated³⁹)
• 2019: Average increase of 7.3%⁴⁰
• 2020: Average increase of 1.5%.⁴¹
• 2021: Average increase of 2.1%.⁴²
• 2022: Average increase of 1.5%.⁴³
• 2023: Average increase of 6.7%.⁴⁴
• 2024: Average increase of 6.2%.⁴⁵
• 2025: Average increase of 8.3%.⁴⁶
• 2026: Average increase of 9.7%.¹

During the 2026 open enrollment period, 118,372 people signed up for individual/family health coverage through the Oregon Marketplace/exchange.²⁰

Source: 2014,⁴⁷ 2015,⁴⁸ 2016,⁴⁹ 2017,⁵⁰ 2018,⁵¹ 2019,⁵² 2020,⁵³ 2021,⁵⁴ 2022,⁵⁵ 2023,⁵⁶ 2024,⁵⁷ 2025⁵⁸ 2026²⁰

As was the case in most states, Oregon’s 2026 enrollment was a decrease from 2025, due to the expiration of federal subsidy enhancements.

Although nationwide Marketplace enrollment had grown to significant record highs in recent years (prior to 2026), Oregon’s enrollment had hovered around the same level for many years before declining in 2026.

For 2024 and 2025, when nationwide Marketplace enrollment grew significantly, Oregon’s did not. But that’s likely because Oregon allowed people to remain on Medicaid with income up to 200% of the poverty level during the post-pandemic “unwinding” process, and then those individuals were able to transition to the new BHP (Oregon Health Plan Bridge) starting in mid-2024, rather than a private Marketplace plan. 

OregonHealthCare.gov
A state-run service that connects Oregon residents with health coverage options.

Explore Health
The new state-run Marketplace that Oregon residents will use to enroll in coverage with an effective date in 2027 or a future year (starting November 1, 2026).

HealthCare.gov
The Marketplace for individuals and families buying their own health coverage; premium subsidies and cost-sharing reductions are available for eligible enrollees who use the Marketplace. (Oregon will no longer use HealthCare.gov starting November 1, 2026.)

Oregon Division of Financial Regulation
Licenses and regulates health insurance companies in Oregon, as well as agents and brokers. Can address consumer questions and complaints about regulated entities.