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Find out how the American Rescue Plan and Inflation Reduction Act have reduced marketplace health insurance costs for Oregonians from Portland, to Salem, Eugene and beyond. And learn about an ongoing opportunity for low-income residents to enroll in $0-premium coverage. Enroll now during open enrollment (through January 15 in Oregon).

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Short-term coverage in Oregon

Oregon limits the duration of short-term health insurance plans to three months. Read more about short-term health insurance in Oregon.

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Medicaid in Oregon

Oregon implemented the Affordable Care Act's Medicaid eligibility expansion in 2014 and the state has seen one of the highest percentage increases in Medicaid/CHIP enrollment since 2013. Read more about Medicaid expansion in Oregon.

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Medicare enrollment in Oregon

As of August 2022, there were 913,846 Oregon residents enrolled in Medicare. Read more about Medicare enrollment in Oregon and its protections for Medigap enrollees

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Flexible dental benefits. Fast approval.

Protect yourself from the soaring costs of dental procedures. Compare plan options to see premiums and deductibles that fit your budget.

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Frequently asked questions about health insurance
coverage options in Oregon

Oregon has a state-run health insurance marketplace (exchange) that uses the HealthCare.gov enrollment platform. The Cover Oregon website – which was used in late 2013 and 2014 as the state’s health insurance exchange platform – is no longer operational.

Consumers can use OregonHealthcare.gov to learn about the state’s health insurance marketplace health insurance plans and eligibility; when they are ready to apply and enroll, they are taken to the federal marketplace website at HealthCare.gov.

The marketplace is used by individuals and families who buy their own health insurance coverage. This includes people who retired (and lost their employer-sponsored coverage) prior to age 65, people who are self-employed, and people who are employed in a small business that doesn’t offer health benefits to workers.

Enrolling through the marketplace (HealthCare.gov) is the only way that Oregon residents can obtain income-based premium subsidies and cost-sharing reductions, which serve to reduce monthly premium costs and out-of-pocket costs for eligible enrollees.

The open enrollment period for individual/family coverage runs from November 1 through January 15 in Oregon. You can learn more about open enrollment in our comprehensive guide

Outside of open enrollment, a qualifying life event is generally necessary to enroll or make changes to your coverage. But Native Americans can enroll anytime, as can subsidy-eligible applicants with household income that doesn’t exceed 150% of the poverty level. And people who are eligible for Medicaid can also enroll anytime.

During the open enrollment period for 2022 coverage, 146,602 people enrolled in private health plans through Oregon’s exchange. This was up from 141,089 people the year before, after three consecutive years of declining enrollment in Oregon’s exchange. 

But enrollment in Medicaid has increased significantly during the COVID pandemic, as people transitioned away from private health insurance (both employer-sponsored coverage and individual/family coverage) and gained coverage under Medicaid instead, due to loss of jobs and income. And Medicaid eligibility redeterminations have been paused nationwide throughout the COVID pandemic, meaning that people have not been disenrolled from Medicaid, even if their income increased.

 

For Oregon’s individual market insurers, the weighted average rate change for 2023 amounted to a 6.7% increase. This followed a 1.5% increase in average rates for 2022, and a 2.1% average increase for 2021.

But average rate changes apply to full-price premiums; rate changes for people who receive premium subsidies — which is the majority of Oregon’s exchange enrollees — can be quite different, depending on fluctuations in the price of the benchmark plan in each area.

For 2023 coverage, six insurers offer plans through Oregon’s exchange; all six also offered plans for 2022. Plans are available in Oregon’s exchange from the following insurers:

  • BridgeSpan
  • Kaiser
  • Moda
  • PacificSource
  • Providence
  • Regence

Residents in every county can select from at least four insurers for 2023 coverage, and most residents can select from among five or six insurers.

Oregon started with two CO-OPs under the ACA but currently has no CO-OPs following the July 2016 closure of Oregon Health CO-OP and the 2015 closure of Health Republic Insurance.

In 2013, about 14.7% of Oregon residents did not have medical insurance – a little higher than the national average.

Despite the troubles Oregon’s health insurance marketplace experienced before switching to the HealthCare.gov enrollment platform, the state’s supportive approach to the ACA, including expanding Medicaid, resulted in a significant decrease in the percentage of residents who have no health insurance coverage. By 2018, the uninsured rate stood at 7.1% — less than half of what it had been pre-ACA. It climbed slightly, to 7.2%, as of 2019.

As of early 2022, there were more than 137,000 Oregon residents with coverage obtained through the Oregon health insurance marketplace, all of whom had coverage for the ACA’s essential health benefits. About 80% of them were also receiving subsidies that reduce their monthly premium costs. Subsidies are larger and more widely available than they used to be, thanks to the American Rescue Plan.

In 2010, both of Oregon’s U.S. Senators – Jeff Merkley and Ron Wyden – voted yes on the Affordable Care Act. In the U.S. House, four of the five Oregon Representatives were Democrats and voted in favor of the law; Greg Walden, a Republican, cast the only no vote, and is still the only Republican in Oregon’s congressional delegation.

Under the leadership of former Gov. John Kitzhaber, a former physician who made healthcare and healthcare reform priorities throughout his years in public service, Oregon opted to expand Medicaid and run its own exchange, known as Cover Oregon.

Medicaid expansion was a success in Oregon, but unfortunately, the state’s initial exchange rollout did not go well. The online enrollment system was inoperable for months, and the exchange had to process thousands of paper applications.

In late April 2014, the Oregon health insurance marketplace board voted to use HealthCare.gov instead of continuing to try to fix the broken website, and Oregon residents started using HealthCare.gov during 2015 open enrollment. They have continued to do so ever since, although the state is considering the possibility of eventually switching back to a state-run exchange platform.

Utilizing federal funds to expand Medicaid coverage eligibility to 138% of the poverty level has played a significant role in reducing the uninsured rate in Oregon.

Oregon has seen some of the nation’s most dramatic jumps in Medicaid plan enrollment under the ACA. From 2013 to July 2022, the average monthly enrollment in Oregon Medicaid grew 113% – the fourth-highest increase of all states. As of mid-2022, there were more than 1.3 million Oregonians covered by Medicaid/CHIP.

Oregon’s “Cover All Kids” law took effect in January 2018, ensuring that all children under age 19 with household income up to 305% of the poverty level have access to Oregon Health Plan coverage, regardless of immigration status.

Read more about Medicaid eligibility expansion in Oregon.

New federal regulations expanded access to short-term health insurance coverage and association health insurance plans in 2018, but the effects of those regulations were muted in Oregon. Oregon limits short-term health insurance plans to three months in duration, so the federal rules do not apply.

Read more about short-term health insurance coverage in Oregon.

As of August 2022, there were 913,846 Oregon residents enrolled in Medicare plans. Most are eligible due to their age, but nearly 11% are under the age of 65 and eligible for Medicare due to a long-term disability, ALS, or end-stage renal disease.

Read more about Medicare enrollment in Oregon.

Oregon has significant protections for Medigap enrollees, including an annual “birthday rule” enrollment period, during which a Medigap enrollee can switch to any Medigap plan with equal or lesser benefits, without medical underwriting. The state also guarantees access to Medigap plans for Medicare enrollees who are under age 65 (federal law only guarantees access when enrollees are 65).

  • OregonHealthcare.gov — A state-run service that connects Oregon residents with health coverage options.
  • 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 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.
  • Medicare Rights Center — A nationwide resource that can answer questions about Medicare and provide information that beneficiaries need.
  • Oregon Senior Health Insurance Benefits Assistance — A local service that can provide assistance, information, and enrollment counseling to Medicare beneficiaries and their caregivers.

Gov. Brown signed OR SB1 into law March 6, 2015, which resulted in the dissolution of Cover Oregon and its board of directors. The remaining responsibilities were transferred to the Oregon Department of Consumer and Business Services. Though the act was effective immediately, the full transfer was not complete until June 2015.

Oregon HB2342 was signed into law in August 2017, granting the state the authority to take a variety of actions to stabilize the individual market, if and when federal changes are made to the ACA.

SB558 was also signed into law by Gov. Brown in August 2017, ensuring access to Oregon Health Plan (Medicaid) coverage for all children with household income up to 305 percent of the poverty level, regardless of immigration status.

SB250, enacted in 2019, codifies various ACA consumer protections into state law.

Before the ACA was implemented, individual health insurance was medically underwritten in Oregon, as it was in nearly all states. Because medical history was a factor in eligibility for coverage, people with serious pre-existing conditions were often unable to purchase a policy in the private market, or if they received an offer of coverage, it often included a substantial rate increase or a pre-existing condition exclusion rider.

In order to address this issue, the state created the Oregon Medical Insurance Pool (OMIP) in 1990 to provide an alternative for people who were unable to get private individual health insurance.

Now that medical underwriting is no longer used in the individual market – thanks to the ACA – there is no longer a need for state-run high-risk pools. Oregon had intended to shutter OMIP at the end of 2013, but the technical problems with the exchange made it difficult for OMIP members to transition to a new plan. So Oregon created a temporary pool that provided coverage for OMIP members for the first three months of 2014. That coverage ended on March 31, 2014.

When it comes to health insurance in Oregon, we’re the voice of experience.

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Talking about health insurance since 1994.
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