Oregon To Claim Nation’s First In Medicaid

Oregon will become the first state in the nation to allow children who enroll in Medicaid at birth to stay to age 6. There are several states that are looking at their enrollment policies for the youngest Medicaid members. However, Oregon is leading the way after getting federal approval to implement a new continuous-enrollment policy.

In May, when the public health emergency ends, Oregon will become the first state to allow children who qualify for Medicaid to enroll at birth and stay enrolled until they turn 6, regardless of changes in their household’s income and without having to reapply. Medicaid enrollment nationally is at a record high after the federal government prohibited states from dropping members during the public health emergency unless they died or moved out of state. That rule has helped push the country’s uninsured rate to a record low.

Of the nearly 90 million people on Medicaid and the Children’s Health Insurance Program — a federal-state program that covers children in households with incomes above Medicaid eligibility — about 41 million are children. Three other states are moving to implement similar policies for their Medicaid plans, which provide health coverage to people with low incomes and are funded by states and the federal government. 

Before moving toward continuous coverage for kids up to age 6, Oregon offered 12 months of continuous eligibility for children. State Medicaid officials estimate that in 2019, prior to the pandemic’s start, more than 70,000 children younger than 6 were in and out of Medicaid. About 29,000 of those kids had coverage gaps that exceeded six months. Children can lose their eligibility if parents fail to renew the coverage each year or don’t respond when a state seeks information to confirm that a family’s income has remained low enough to qualify.

Oregon officials estimate that after four years in place, the new enrollment policy will benefit more than 51,000 children in 2027, at a cost of $177 million. Before the COVID-19 public health emergency began in 2020, millions of children were losing coverage because of administrative problems, rather than because their family’s income had increased and made them ineligible