Image for Oregon Health Plan Holding Up Under Strain of COVID-19

The Oregon Health Plan appears to be one part of the social safety net that is holding up in the midst of the COVID-19 pandemic, as newly unemployed and uninsured Oregonians flock to enroll in the state’s Medicaid program.

The Oregon Health Plan already provided coverage for 1 million Oregonians, roughly one in four residents, including older adults, low-income families and children. New rules allow individuals to sign up for coverage without normal verification procedures to ensure quick, seamless access to health care for some of the more than 250,000 Oregon workers out of a job.

The Lund Report estimates an additional 150,000 Oregon Health Plan enrollees could cost the state $900 million per year. A partial financial cushion came in the Families First Act that increased the federal share of payments of Medicaid enrollments by 6.2 percent. The total Oregon Medicaid budget is now $15.4 billion. The act allowed states to modify eligibility criteria to make it easier for newly unemployed people to qualify for coverage. Oregon is allowing enrollees to self-attest they are eligible.

Oregon officials anticipate a projected sharp drop in state tax revenues in the quarterly economic report due out later this month. Finding money to sustain the Oregon Health Plan, including the 367,000 enrollees who joined the plan as part of expanded Medicaid eligibility under Obamacare, is a continuous challenge for lawmakers. The governor and lawmakers have worked with state hospitals and health insurers on funding schemes that attract additional federal matching dollars. The 2019 legislature sent a tobacco tax increase to Oregon voters this November that potentially would provide funding for health care programs and free up General Fund revenues to support the Oregon Health Plan.

Meanwhile, state officials indicate they have been able to handle the cost of increased enrollment caused by layoffs in response to COVID-19 lockdown orders. As the state gradually reopens and many people return to their former jobs, the pressure is expected to lessen.

Oregon has not joined many other states in reopening locked-down economies, though news reports indicate Governor Brown is reviewing plans to relax stay-at-home orders for rural parts of the state with few if any confirmed cases of the virus. Brown also announced an ambitious COVID-19 testing and contact tracing strategy, which still doesn’t have all the details spelled out clearly.

Calling the $6 million testing and contact tracing plan a “game-changer,” Brown said, “We must understand the prevalence of the disease in Oregon” to discover who is who sick and “see where virus may be hiding.” “Our efforts to move forward gradually and incrementally, taking steps based on science and the data are the right approach,” Brown added. “We can’t stand still.”

In coordination with Oregon Health & Science University and Portland State University, state health officials will seek 100,000 randomized volunteers to be tested as a way to measure how extensively the coronavirus has penetrated the state. Invitations for the “Key to Oregon” study will go out in mid-May. Participants will receive home testing kits to provide data about symptom-free infections and prevent wider spread. Test results will be reported to the Oregon Health Authority to guide contact tracing and home isolation for those who test positive. Brown wants the capability to administer 12,250 tests per week, which would reflect a rate of 29 tests per 10,000 population.

Oregon health officials also will be recruiting a legion of contract tracing monitors, with a goal of one monitor for every 10,000 state residents. Initially, the plan will involve hiring and training 600 monitors to find people who may have unsuspectingly come in contact with the virus with asymptomatic carriers. Contact tracing is intended to help keep track of the potential community spread of the highly communicable virus, which in turn can localize the need for quarantines.

Portlanders who have contracted COVID-19 have been part of the promising clinical trial for the drug Remdesivir. Early results indicate it can help seriously afflicted patients by reducing their recovery time by about a third. Providence Portland Medical Center and Kaiser Sunnyside Hospital were among hospitals worldwide participating in the Remdesivir clinical trial.

Oregon’s major hospitals in partnership with smaller rural hospitals have agreed on a united approach to manage COVID-19 testing statewide. OHSU has built a Biosafety Level 2+ lab to speed COVID-19 test results.