Important – Medicaid Eligibility Changes Due to Public Health Emergency End 3/31/23

We want to be sure you’re aware of some important upcoming changes to Medicaid that may create some enrollment movement onto group plans.

Throughout the COVID Public Health Emergency, those enrolled on Medicaid (Oregon Health Plan (OHP) in Oregon) have had continuous coverage because of the Family First Coronavirus Response Act. The act removed administrative barriers to enrollment on the program as eligibility was not verified. The Public Health Emergency is scheduled to end on March 31, 2023 and therefore the continuous Medicaid enrollment will end as well and states will redetermine eligibility for all Medicaid members. This redetermination could result in employees and their families who previously waived group health coverage to experience a loss of Medicaid coverage if they no longer qualify for the program.

As a reminder, a qualifying life event is needed for an employee and/or their dependents to enroll on a group health insurance plan outside of open enrollment and the new hire enrollment period. Involuntary loss of other coverage is a qualifying life event creating an enrollment opportunity effective the day immediately following the date when other coverage is lost. In most situations, employees must notify their employers of a qualifying life event within 30 days from the event however, employees may notify their employer and submit their enrollment within 60 days of the event if the event is involuntary loss of Medicaid coverage.

The state of Oregon has already started reaching out to OHP members to confirm their contact information. OHP renewals and redeterminations are expected to begin April 2023. It’s important that those enrolled on OHP update their contact information with The State and respond to their renewal notices right away. Their renewal notice will provide information about what they need to do to maintain coverage or seek other services. Those who are eligible may reach out to their employer for information about enrolling on the group health plan due to a loss of other coverage.