Health Reform Facts: Oregon

DEMOGRAPHY
The Patient Protection and Percent of Population in Oregonper Race / Ethnic Group 2
Affordable Care Act (ACA) was
enacted on March 23, 2010.
Successful implementation requires
cooperation between key
stakeholders, federal and state 5.3
agencies, and reform advocacy 11.0
organizations. Because the fifty
2.0 White (Non-Hispanic)
states vary greatly, each state’s
implementation process will be Black
unique. Hispanic

80.0 Other*
In 2009, Oregon’s population was
estimated to be 3,825,657. 1 While
the state’s population is primarily
White, there are communities with
substantial racial diversity, which
will present Oregon with varying
challenges as it strives to
*Others include American Indian, Alaska Native, Asian, Native Hawaiian, and other
implement health reform that
Pacific Islanders.
works for all residents.
OREGON AND THE UNINSURED: HOW WILL THE AFFORDABLE CARE ACT HELP?
While 83.4% of all Oregon residents have health insurance, over 626,200 individuals remain uninsured, 3
including about 11.3% of Oregon’s children 4 and almost 21% of the state’s working population.5

ACA is designed to address these concerns by providing affordable access to health insurance coverage
to those individuals who would otherwise be unable to obtain coverage, and to extend current benefits
and services provided by Medicaid (a federal and state funded public insurance program that provides
health insurance coverage for low-income and disabled individuals and families).
NEW BENEFITS UNDER ACA: THE EFFECTS IN OREGON

ACA establishes new requirements for private health insurers in order to make health
Insurance care plans more accessible to the public. These requirements include the following:
Coverage  Effective Immediately: Plans must cover certain preventive health services, such as
vaccines and screenings, without a co-pay.

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National Coalition on Health Care June 2010
  Effective September 2010:
• Insurers will not be allowed to drop any insured person because he/she gets
sick or develops a chronic health condition. In addition, ACA allows individuals
to renew health insurance coverage regardless of their health status.
•Individuals up to the age of 26 can choose to be covered under their parents’
insurance plan.
 Effective January 2014:
• Under the “guaranteed issue” provision, an insurer must accept every
employer and individual in the state that applies for coverage.
• Insurers cannot exclude people from coverage if they have a pre-existing
condition (e.g., asthma, diabetes, or any other long-term condition) or past
illness.
• All insurers will be required to offer a coverage package that offers essential
benefits.
Effective Immediately: ACA makes tax credits available to qualifying small businesses to
Small
help them afford coverage for their employees. These tax credits could total up to 50% of
Business
a business’s health insurance premiums. In 2008, Oregon had over 77,468 small
Assistance
businesses, 6 which represented almost 78% of the state’s employers. 7
Effective January 2014: ACA requires that states create an insurance market “exchange”
Health – a marketplace where people will be able to compare and shop for health insurance.
Insurance This will make access to health plans easier and more efficient. U.S. citizens, legal
Exchanges immigrants, and small businesses will be able to purchase insurance through these
exchanges.
Effective January 2014: ACA provides a tax credit to qualified individuals so that they may
Tax Credits purchase health insurance through the exchanges. Qualification for the tax credit will be
for based on the individual’s household income and his/her number of dependents. A
Individuals person who earns between 133% and 400% of the federal poverty level 8 may be eligible
for individual tax credits.
Effective July 2010: High-risk pools are designed to provide health insurance coverage to
people who were previously uninsurable due to a pre-existing condition. The Department
High-Risk of Health and Human Services (HHS) will allocate approximately $66 million for Oregon to
Insurance implement a high-risk pool that complies with ACA’s requirements.9 The high-risk pool
Pools may provide services to approximately 6,700 Oregonians, while also saving the state $65
million over the next three years. 10 Oregon chose to administer the federally funded
high-risk pool alongside the already existing Oregon Medical Insurance Pool.

Expansion Effective January 2014: ACA contains provisions that will create new eligibility
of requirements for Medicaid. For example, adults under the age of 65 earning less than
Medicaid 133% of the federal poverty level, may be eligible to apply regardless of whether they
have children. It is estimated that approximately 294,600 Oregon residents may be

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National Coalition on Health Care June 2010
 eligible to enroll in Medicaid. 11

IMPLEMENTATION CHALLENGES IN OREGON

Successful implementation of ACA will require a joint effort among local, state, and federal agencies, as
well as many non-governmental organizations. The State of Oregon will face several challenges:
 Health Care Workforce– With the potential increase of Oregon’s insured population, it is important
that primary care physicians and other necessary health care professionals are engaged in health
care reform. ACA provides grants and loan forgiveness to health care professionals; this will help
Oregon ensure that it has an appropriate supply of doctors, nurses, social workers, and other
professionals to cover the increased demand.
 Insurance Oversight – Oregon’s government will need to work alongside the Department of Health
and Human Services and other federal agencies to establish procedures and reporting requirements
to oversee insurance companies’ compliance with ACA regulations

1
U.S. CENSUS BUREAU, STATE AND COUNTY QUICKFACTS (2010), available at http://quickfacts.census.gov/qfd/states/41000.html (last accessed
June 2010). These figures are from 2009.
2
Ibid. These figures are from 2008.
3
THE KAISER FAMILY FOUNDATION, statehealthfacts.org. Data Source: Urban Institute and Kaiser Commission on Medicaid and the Uninsured
estimates based on the Census Bureau's March 2008 and 2009 Current Population Survey (CPS: Annual Social and Economic
Supplements), available at http://www.statehealthfacts.org:/comparetable.jsp?ind=125&cat=3 (last accessed June 2010).
4
THE KAISER FAMILY FOUNDATION, statehealthfacts.org. Data Source: Urban Institute and Kaiser Commission on Medicaid and the Uninsured
estimates based on the Census Bureau's March 2008 and 2009 Current Population Survey (CPS: Annual Social and Economic
Supplements), available at http://www.statehealthfacts.org:/comparetable.jsp?ind=127&cat=3 (last accessed June 2010).
5
COVER THE UNINSURED, ROBERT WOOD JOHNSON FOUNDATION, U.S. UNINSURED WORKERS, available at
http://covertheuninsured.org/uninsured_workers#map (last accessed June 2010). These figures are from 2006-2007.
6
Small businesses include employers with fewer than 50 employees.
7
U.S. DEP’T OF HEALTH & HUMAN SERVS., MEDICAL EXPENDITURE PANEL SURVEY (2008), available at
http://www.meps.ahrq.gov/mepsweb/data_stats/summ_tables/insr/state/series_2/2008/tiia1.pdf. These figures are from 2008.
8
The federal poverty level for the 48 contiguous states is $10,830 for a single individual. ASSISTANT SEC'Y FOR PLANNING AND EVALUATION, U.S.
DEP’T OF HEALTH & HUMAN SERVS. THE 2009 HHS POVERTY GUIDELINES (2010), available at http://aspe.hhs.gov/poverty/09poverty.shtml (last
accessed June 2010).
9
U.S. DEP’T OF HEALTH & HUMAN SVCS., FACT SHEET – TEMPORARY HIGH-RISK POOL PROGRAM, available at
http://www.hhs.gov/ociio/initiative/hi_risk_pool_facts.html (last accessed June 2010).
10
DAVID ROSENFELD, THE LUND REPORT, HIGH RISK POOL TO SAVE INSURERS MILLIONS (2010), available at
http://www.thelundreport.org/resource/high_risk_pool_to_save_insurers_millions (last accessed July 2010).
11
JOHN HOLAHAN & IRENE HEADEN, KAISER COMMISSION ON MEDICAID AND THE UNINSURED, MEDICAID COVERAGE AND SPENDING IN HEALTH REFORM: NATIONAL
AND STATE‐BY‐STATE RESULTS FOR ADULTS AT OR BELOW 133% FPL 41 (2010), available at http://www.kff.org/healthreform/upload/Medicaid-
Coverage-and-Spending-in-Health-Reform-National-and-State-By-State-Results-for-Adults-at-or-Below-133-FPL.pdf (last accessed June
2010).

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