The federal Consolidated Appropriations Act of 2023 signed into law Dec. 29, 2022, directed state Medicaid agencies to resume normal eligibility determinations no later than April 1, 2023. The Oregon Health Authority (OHA) is determining Oregon Health Plan (OHP) member eligibility using a phased approach from April 2023 through January 2024.
Disenrollment timing will be based on criteria established by OHA, the state agency responsible for OHP and the Marketplace. OHA and the Oregon Department of Human Services are working together to prepare the upcoming changes to Medicaid to preserve benefits for individuals and families.
For those losing OHP benefits, there is a Marketplace Special Enrollment Period (SEP) from April 1, 2023, through June 30, 2024. If a member is no longer eligible for benefits, that member will be referred to the Marketplace to consider other affordable coverage options. OHP will send participant information directly to the Marketplace, which will communicate information and assist with a Marketplace plan enrollment.
An SEP also exists for OHP members that lose coverage and have access to employer based coverage. The employee must request enrollment in the employer plan within 60 days of their OHP termination date.
In October 2022, CMS issued a rule to permit an SEP for Medicare enrollment if Medicaid coverage is terminated after the COVID-19 PHE ends on or after Jan. 1, 2023. For more information visit:
For more information on Oregon’s PHE Medicaid unwinding visit: