Oregon Offers ‘Bridge’ Between Medicaid, Marketplace Insurance Plans

Through a new benefit program called Oregon Health Plan (OHP) Bridge, an estimated 100,000 people are anticipated to eventually qualify for free health coverage. 

Oregon created the new eligibility category through a Medicaid demonstration assuring coverage for American Indian/Alaska Native populations and by establishing a Basic Health Program (BHP). Oregon is the third state in the nation to establish a BHP.

Before the COVID-19 pandemic, many adults in Oregon with income just above traditional Medicaid limits were uninsured. Additionally, about 34% of members who lost benefits would return to Medicaid within a year due to fluctuating income. OHP Bridge is designed to help people keep their coverage and their same doctors despite short-term fluctuations in income.

“Oregon Health Plan was one of the first Medicaid programs in the country to expand to adults with lower incomes,” said OHA Director Sejal Hathi, M.D., M.B.A., in a statement. “The new OHP Bridge program continues Oregon's long history of leading the nation in efforts to make health coverage accessible to everyone in Oregon. It also advances our strategic plan to eliminate health inequities by 2030, by helping to expand access to affordable care for all and honoring our government-to-government relationship with the Tribes.”

Oregon’s BHP will be administered by OHP, which also administers the state Medicaid program. The name references the goal to “bridge” the health coverage gap between people who have traditional OHP and people who have Marketplace coverage.

OHP Bridge will have no member costs, which means no premiums, co-payments, coinsurance, or deductibles. Oregon will be the first state to offer a BHP with no out-of-pocket costs for members.

Through OHP Bridge, people in Oregon can get medical, dental and behavioral healthcare with no member costs. Members will also have access to additional benefits, like transportation to medical appointments and other health-related services.

There are a few things OHP Bridge will not cover that other Medicaid programs cover. OHP Bridge will not cover long-term services and supports  that help with tasks of daily living, or Oregon’s new health-related social needs benefit, which covers some climate, food and housing needs.

The federal government granted OHA approval to move forward with OHP Bridge on June 24.