Oregon Health Plan (OHP) Bridge
Frequently Asked Questions
Updated 5/3/2024 1
Contents
Purpose ................................................................................................................................................ 3
OHP Bridge .......................................................................................................................................... 3
What is OHP Bridge? ....................................................................................................................... 3
When will OHP Bridge start? ........................................................................................................... 3
Why is OHP Bridge important? ........................................................................................................ 3
Who specifically will benefit from OHP Bridge? ............................................................................. 4
What is considered an eligible citizenship or immigration status for OHP Bridge?..................... 5
How many people are expected to be eligible for OHP Bridge? .................................................. 5
What benefits will OHP Bridge have? ............................................................................................. 5
How much will OHP Bridge cost for members? ............................................................................. 5
Background ......................................................................................................................................... 5
How was OHP Bridge created? ....................................................................................................... 5
What’s the status of OHP Bridge? What is the timeline? .............................................................. 5
Is Oregon keeping OHP Bridge-eligible adults on OHP Plus until OHP Bridge starts?.............. 6
What is the BHP Blueprint? ............................................................................................................. 6
What is the timeline for Oregon to submit a Blueprint for federal approval? ............................... 6
How is Oregon’s approach to a Basic Health Program different from other states? .................. 6
How is OHP Bridge funded? ............................................................................................................ 6
Which health insurance carriers will deliver OHP Bridge benefits to members? ........................ 6
Moving Members to OHP Bridge ..................................................................................................... 7
How is Oregon ensuring people moving between Oregon Health Plan (OHP) Plus, OHP
Bridge and the Marketplace will be able to access the care they need? ..................................... 7
How will people in Oregon be able to enroll in OHP Bridge?........................................................ 7
How will people currently enrolled in OHP enroll in OHP Bridge? ....................................... 8
When will people not currently enrolled in OHP Plus be able to enroll in OHP Bridge? ............ 8
When will Marketplace enrollees be able to move to OHP Bridge? ............................................. 8
Will Marketplace enrollees be automatically moved to OHP Bridge upon launch? .................... 8
Will Marketplace plans cancel automatically when someone moves to OHP Bridge? ............... 8
Will Marketplace enrollees be required to move to OHP Bridge? ................................................ 8
How can Marketplace enrollees keep their Marketplace plan? .................................................... 9
Will people who keep their Marketplace plan but are eligible for OHP Bridge need to repay
financial help? ................................................................................................................................... 9
Updated 5/3/2024 2
OHP Bridge Interaction with Marketplace ...................................................................................... 9
How many people are anticipated to move from the Marketplace to the BHP? .......................... 9
Will these changes lower uninsured rates in Oregon? .................................................................. 9
How will removing the OHP Bridge population from the Marketplace effect premiums for
remaining Marketplace enrollees? .................................................................................................. 9
What is Oregon doing to lessen the impact on Marketplace enrollees above 200 percent FPL?
.......................................................................................................................................................... 10
How much are insurance premiums expected to go up? ............................................................ 10
Will OHP Bridge coverage be comparable to Marketplace plans?............................................. 10
How is Oregon seeking to address market effects from OHP Bridge? What are the next
steps? .............................................................................................................................................. 10
Updated 5/3/2024 3
Purpose
This document answers Frequently Asked Questions (FAQs) about Oregon Health Plan
(OHP) Bridge, formerly known as Oregon’s Basic Health Program (BHP). It will be
updated as additional information is made available.
OHP Bridge
What is OHP Bridge?
OHP Bridge is a new OHP benefit that will cover adults up to age 65 with income up to
200 percent of the federal poverty level (FPL) who do not have access to other
affordable health insurance. Adults must have an eligible citizenship or immigration
status to qualify.
Family
Size
200% FPL
(through Feb.
2025)
1
$30,120
2
$40,880
3
$51,640
4
$62,400
OHP Bridge will cover medical, dental and behavioral health care. Members will have
access to additional benefits like rides to appointments and health related services.
OHP Bridge will not cover long-term services and supports or Health Related Social
Needs. Just like OHP Plus, OHP Bridge is free to members. That means no premiums,
no co-payments, no coinsurance, and no deductibles.
When will OHP Bridge start?
OHP Bridge will open for enrollment on July 1, 2024. Prior to July 1, 2024, eligible OHP
members who have incomes between 138 and 200 percent FPL will be able to keep
their OHP Plus benefits. If they do not have coverage offered from an employer and are
still eligible, they will be moved to OHP Bridge starting July 1, 2024. This will continue
their current health coverage.
Starting July 1, 2024, other people in Oregon can also apply for OHP Bridge. The best
way to apply is online. To do this, go to benefits.oregon.gov. You can also use that link
to find information about how to apply in person, to get help to apply, or to get a paper
application. Or you can apply over the phone by calling the ONE Customer Service
Center at 1-800-699-9075.All relay calls accepted, and help is available in many
languages.
Why is OHP Bridge important?
Before the COVID-19 pandemic, adults in Oregon with income just above traditional
OHP Plus limits were more often uninsured. This group struggled to afford coverage
and was more likely to delay health care due to cost.
Updated 5/3/2024 4
During the pandemic, many of these people kept coverage due to rules allowing them to
keep OHP Plus for the rest of the public health emergency. OHP Bridge will help these
people stay covered.
OHP Bridge will let eligible members stay in their current health plan and coordinated
care organization (CCO). This will avoid coverage gaps, like being uninsured. And it
means people do not need to move to and from the Oregon Health Insurance
Marketplace.
OHP Bridge will reduce the disruptions that happen when people lose and regain OHP
Plus due to income changes. OHP Bridge will keep eligible members in their CCO.
OHP Bridge will help members keep their doctors. This makes it easier for people to
manage chronic health conditions or seek treatment for health issues before they
become more serious. It will also decrease administrative costs for providers and the
state.
Unlike private health insurance plans, OHP and OHP Bridge have NO member costs.
That means no premiums, co-payments, coinsurance or deductibles. Getting rid of
these costs should increase the number of people with health coverage. This will make
it easier for them to access health care.
Who specifically will benefit from OHP Bridge?
OHP Bridge is a new OHP benefit that will cover adults up to age 65 with income up to
200 percent of the federal poverty level (FPL) who do not have access to other
affordable health insurance. Adults must have an eligible citizenship, US national, or
immigration status to qualify.
2024 income limits for OHP Plus for adults and OHP Bridge are below. These income
limits change in March of each year per federal guidelines.
Household size
Income limit for
OHP Plus for
adults
(138% FPL)
Income limit for
OHP Bridge
(200% FPL)
1
$20,784
$30,120
2
$28,212
$40,880
3
$35,640
$51,640
4
$43,056
$62,400
5
$50,484
$73,160
6
$57,912
$83,920
Certain groups will continue to be eligible for OHP Plus (Medicaid), even if they have
higher incomes. This includes American Indians or Alaska Natives (AI/AN) and pregnant
adults. OHP Bridge will not include children because they already have access to OHP
Plus with even higher income limits.
Updated 5/3/2024 5
What is considered an eligible citizenship or immigration status for OHP Bridge?
To qualify for OHP Bridge, adults must be a U.S. citizen, a U.S. national, or a lawfully
present immigrant. Lawfully present includes people who have a qualified non-citizen
immigration status (there is no waiting period for OHP Bridge), a humanitarian status or
circumstance (including Temporary Protected Status, Special Juvenile Status, asylum
applicants, Convention Against Torture, victims of trafficking), a valid non-immigrant
visa (like a student or employment visa), or a legal status conferred by other laws
(temporary resident status, LIFE Act, Family Unity individuals). Currently, people with a
Deferred Action for Childhood Arrivals (DACA) status and people without documentation
do not qualify for OHP Bridge.
How many people are expected to be eligible for OHP Bridge?
OHP Bridge will cover about 100,000 people. Of those 100,000 people:
• Up to 55,000 people who currently have OHP Plus are expected to move to OHP
Bridge when it launches in July 2024.
• Over 11,000 people who are currently uninsured will sign up for OHP Bridge,
according to research.
• Another 35,000 people who currently have a health plan through the Marketplace
will move to OHP Bridge. People with income above 200 percent of the federal
poverty level can still get coverage and financial help through the Marketplace.
What benefits will OHP Bridge have?
OHP Bridge will cover medical, dental and behavioral health care. Members will have
access to OHP Plus benefits, like rides to appointments and health services.
OHP Bridge will not cover long-term services and supports (LTSS). LTSS are available
to eligible OHP Plus members through programs run by the Oregon Department of
Human Services (ODHS). People can qualify for LTSS if they need help with activities
of daily living and meet “level of care” needs, in addition to other financial and
nonfinancial criteria. In most cases, income-eligibility in Oregon’s LTSS programs is
higher than OHP Bridge limits. This means that people meeting “level of care” criteria
who have income in the OHP Bridge range will continue have access to LTSS through
existing programs, if they meet all other eligibility requirements. The creation of OHP
Bridge will not affect eligibility for LTSS services or create gaps in the Medicaid
program.
How much will OHP Bridge cost for members?
Just like OHP Plus, OHP Bridge is free to members. That means no premiums, no co-
payments, no coinsurance, and no deductibles.
Background
How was OHP Bridge created?
The Oregon legislature passed a law known as House Bill 4035 (2022). The law says
the state must help people who regularly enroll and disenroll in OHP Plus because of
frequent changes in income.
What’s the status of OHP Bridge? What is the timeline?
Updated 5/3/2024 6
Oregon is getting ready to launch OHP Bridge. The process includes getting federal
approval and preparing state systems. Right now, eligible OHP Plus members are
getting the Temporary Medicaid Expansion as they go through renewal. This will allow
them to keep their coverage until OHP Bridge launches in July 2024. On July 1, 2024,
all adults in Oregon with income between 138 and 200 percent FPL may apply for OHP
Bridge. This includes people covered through the Marketplace and uninsured people.
Is Oregon keeping OHP Bridge-eligible adults on OHP Plus until OHP Bridge
starts?
Oregon will keep adult OHP Plus members with income between 138 and 200 percent
FPL enrolled in OHP Plus while the state prepares to launch OHP Bridge. This is the
“Temporary Medicaid Expansion.” This will allow current OHP Plus members at that
income level to keep OHP Plus during renewals. Most members can stay with their
current CCO. This will be available for about 14 months, from May 2023 — July 2024.
What is the BHP Blueprint?
The Basic Health Program (BHP) is an option for states under Section 1331 of the
Affordable Care Act (ACA). States use the BHP Blueprint form to apply for approval
from the Department of Health and Human Services (HHS). The form is used to
describe program design choices, management, and compliance with federal rules.
What is the timeline for Oregon to submit a Blueprint for federal approval?
Oregon has submitted a Basic Health Program (BHP) Blueprint to the federal
government. This document is required to receive approval to begin a BHP. The
Blueprint outlines key program design decisions and other federal requirements. Tribal
and public comment periods ended in August 2023. The Oregon Health Policy Board
voted in support of the Blueprint in September 2023. The Blueprint has been sent to the
Center for Medicaid and Medicare Services (CMS) for review. If approved by CMS, the
plan would begin in July 2024.
How is Oregon’s approach to a Basic Health Program different from other states?
Oregon will be the third state to start a BHP. The other states are New York and
Minnesota. Plans vary in design, cost, and benefits from state-to-state. They all expand
coverage and affordable care to eligible people.
How is OHP Bridge funded?
OHP Bridge will be almost entirely paid for by the federal government. The program
would be funded under Section 1331 of the ACA. States with a BHP get federal funding
equal to 95 percent of the tax credits which would have gone to people who purchased
Marketplace coverage. The BHP funding formula includes additional funding to cover
the population below twice the poverty level. Research shows federal funding will be
enough to cover OHP Bridge benefits without additional state funding. The state will pay
the cost to run the program.
Which health insurance carriers will deliver OHP Bridge benefits to members?
Updated 5/3/2024 7
OHP Bridge will be run by the CCOs currently serving OHP Plus members. Adults who
are transitioning from OHP Plus to OHP Bridge can keep their CCO. This means people
transitioning from OHP Plus can keep their doctor. A CCO is a network of health care
providers who work together to serve people in their community. You can find a list of all
CCOs here.
There will be two programs within the OHP Bridge category: OHP Bridge - Basic Health
Program and OHP Bridge - Basic Medicaid. Individuals who receive OHP Bridge –
Basic Health Program will be enrolled in Coordinated Care Organizations (CCOs),
whereas OHP Bridge - Basic Medicaid will offer American Indian/Alaska Native
members the continued choice between CCO and Open Card coverage. We will share
more information about the differences between these OHP Bridge programs in the
near future.
Moving Members to OHP Bridge
How is Oregon ensuring people moving between Oregon Health Plan (OHP) Plus,
OHP Bridge and the Marketplace will be able to access the care they need?
OHP Bridge benefits will be provided by the same coordinated care organizations
(CCOs) that serve OHP Plus members. This will ensure continuity of coverage and care
for most people moving between OHP Plus and OHP Bridge. Most members will be
able to move between programs without a change in benefits, and will also be able to
keep their doctors.
Oregon is committed to preventing disruptions for people who must move from OHP
Plus or OHP Bridge to the Marketplace because their income changed. In the past,
many people chose not to enroll in another health plan when they lose OHP Plus
coverage. Oregon will look at health care and billing data for these members to see
where they get health care. Then, the Marketplace will share information about the
Silver health plans that cover the providers someone used in the last year.
Oregon currently uses HealthCare.gov for its Marketplace. This limits the ability to send
member information between OHP and Marketplace systems. For example, the
Marketplace can transfer information to Oregon's ONE system for state programs. But
Oregon cannot transfer complete Marketplace applications to HealthCare.gov. Oregon
will work to add this capability to its state-based marketplace (SBM), when it launches
for plan year 2027.
How will people in Oregon be able to enroll in OHP Bridge?
Prior to July 1, 2024, eligible OHP members who have incomes between 138 and 200
percent FPL will be able to keep their OHP Plus benefits. If they do not have coverage
offered from an employer and are still eligible, they will be moved to OHP Bridge
starting July 1, 2024. This will continue their current health coverage.
Starting July 1, 2024, other people in Oregon can also apply for OHP Bridge. The best
way to apply is online. To do this, individuals can go to benefits.oregon.gov. Individuals
can also use that link to find information about how to apply in person, to get help to
apply, or to get a paper application. Or, individuals can apply over the phone by calling
Updated 5/3/2024 8
the ONE Customer Service Center at 1-800-699-9075. All relay calls accepted, and help
is available in many languages.
How will people currently enrolled in OHP enroll in OHP Bridge?
Prior to July 1, 2024, eligible OHP members who have incomes between 138 and 200
percent FPL will be able to keep their OHP Plus benefits. If they do not have coverage
offered from an employer and are still eligible, they will be moved to OHP Bridge
starting July 1, 2024. This will continue their current health coverage.
When will people not currently enrolled in OHP Plus be able to enroll in OHP
Bridge?
Starting July 1, 2024, individuals not currently enrolled in OHP Plus will be able to apply
for OHP Bridge. The best way to apply is online. To do this, individuals can go to
benefits.oregon.gov. Individuals can also use that link to find information about how to
apply in person, to get help to apply, or to get a paper application. Or, individuals can
apply over the phone by calling the ONE Customer Service Center at 1-800-699-9075
(all relay calls accepted, and help is available in many languages).
When will Marketplace enrollees be able to move to OHP Bridge?
People with Marketplace plans will have the option to apply for OHP Bridge starting July
1, 2024. Those found eligible would be enrolled in OHP Bridge. People who are found
eligible for OHP Bridge on or before the 15
th
of the month will have benefits starting the
first of the next month. If found eligible after the 15
th
of the month, benefits will begin the
first of the following month. People will need to contact HealthCare.gov to cancel their
Marketplace coverage once enrolled in OHP Bridge.
Will Marketplace enrollees be automatically moved to OHP Bridge upon launch?
No. People with Marketplace plans will not be automatically moved to OHP Bridge. It is
important to know that if someone makes any updates to their Marketplace application,
like a change in contact information or income, their information will be sent to the state
to determine eligibility. The state may request more information before deciding
eligibility. People eligible for OHP Bridge will no longer be eligible for Marketplace-
based financial help, like tax credits. People eligible for OHP Bridge, they will need to
cancel their Marketplace health plan, it will not cancel on its own.
Will Marketplace plans cancel automatically when someone moves to OHP
Bridge?
No. It is important that people who are found eligible for OHP Bridge cancel their
Marketplace plan. They can do this by logging in to HealthCare.gov or by calling the
HealthCare.gov call center (800-318-2596). People who need to cancel Marketplace
coverage for some enrollees in the household, but not everyone, should call the
HealthCare.gov call center. Marketplace enrollees found eligible for OHP Bridge will no
longer be eligible for Marketplace-based financial help.
Will Marketplace enrollees be required to move to OHP Bridge?
Updated 5/3/2024 9
People with Marketplace plans will not automatically move to OHP Bridge when it
launches. If someone with a Marketplace plan is eligible for OHP Bridge, they can keep
their coverage and financial help until their automatic re-enrollment period ends.
How can Marketplace enrollees keep their Marketplace plan?
People with Marketplace plans can keep their 2024 plan year coverage through
December 2024 if they do not make updates to their application. Updates include
changing contact information, family size, income, etc. They can also keep their plan for
up to two more years (2025 and 2026) if they agree to auto-enroll for the next plan year.
They must also refrain from making updates to their application in 2025 and 2026.
People enrolled in Marketplace plans who have experienced changes MUST update
their application. Updates must be reported even if they cause people to move to OHP
Bridge. This includes changes like moving or an increase or decrease in income. If they
do not update their application, they may lose financial help from the Marketplace.
Will people who keep their Marketplace plan but are eligible for OHP Bridge need
to repay financial help?
People will not be subject to tax credit reconciliation even if their income is within the
OHP Bridge range. However, other reconciliation rules would still apply like they would
for others in Marketplace plans. This includes rules like income calculations or caps on
repayment.
OHP Bridge Interaction with Marketplace
How many people are anticipated to move from the Marketplace to the BHP?
We expect more than 35,000 people with Marketplace plans will be eligible for OHP
Bridge. We anticipate these people will gradually move to OHP Bridge between 2024
and 2027.
Will these changes lower uninsured rates in Oregon?
OHP Bridge is estimated to cover more than 31,000 people who would likely not have
other coverage, including:
• More than 11,000 people who do not have health insurance.
• More than 20,000 people who would have lost their OHP Plus coverage but will
now remain covered through OHP Bridge.
Most people with Marketplace plans will keep their coverage. Some are expected to
switch to lower-premium plans. An estimated 1,800 people are projected to drop
Marketplace coverage. 141,963 Oregonians enrolled through the Marketplace during
open enrollment for 2023 coverage.
How will removing the OHP Bridge population from the Marketplace effect
premiums for remaining Marketplace enrollees?
Independent researchers studied the effect of creating OHP Bridge. This included the
effect of some people moving from Marketplace plans to OHP Bridge. Their research
found that people in Marketplace plans with income above 200 percent FPL may:
Updated 5/3/2024 10
• Experience cost increases: Premiums will increase for most people with
Marketplace plans. Premium increases will take place gradually, starting in 2025.
Premium changes will vary be based on age, income and plan choice. Some
people will pay the same or lower premiums.
• Drop coverage: We expect 1,800 people to drop their Marketplace coverage
due to premium increases. On the other hand, more than 31,000 people will gain
coverage through OHP Bridge.
• Switch plans: Most people will stay on their plan or switch plans within the
Marketplace. Researchers expect some members will move from Gold to Silver
plans that will have lower premiums. This is because many of the additional cost
reductions that made Gold plans less expensive will no longer be available.
What is Oregon doing to lessen the impact on Marketplace enrollees above 200
percent FPL?
Premiums for the 2024 plan year will not be affected by the mid-2024 launch of OHP
Bridge. Oregon is currently pursuing short-term solutions for 2025 and 2026 in
partnership with carriers. When Oregon moves to a state-based Marketplace in 2027,
the state will be able to pursue additional federal funding pathways from CMS.
How much are insurance premiums expected to go up?
OHP Bridge will not affect premiums for 2024.
For 2025, most people with Marketplace plans will not see significant increases to their
monthly premium, outside typical annual premium changes. The Oregon Health
Authority and Oregon Division of Financial Regulation are continuously assessing
impacts to the Marketplace and working with insurance carriers to minimize rate
increases while keeping the market stable.
Will OHP Bridge coverage be comparable to Marketplace plans?
Marketplace plan coverage varies, but all ten essential health benefits are covered by
OHP Bridge. There are no premiums or out-of-pocket costs for OHP Bridge covered
services.
How is Oregon seeking to address market effects from OHP Bridge? What are the
next steps?
• OHP Bridge will begin in July 2024.
• OHA will keep looking for ways to improve affordability in the Marketplace.
• OHA and the Department of Consumer and Business Services (DCBS) have met
with insurance companies six times to work together on this issue. OHA and
DCBS will continue to bring together insurers to explore ways to make the
Marketplace more affordable in 2025 and 2026.
• Oregon is expected to have a State Based Marketplace in 2027. This will help
overcome some barriers to improving Marketplace costs.
