Washington County residents on the Oregon Health Plan face new work requirements and more frequent eligibility reviews after state health officials told lawmakers the 2025 federal tax law will cost Oregon nearly $1.3 billion in Medicaid funding over four years.
Fariborz Pakseresht, interim 3director of the Oregon Health Authority, laid out the numbers at a Senate Health Care Committee hearing Wednesday, Sept. 9.
The agency projects a $421 million deficit for the next two-year budget cycle and an $868 million gap for the two years after that, Your Oregon News reported.
Oregon had already allocated about $110 million earlier in 2026 to hire eligibility-review staff required by the law.
"Even with our best work, there are going to be people who lose coverage," Pakseresht told senators. "We need to know that before we step into this."
Researchers at Princeton University estimate about 200,000 Oregonians will lose Medicaid coverage as the changes take effect over the next few years.
The losses stem from work requirements, tighter eligibility reviews and new restrictions on immigrant coverage.
The health authority expects to notify about 600,000 Oregonians by late September about requirements to prove they complete 80 hours per month of work, volunteering or education.
The mandate applies to adults ages 19 to 64. Parents or caregivers of children under 14 are exempt, as are people with severe medical conditions.
By the end of 2027, most Oregon Health Plan members will face eligibility reviews every six months instead of every two years, according to the health authority's federal-changes page. Vivian Levy, the agency's Medicaid deputy director, told the committee the review process will only get harder.
She added that federal Health and Human Services officials have cast doubt on states' ability to delay the work requirements through a "good faith" waiver.
The law also strips federal Medicaid eligibility from certain legal immigrants, including refugees, asylees and survivors of domestic violence or human trafficking.
By October, about 7,000 people in those categories will be moved onto Oregon's Healthier Oregon program, which uses state funds to cover low-income residents who are not eligible for federal Medicaid.
Most Washington County Oregon Health Plan members are assigned to Health Share of Oregon as their coordinated care organization. Residents with questions about their coverage can contact Washington County Behavioral Health at 503-846-4528.
