Thousands of young adults with special needs now have access to health care coverage thanks to an extension from Oregon officials.
Approximately 4,000 19- and 20-year-olds with mental, physical, or intellectual disabilities, as well as those with certain medical or behavioral illnesses including diabetes and asthma, are eligible for free Medicaid benefits under a new trial program. They would normally not be eligible since they or their family earn more than the Medicaid eligibility limit, which is 138% of the federal poverty line, or more than $35,600 for a family of three or about $20,800 for an individual annually. The program’s upper maximum has been raised to 205% of the federal poverty threshold, which is more than $52,900 for a family of three and about $30,900 for an individual annually.
Those who qualify at the ages of 19 and 20 can continue to receive benefits until they turn 26. The program covers expanded dental and vision services, such as crowns, braces, and contact lenses. An estimated 15,000 Medicaid beneficiaries who are 19 or 20 years old will benefit from the program, maintaining their expanded benefits until they are 26. The organization intends to add more ages in the upcoming years until age 26 is included in the qualifying standards, according to Kristen Lambert, a health authority representative.
In Oregon, approximately 174,300 people, or one in five children, have special health care needs. Approximately 1.4 million persons in the state are covered by Medicaid.
The initiative is a component of Oregon’s objective to eradicate disparities in health care access and increase access to health insurance. By 2030, it aims to remove all obstacles to health care in the state.
According to OHA policy director Steph Jarem, individuals with particular health care requirements may experience changes in insurance coverage as they get older, which could interfere with their ability to get necessary care. Our objective is to close the gap between pediatric and adult care and expand access to reasonably priced treatment. As they enter adulthood, young individuals with complicated health care needs will be able to continue receiving their usual treatment thanks to these new benefits.
Benefits include climate equipment, such as air conditioners or heat pumps, to protect people from severe weather, food support, and rent aid to keep them housed. These benefits, which are part of new services provided by OHA to certain Medicaid members under a pilot program authorized by the federal Centers for Medicare and Medicaid Services, are intended to prevent patients from losing access to care due to their housing conditions.
As part of its long history of Medicaid innovation, the Oregon Health Authority established a new Bridge Plan that offers Medicaid coverage to those with incomes between 138% and 200% of the federal poverty threshold. The goal of that strategy, which went into effect in July, is to stop people from switching Medicaid programs when their income fluctuates. By 2027, OHA officials predict that 100,000 Oregonians will be covered by the bridge proposal.
The state was the first to provide rental help to Medicaid participants statewide, and the new extended coverage for young adults is the first of its kind in the nation, according to the health authority. According to health experts, the government anticipates that these additional benefits will enhance health outcomes in Oregon, which will lower total health care expenditures. Health issues worsen and become more expensive to address when they worsen.
— The Oregon Capital Chronicle’s Lynne Terry
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