Oregon health agencies say ‘Big, Beautiful, Bill’ could ‘destabilize entire system’

PORTLAND, Ore. (KOIN) — Oregon’s largest Medicaid provider is speaking out about the potential impacts of Republican’s tax and spending law on health coverage across the state.

Aimed at removing waste and fraud, the legislation coined as the “Big Beautiful Bill,” includes some of the largest tax cuts in U.S. history.

The law would increase funding for immigration enforcement and border security while raising the child tax credit from $2000 to $2,200, and removing tax on tips and overtime wages — with some limitations.

However, those changes come at a cost. Beyond slashed federal funding for SNAP and other social programs, the law includes cuts to Medicaid estimated at $1 trillion over the next 10 years.

President and CEO of CareOregon Eric Hunter told KOIN 6 News the law will impact all Oregonians, not just those on Medicaid.

“Medicaid is a part of an already delicate medical ecosystem,” Hunter said. “It could be the tipping point that destabilizes the entire system for everyone.”

According to CareOregon, the nonprofit serves roughly one-quarter of the State’s Oregon Health Plan members.

“Ultimately, the bill will knock a lot of people off of the rolls to receive Medicaid services,” Hunter said. “That number could be as large as 30% to 40% of the population that will have to go through additional hoops and jump through hurdles to try to get their eligibility in.”

Hunter says states like Oregon are particularly vulnerable to the new law’s stricter Medicaid eligibility requirements — having expanded coverage under the Affordable Care Act.

“This undoes a lot of that,” Hunter said. “How do we make sure that those folks who really need care can continue to get it, but work with our state and local partners to say, then, ‘how do we pay for it?’” 

According to the Oregon Health Authority, 1.4 million Oregonians are currently on Medicaid.

Of those, OHA estimates more than 450,000 members between the ages of 19 and 64 could be required to fill out paperwork every six months to prove they are working or volunteering 80 hours each month.

“Due to red tape, an estimated 200,000 people could lose coverage due to these work requirements,” OHA said.

State health officials estimate the subsequent drop in enrollment could lead to a loss of $1.4 billion in federal funding for the state each year.

“That’s you, that’s me, it’s our families, and our communities,” Hunter said. “So, we have to take this seriously.”

Under the new federal law, states like Oregon would be required to lower the tax on hospitals and other providers — which could mean less money to help fill the gap for those who can’t afford to pay their bills.

“Hospitals are already losing money across the board and struggling,” Hunter said. “If those hospitals go away, particularly in rural areas, no one in that community, whether they have a job, Medicaid, Medicare or not, will have access to healthcare.”

He added, “Vulnerable folks and those who are already marginalized in society, they’re the ones that will be left behind as we make those tough decisions and can’t do the kind of outreach to bring people into the system.”

Right now, Hunter stressed nothing has changed for CareOregon, none of their clients have lost coverage, and the nonprofit is serving people as usual.

So, what comes next? As CareOregon continues to work with State and local partners, Hunter said the team is posing the question: ‘What can we change?’

“Nothing is final. Laws are designed to be litigated and discussed and changed, and we’re all in for that conversation,” Hunter said. “How do we move the needle to say, ‘let’s minimize the damage, let’s mitigate some of the issues, and let’s make sure we continue to serve people.’”