Oregon Health Plan 2

The Oregon Health Plan (OHP) Demonstration allows the State to uses savings from two sources (Medicaid managed care and a restructured benefit package based on a prioritized list of services) to provide Medicaid-funded coverage to additional low-income individuals who otherwise would not be eligible for Medicaid. It also provides an option for CHIP-eligible children to receive a premium assistance benefit instead of CHIP coverage. Four distinct benefit packages are offered to different categories of individuals participating in the demonstration. OHP Plus is the broadest benefit package, and is provided to Medicaid State plan populations. OHP Standard, which is less comprehensive in coverage than OHP Plus, is provided to expansion parents and childless adults/couples up to 100% FPL. Both OHP Plus and OHP Standard are governed by the prioritized list of services, which is updated every two years by the Oregon Health Services Commission. The third benefit package is the Family Health Insurance Assistance Program (FHIAP), which provides premium assistance for the purchase of employer-based or individual private health insurance coverage. OHP participants who are eligible for OHP Plus or OHP Standard (including children eligible for the State's Medicaid expansion CHIP program) can elect to receive the FHIAP benefit instead. FHIAP is the only benefit available to expansion parents and childless adults/couples between 100% and 185% of FPL. Finally, children with incomes between 200% and 300% FPL who are eligible for CHIP can elect to receive a subsidy for the purchase of employer-sponsored insurance under the Healthy Kids ESI program.