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Oregon Health Authority Prepares Oregon Health Plan Members for Upcoming Federal Rule Changes

Oct 29, 2026

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The Oregon Health Authority (OHA) is gearing up for a major shift in how some adults ages 19–64 qualify for Oregon Health Plan (OHP / Medicaid) coverage, as new federal requirements take effect in January 2027. These updates stem from House Resolution 1 (HR1), a federal law mandating changes to Medicaid programs nationwide.

Under the new rules, certain OHP members will need to meet work or activity rules when applying for or renewing their benefits. Members can meet the rules by having a monthly income of at least $580, being enrolled in school half-time, or completing a mix of work, volunteering, education, or training totaling 80 hours per month.

These requirements will not apply to everyone. Many members—such as those who are pregnant, enrolled in Medicare, qualify based on disability, or have serious medical needs—are exempt.

Caregivers, veterans with total disability ratings, and American Indian/Alaska Native members are also among those who may qualify for exemptions. OHP members may need to provide more information or provide proof to meet an exemption.

Notices sent to members this fall

OHP started sending informational notices to about 600,000 members in October 2026. These early alerts are meant to help people understand whether the changes could affect them and what steps they may need to take before their next renewal.

Keeping contact information current remains one of the most important actions members can take to avoid communication gaps.

Local impact and how counties can help

Counties could play an important role in helping members through these shifts. Local offices will be a resource for OHP members who need help updating information, understanding exemption requirements, or gathering documents.

 Starting in January, counties can connect residents with community partners, workforce organizations, or education and volunteer programs to meet the new requirements. If OHP members have questions about the new requirements, counties should direct them to an OHP assister or ODHS. Given the very detailed nature of the new rules, we want to make sure that OHP members have the most accurate, timely information possible. 

Here is how OHP members can get additional information:

  • Go to benefits.oregon.gov
  • Call 1-800-699-9075 (relay calls welcome)
  • Visit an Oregon Department of Human Services office.
  • Find a local office at ODHSoffices.oregon.gov
  • Find an OHP assister who can help at oregonhealthcare.gov/gethelp

Stay Connected. Stay Covered.

To support partner organizations and members alike, OHA launched Stay Connected. Stay Covered, a campaign to share updates through web pages, newsletters, and social media. This includes tools, sample notices, and materials that partners can use in their own outreach efforts. We encourage counties to put up these posters or to have pocket cards available for OHP members. 

What comes next

Many OHP members will keep their coverage, but the new rules mean that some people may have to renew more frequently or provide new documentation. Counties can help members stay covered by emphasizing the need for accurate contact information and directing them to experts. 

In October, OHA, in partnership with Oregon Department of Human Services (ODHS), launched a new monthly bulletin to share information and resources about federal changes to OHP with partners. Subscribe to the bulletin here.

These changes will be a major transition for many OHP members. Counties can help soften the impact by learning the new rules and clearly communicating with members to help ensure communities remain connected to essential health coverage.

Resources