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Monitoring Federal Changes and any Impacts on Oregon

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July 10, 2025

We are aware of the U.S. Department of Health and Human Services (HHS)’s decision to rescind the 1998 interpretation of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA). We recognize that this notice represents a significant policy change and has already prompted concern and confusion.

The State is actively evaluating the potential impacts of this policy on critical programs in Oregon, including behavioral health services, early childhood supports, and other community health resources. As this analysis continues, we strongly recommend that providers consult with legal counsel to assess specific operational risks.

We remain committed to transparency and to supporting providers and partners as we navigate this evolving situation together. We will share additional information and guidance as soon as it becomes available.

Every change in federal administration carries potential impact on Oregon and, like other health agencies across the country, OHA is monitoring these changes closely.

At this time, no changes have been made to Oregon Health Plan and Healthier Oregon.

It is important for people in every Oregon community to access the health care and other services they need.

OHA remains clear-eyed and committed to its 2030 goal and Strategic Plan.

To keep Oregon informed, this page has resources on the following topics:

  • Medicaid / Oregon Health Plan (OHP)
  • Health Provider Resources
  • Health Care & Immigration
  • Reproductive Health
  • Gender-Affirming Health Care
  • Health Equity
  • Oregon Health Insurance Marketplace
  • Oregon Sanctuary Promise
  • Public Charge

Oregon Health Plan (OHP / Medicaid) is funded by both Oregon and the federal government. The program provides health coverage to 1.4 million people in Oregon. Fifty-seven percent of children in Oregon and forty percent of all births are covered by Medicaid.

O​HP benefits have not changed at t​his time. OHP members should keep appointments and continue to use medical​ benefits.​​​ Providers serving OHP members should continue to provide care. OHP members can visit the OHP web site for more information, including how to apply for benefits.

Learn more: facts about Medicaid in Oregon and who is covered.​

Potential ​Impact of Federal Requirements ​and Funding Cuts to OHP.

The Centers for Medicare and Medicaid Services (CMS) released an announcement on April 10, 2025 stating they do not intend to approve new or renew existing requests for federal matching funds for designated state health programs and designated state investment programs (DSIP).​

CMS’ announcement does not affect the designated state health program (DSHP) funds that support Oregon’s current 1115 OHP Medicaid waiver, which runs until September 30, 2027. The announcement does not have an immediate impact on Oregon Health Plan benefits or members.

OHA information ​about Federal Request for Oregon Health Plan member Data

Federal law requires the Oregon Health Authority (OHA) to submit data to the Centers for Medicare & Medicaid Services (CMS) for individuals enrolled in the state’s Medicaid Program (Oregon Health Plan (OHP)). Medicaid is a partnership between the federal government and Oregon, using federal and state dollars to provide affordable, comprehensive health care to lower-income Oregonians.

As required by federal law, OHA must submit certain data to CMS to ensure federal funds are used for allowable program purposes. This information is provided monthly to CMS. These mandatory monthly reports include eligibility and demographic information. This data sharing relationship has not changed.

Some Oregonians who are not eligible for full Medicaid due to immigration status are lawfully eligible for limited services paid for with federal funding, such as emergency medical services and labor and delivery medical services. These individuals may also access services through the Healthier Oregon program which provides coverage for medical and some other services. The Healthier Oregon Program is paid for through state funds only.

All data required by CMS and submitted by OHA is confidential under both federal and state law. CMS is legally required to protect and limit use of this data for the administration of the Medicaid program and to protect against unauthorized disclosure.

Additional Data requeste​d by CMS​​

On June 6, 2025, CMS requested additional information about Oregon Medicaid members who benefit from federally funded services. CMS has stated the purpose of this financial data review is to ensure that claims for federal financial participation meet all applicable statutory requirements for individuals who are not eligible for full Medicaid services due to immigration status but are lawfully eligible for limited federally funded services.

OHA is reviewing the additional CMS data request

OHA has not yet responded to CMS’ request for additional information while the request is currently being reviewed by the agency.

OHA is aware of concerning reports regarding misuse of data

OHA is aware of reports that CMS or the U.S. Department of Health and Human Services may have shared the personal data of Medi-Cal (California’s Medicaid program) and Apple Health (Washington’s Medicaid program) with the Department of Homeland Security. OHA, in consultation with the Governor’s office, is working closely to understand reports from both states concerning misuse of protected program data.

OHA deeply values the privacy of Oregonians

State and federal laws concerning data privacy have not changed. OHA deeply values the privacy of all Oregonians. OHA will continue to follow federal and Oregon state laws to protect people’s private health information for all 1.4 million Oregonians who benefit from the Oregon Health Plan. Information sent to CMS related to the administration of the Medicaid program is subject to state and federal confidentiality laws concerning protected health information.

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A federal district court judge issued a preliminary injunction in a lawsuit brought by 23 states, including Oregon, against the U.S. Department of Health and Human Services (HHS) over the termination of public health and behavioral health grants, without cause or authority. This ruling ensures federal funding can continue flowing while litigation proceeds. 

HHS, through the Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA), had abruptly terminated roughly $117 million in COVID-era grants and funding for Oregon Health Authority programs, an impact that would have been felt in all nine federally recognized Tribal communities and in every county in Oregon. To learn about what programs were impacted by the reductions, click here

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There have been no changes to OHP billing or services, due to recent federal announcements. The Medicaid payment system was offline temporarily on Jan. 28, but is back up.

Medicaid partners and providers are encouraged to take proactive steps to safeguard Protected Health Information (PHI) and Personally Identifiable Information (PII) to ensure operational continuity. Cyber resilience is a shared responsibility that extends to all state employees, volunteers, providers, contractors and vendors. Member data, including Race Ethnicity Language and Disability Sexual Orientation and Gender Identity (REALD SOGI) and immigration data, should not be shared with anyone, including with federal authorities without a subpoena.   ​

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OHA remains committed to helping all people in Oregon achieve their best possible physical, mental and social health, regardless of their immigration status. Under Oregon law, state, county and city governments and their law enforcement agencies are prohibited from directly or indirectly supporting federal immigration law enforcement. OHA does not share information with federal immigration authorities without a judicial warrant. For additional resources on this topic, visit:

Oregon law guarantees the right to abortion without any restrictions or state interference. While Oregon evaluates the potential effects of federal policy decisions, OHA will continue to support the life-saving work of its community partners who work in reproductive health. More information is available in OHA's Abortion Access in Oregon webpage.​​

Oregon Health Authority (OHA) is actively monitoring and assessing changes at the federal level for any impact on accessing quality and affordable health care in Oregon. Recent federal actions have not changed Oregonians' access to gender-affirming care, which is protected by Oregon state law. 

OHA and other state agencies follow Oregon law when it comes to protecting access to quality health care and improving the lifelong health of everyone in our state, including transgender and gender-diverse people.

The Oregon Equality Act of 2007 prohibits discrimination on the basis of a person's gender identity and 2023's Ore​gon House Bill 2002 prohibits insurance carriers from denying gender-affirming treatment that is medically necessary as determined by a qualified health care provider. Oregon's public and many private health insurance plans cover medically necessary care that affirms an individual's gender identity according to accepted standards of care. 

For more information about gender-affirming care coverage under Oregon's Medicaid program, visit the Oregon Health Plan (OHP)  webpage. If an OHP member has a concern about receiving gender-affirming care, they should contact their Coordinated Care Organization (CCO). Those who do not have a CCO or need further assistance can also contact OHA Client Services (1-800-273-0557, Ask.OHP@odhsoha.oregon.gov) or the OHA Ombuds Program (1-877-642-0450, OHA.OmbudsOffice@odhsoha.oregon.gov).

For more information about private health plan requirements, please visit the Department of Consumer and Business Affairs Division of Financial Regulation webpage. ​

For more information about what state law says about gender-affirming care, visit the Oregon Department of Justice's webpage. 

  • ​​​OHA continues to be guided by its strategic plan to eliminate health inequities by 2030. Achieving this goal would ensure that all people i​n Oregon can reach their full health potential and do not face disadvantages due to where they live or their race, ethnicity, spoken language, disability, immigration status​, age, gender, gender identity, sexual orientation or social class. OHA is determined to remove unfair barriers that limit health care access and lead to health disparities for too many Oregonians.
  • ​​Attorney General Dan​ Rayfield has issued a statement on Multi-State Guidance here: Multi-State Guidance Concerning Diversity, Equity, Inclusion, and Accessibility Employment Initiative
    • The guidance covers the following sections:
      1. Diversity, Equity, Inclusion, and Accessibility Initiatives Help Busine​sses Prevent Workplace Discrimination
      2. Diversity, Equity, Inclusion and Accessibility Initiatives are Consistent with Federal and State Law
      3. Best Practices for Diversity, Equity, Inclusion, and Accessibility
      4. Recruitment and Hiring​
​

​​The Affordable Care Act (ACA) has not changed at this time. Please visit the Oregon Health Insurance Marketplace for additional information. 


​As a sanctuary state since 1987, Oregon stands for the safety, dignity and human rights of all Oregonians. Oregon was the first state in the nation to pass a statewide law stopping state and local police and government from helping federal authorities with immigration enforcement. It is against Oregon law for state and local law enforcement or public agencies (state and local government offices) in the state of Oregon to participate directly or indirectly in immigration enforcement without a judicial warrant. To find out more including how to make a report about a potential violation, visit the Oregon Department of Justice the Oregon Sanctuary Promise.   ​


​When people want to get legal status to enter or stay in the U.S., immigration officials consider if they are likely to need economic help from the government. This is called the "public charge test." While many benefits aren't counted in the public charge test, it's important to understand how getting benefits could impact your immigration case.

Call the Oregon Public Benefits Hotline to talk with someone about your situation (800-520-5292, Monday - Thursday).​​