PORTLAND, Ore. (KOIN) – As President Trump’s “big, beautiful bill” makes its way through the Senate, Oregon lawmakers held a hearing on Tuesday, detailing the impact proposed Medicaid cuts under the bill could have on Oregon.
Republicans’ reconciliation bill includes at least $880 billion in spending cuts, largely to Medicaid, to cover the cost of $4.5 trillion in tax breaks, as reported by the Associated Press, noting Republicans are pushing for the spending cuts to root out “waste, fraud and abuse.”
On Tuesday, the Oregon Senate Committee on Health Care held a hearing with representatives from the Oregon Health Authority, health care clinics and health care consumers to learn more about what the cuts to Medicaid could mean for Oregon.
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Emma Sandoe, the Medicaid director for the Oregon Health Authority, was among those who testified at the hearing.
According to Sandoe, Congress is mostly addressing spending cuts to Medicaid by aiming to reduce the number of people enrolled in the program.
The Oregon Health Plan — Oregon’s Medicaid program — insures 1.4 million people in the state, or about 33% of the state’s population, Sandoe said. Medicaid covers a variety of services for nearly half of all births in Oregon along with long-term health services and coverage for people with disabilities.
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Under the “big, beautiful bill,” upwards of 100,000 Oregonians could lose Medicaid coverage, according to Sandoe, noting the bill could lead to at least $1 billion in Medicaid cuts to Oregon in the 2027-2029 biennium. Those payments support hospitals, clinics and health care providers.
Medicaid cuts in the state would especially harm Oregonians and health care providers in rural counties, Sandoe said.
“For example, in Eastern Oregon, Malheur County for instance, 51% of the population is enrolled in Medicaid. So, providers in those counties rely heavily on Medicaid funding and if those providers aren’t able to stay in business, not only does it impact the 51% of people that have Medicaid coverage, it also impacts the 49% of people that rely on other health insurance coverage to see those providers in that area,” Sandoe explained.
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“When more people have coverage, it’s not just good for the people who are enrolled, it is good for the whole system,” Sandoe told the committee. “People covered are able to treat disease earlier, and providers are able to be paid for the health care services they deliver. This keeps providers in business for everyone.”
During Sandoe’s presentation to the health care committee, she explained several changes the federal bill would make, including adding new work requirements. The bill proposes requiring states to verify 80 hours of work activities per month for Medicaid applications and renewals twice per year. This would be required for people ages 19-64 in the Medicaid expansion group starting December 31, 2026.
For Oregon, this means up to 462,000 Oregonians — many of whom work — could face additional red tape to keep their health care coverage, according to Sandoe, adding that 100,000-200,000 Oregonians could lose Medicaid coverage because of challenges demonstrating that they meet the work requirements.
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Additionally, the bill would require copays. This would be a change for Oregon, which has not charged copays since 2017, Sandoe explained, noting, “copays of any dollar amount can be detrimental for Medicaid patients, preventing patients from getting needed medical care or consistent access to their prescription drugs.”
The “big, beautiful bill” also proposes stripping Medicaid funds from Planned Parenthood clinics. According to Sandoe, this could lead to clinic closures in Oregon, noting tens of thousands of people could lose access to birth control, cancer screenings and abortion care provided by Planned Parenthood.
The bill would also prohibit Medicaid funds from covering some healthcare services.
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Today, Oregon law requires the Oregon Health Plan and private health insurance plans to cover medically necessary gender-affirming care. However, the federal proposal would ban Medicaid funding for gender-affirming care for people of all ages and private insurers would no longer be required to cover this type of care – putting access to gender-affirming care at risk for more than 7,000 Oregonians, according to Sandoe.
The OHA Medicare director warns these cuts to Medicaid could end up costing taxpayers more in the end.
“When we have instances that providers go out of business or — for example, (federally qualified health centers) or other providers that provide primary care services — then we’re not able to do what we do really well in Oregon which is to ensure that we’re treating the person early in their health care conditions before it becomes at a stage of needing higher costs and ultimately when a person is sick, they end up using the health care system in some capacity and having that higher cost does cost everyone more if it’s uncompensated care.”
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Following the hearing, Committee Chair Deb Patterson (D-Salem) released a statement, saying, “More than 1.4 million Oregonians have Oregon Health Plan coverage funded by Medicaid, and it’s clear from the testimony today that slashing the program will have serious impacts on that population and well beyond.
Patterson added, “Our rural hospitals and clinics will lose funding, decreased staffing could make appointments harder to get, and people who are forced to delay care will face worse health outcomes.”
The proposed budget bill passed the House on May 22 and is now being considered in the Senate. President Trump said he wants the bill passed by July 4.
