How H.R.1 Could Affect Healthcare in Oregon October 15, 2026 New federal requirements will change Medicaid coverage, funding and access to care. Theresa works part time as a home-care aide while also helping care for her grandchildren. Her hours vary and her employer does not offer health insurance. She relies on the Oregon Health Plan to manage her diabetes and stay on top of routine care. Beginning in 2027, Theresa and many other Oregonians may need to renew their coverage more often and provide additional information showing they meet new federal requirements or qualify for an exemption. H.R.1, a federal budget law passed in 2025, includes changes to Medicaid that will take effect over several years, starting on Jan. 1, 2027. The changes affect eligibility, renewals, federal funding and, for some members, out-of-pocket costs. For Patients For many people, the greatest challenge may be keeping their health coverage. “In Oregon, upwards of 210,000 people could lose insurance because of new work requirements, stricter eligibility rules and more frequent renewal checks,” said Andi Easton, Samaritan Health Services Government Relations director. Many adults will need to renew every six months and submit more paperwork. Even people who remain eligible could lose coverage due to missed forms, deadlines or difficulty documenting their eligibility. Some members may also face new copays beginning in 2028. “These changes are likely to lead to delayed care, greater reliance on emergency services and poorer health outcomes, particularly for vulnerable populations,” she said. For Hospitals Oregon is expected to lose more than $1 billion in federal funding in the current budget cycle with the greatest impact felt within Medicaid and human services. As more people become uninsured, hospitals and clinics may care for more people who cannot afford their care, creating financial strain on health systems. Easton said, “Healthcare providers, especially in rural and underserved areas, are likely to face growing financial pressure and may need to adjust services, staffing or both.” How We’re Responding Samaritan is preparing by focusing on stability, access and support for patients. This includes carefully managing costs, improving efficiency and working closely with community partners like county health departments and federally qualified health centers, as well as our local InterCommunity Health Network-CCO to help people keep their coverage and retain access to care. “Our goal is simple: continue to serve our patients and communities, even as the landscape shifts,” Easton said. For updates and additional information, visit OHP.Oregon.gov/HR1.
