Oregon Public Option Report: An Evaluation and Comparison of Proposed Delivery Models

Prepared on behalf of the Oregon Health Authority

Section 9 of Oregon State Senate Bill 770 (SB 770), signed into law in 2019, directed the state of Oregon to engage in an analysis to help policymakers develop policy around a public option or Medicaid buy-in model for Oregon. The goal of the public option is to improve affordability and increase access to healthcare to help the state continue to move toward universal coverage.

In “Oregon Public Option Report: An Evaluation and Comparison of Proposed Delivery Models,” a new white paper prepared by managing director Chiquita Brooks-LaSure, manager Kyla M. Ellis, consultant Emily C. Polk and managing director Joel S. Ario, on behalf of the Oregon Health Authority, Manatt Health explores three proposed public option delivery models and how they may be designed to broadly benefit Oregonians and serve the unique needs of the uninsured and underinsured populations. The models were identified and refined based on preliminary recommendations and include:

  • A coordinated care organization (CCO)-led model, in which the state utilizes existing CCOs—ideally serving the same geographic service area for which they deliver Oregon Health Plan (OHP) benefits—to offer a public option product to a broader population. An addendum also includes an analysis of a more narrowly targeted CCO-led model.
  • A carrier-led model, in which the state utilizes commercial insurance carriers to deliver a public option product in the individual market under a state contract.
  • A state-led model in partnership with a third-party administrator (TPA), in which the state holds the plan risk as the insurer and uses a TPA for processing claims and plan implementation. This option could be modeled on the self-insured plan covering state employees and affords the most flexibility in plan design.

When evaluating these models, the report considers how the model design aligns with the needs of target populations, the associated premiums and cost-sharing to ensure affordability for consumers, risk pool placement to minimize negative impact on existing markets, interactions with federal funding and authority, and potential cost savings, as well as other considerations.

To access the full report on Oregon’s public option, click here.



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