CMS finalized sweeping new rules under House Resolution 1 reshaping OHP starting 2027: mandatory work requirements of 80 hours/month, six-month eligibility redetermination cycles, elimination of retroactive coverage, and new cost-sharing. OHA projects $344 million in current biennium costs and $2.2 billion in 2027-29.

OHA expanded the Post-Hospital Extended Care benefit and began March 2026 listening sessions. CMS also finalized rules allowing limited data-sharing with ICE for undocumented individuals — a policy OHA is monitoring for chilling effects on enrollment.

OHA estimates it needs 398 new positions for verification, exemption reviews, and compliance. Major IT overhauls are needed. For CCOs, more frequent eligibility checks threaten to destabilize risk pools.

Watch for: OHA's implementation timeline, including mandatory member outreach between June 30 and August 31. Whether Oregon seeks 1115 waiver flexibility to soften work requirements. Rural counties with 40% Medicaid enrollment will feel the impact first.