Medicaid
At Community Pathways, our current goal is to ensure that as many people as possible understand what Medicaid is and what it pays for. For those using Medicaid services, we know that the current rate of pay and reimbursement for the work Medicaid funds is not enough. We also know that every cut to our state programs, like schools and other essential services, results in fewer dollars to fund services like I/DD services.
Resources
Explains how Medicaid supports people with I/DD, who is supported by state systems, and what the potential implications of federal adjustments to Medicaid are.
Medicaid in Oregon Fact Sheet (PDF)
Shares data about the number of people enrolled in Medicaid in Oregon, who is covered by Medicaid in Oregon, the total Medicaid spending by service in Oregon, and more.
Oregon Health Plan (OHP) Enrollment Quick Facts (PDF)
Provides high-level data on how many people are enrolled in OHP and the percent of the population is enrolled in Medicaid by county, eligibility group, race and ethnicity, and congressional districts.
Impacts of Proposed Medicaid Cuts in Oregon by 119th Congressional District (PDF)
Provides estimates of average Medicaid/Children Health Insurance Program (CHIP) reductions in federal spending and enrollment.
About Medicaid
What is Medicaid?
The U.S. Department of Health and Human Services defines Medicaid as “a joint federal and state program that helps cover medical costs for some people with limited income and resources…People with Medicaid usually don’t pay anything for covered medical expenses but may owe a small co-payment for some items or services.”
For more information, visit Medicaid.gov.
Who is eligible for Medicaid?
People with an income equal to social security (SSI) or less (currently $976.00/month). People who receive services from agencies like Community Pathways can earn up to 300% of the SSA amount (or up to $2928/month) and still retain the above Medicaid services. Earning over the SSA amount allows people to earn money from employment or other sources without losing essential services or healthcare.
What does Medicaid pay for?
Some of the things Medicaid pays for include:
Direct Support Professionals (DSPs) are people working in individual homes or meeting community members for services. DSPs also support people with employment, housing and other essential needs. Independent agencies employ these workers, many of them non-profits.
Personal Support Workers (PSWs) are people employed by customers or someone close to them. They work in the home or community with individuals, helping with many of the same services as DSPs.
Case Management—Personal Agents (PA) and Service Coordinators (SC): Community Pathways does this work. We are the primary conduits for helping explain and navigate complex systems. We provide support for finding and accessing a wide range of services and supports. We also monitor services to ensure they are happening.
Oregon Health Plan (OHP): Health Insurance. Many of our customers use OHP for all medical care.