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Healthcare for Illegal Aliens
“The remaining gaps are in the BIPOC communities”

In 2009, the Legislature passed HB 2116, establishing the Health Care for All Oregon Children (Healthy Kids) program that made healthcare coverage available to children 0-18 whose family earned up to 300 percent of the federal poverty level.

The in 2017, SB 558, Cover All Kids, passed and extended coverage to all children residing in Oregon, regardless of immigration status, whose families fell below 300 percent of the federal poverty level. According to the Oregon Health Authority, at the end of the 2017-19 biennium, nearly 5,900 children had enrolled in Cover All Kids program.

In March, Governor Brown introduced HB 2164 which she referred to as “Cover All People Program”. The legislation came out of the Racial Justice Council Health Equity Committee. “All Oregonians must have quality, affordable healthcare regardless of who they are or where they live”. The Governor told the committee. “94% of Oregonians and 100% of children currently have access to healthcare, but the remaining gaps are in the BIPOC communities”. HB 2164 and the -3 amendment would work to close that gap.

HB 2164 was a placeholder bill until the hearing where the 14 page -3 amendments were introduced by Representative Salinas (D-Lake Oswego). By modifying the original language of the bill from Health Care for All Oregon Children Program to the Cover All People Program, it gets at the hear of the Governors desired changes. “Cover All People is a program to provide authorization for a State based Oregon health plan which would include coverage to medically underserved people for example undocumented adults, DACA recipients and legal permanent residents” she noted.

The Federal Affordable Care Act (ACA) passed in March of 2010, sometimes referred to as Obamacare, has eligibility requirements that exclude many people living in Oregon from access. It was pointed out by the Oregon Center for Public Policy in written testimony that “Latinos comprise Oregon’s largest group of immigrants. Because of exclusionary health insurance structures based on immigration status, Latinos have one of the highest uninsured rates among racial and ethnic groups in the state”. Indeed, the eligibility requirement to access the ACA program are that the individual must be currently living in the United States, be a US citizen or legal resident and not be incarcerated. The -3 amendment to HB2164 works around the ACA. SECTION 1 of the proposed amendment would eliminate that Federal barrier. The changes ORS 414.231(2) would now read:

“The Cover All People program is established to make affordable, accessible health care available to all residents in this state, regardless of immigration status. The program provides medical assistance, funded in whole or in part by Title XIX of the Social Security Act, by the State Children’s Health Insurance Program under Title XXI of the Social Security Act or by moneys appropriated or allocated for that purpose by the Legislative Assembly”.

Title XIX of the Social Security Act, more commonly known as Medicaid, provides health care to individuals who have low incomes, including persons who are blind or disabled. The only non-citizens covered are those that are lawfully admitted for permanent residence, and those admitted as refugees.



The Health Insurance program under the Federal Title XXI Act is to be used to assist states in initiating and expanding children's health assistance programs to uninsured, low-income children. This program also does not cover noncitizen adults either. Therefore, the change to the program proposed under the -3 amendments would most likely be funded by moneys appropriated or allocated for that purpose by the Legislative Assembly, as stated in Section 1 (2):

Eligibility for the pilot program would be limited to Oregonians under 138% of the poverty level, 190% for pregnant women. As a portion of her introduction, Governor Brown stated that HB 2164 and the -3 amendment are “really smart economic policy”. Unfortunately, as of press time, Legislative Fiscal had yet to produce a Fiscal impact statement which would show the estimated economic impact of the policy to the State General Fund.

HB 2164 and the -3 amendment are scheduled for a work session on April 8, 2021 at 3:15pm in the House Committee on Health Care.

--Terese Humboldt

Post Date: 2021-04-07 18:21:45Last Update: 2021-04-07 20:05:53

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