President Donald Trump, center, answers a reporter's question as Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services, left, and Food and Drug Administration Commissioner Martin Markary, right, listen during an event at the White House, May 12, 2025, in Washington.
Mark Schiefelbein / AP
Last week, President Trump signed the Republicans’ domestic policy bill into a law that will preserve the 2017 tax cuts, significantly increase funding for the administration’s immigration enforcement efforts, cut funding for a number of environmental programs and make sweeping changes to entitlement programs like SNAP and Medicaid.
An analysis of an earlier version of the bill found that Oregon would be disproportionately hit by Medicaid cuts, with more people likely to lose coverage and end up uninsured.
Eric Hunter, president and CEO of the state’s largest Medicaid provider, CareOregon, spoke with OPB “All Things Considered” host Geoff Norcross about how the bill affects people on the Oregon Health Plan.
This conversation has been edited for length and clarity.
Geoff Norcross: First of all, what was last week like for you, trying to absorb all the changes to the various versions of the Senate and House bills — and just waiting to see what would pass?
Eric Hunter: You know, for us, last week was really a whirlwind, and the culmination of work that we’ve seen coming for actually quite some time, to be honest with you. We’ve waited with bated breath to see what would come out at the end — hopefully, cooler heads would have prevailed to prevent some of the most dramatic and drastic rollbacks of health care that we’ve really ever seen. But [at] the end of the day, that didn’t happen.
The one thing that we try to stress more than anything to our members and Oregonians writ large is that right now, nothing is going to change in the benefits or care they’re accessing. We’ve had a lot of calls from members and providers, concerned people about, ‘Do these things take effect today? Am I no longer eligible for something tomorrow?’
As we stand, benefits continue, care continues. We’re going to do our best to serve people. Our goal now is to work with state, local, [and] federal officials to say, ‘How do we prepare for the inevitable which will make all of our lives much more difficult?’
Norcross: The bill requires adults between 19 and 64 to prove they are working or volunteering 80 hours a month to enroll in Medicaid to keep their coverage. It also mandates some Medicaid recipients, about 40% of members of the Oregon Health Plan, which is our version of Medicaid, to do more frequent eligibility checks to maintain their coverage. What will all of that mean for CareOregon?
Hunter: The challenge will be — as we’ve seen in Arkansas and Georgia, which have implemented similar work requirements in the past — that people fall off of the rolls. Not because they don’t qualify, but because of the administrative burden of going through the hassles of the paperwork, the systems and the states having to build the infrastructure to maintain and report on those things. So we’re really looking at, ‘How do we allow people to navigate a really complicated system, and try to make it as simple as possible?’ So that’s the real challenge there.
As far as the more frequent eligibility, I liken it to telling people that you have to file your taxes twice a year now. When we try to get people to understand the burden that puts on an individual, it’s not as simple as just checking a box or making a phone call. It’s a complicated process and they’ll lose coverage even if they deserve it — which we’ve known and we’ve seen across the board, negatively impacts their health care. When they do reenter the health care system, they’re worse off and costs the system much more money. So it’s really shortsighted and probably one of the most mean-spirited aspects of the bill.
Norcross: The bill also places new restrictions on what are called ‘provider taxes’ that states use to fund their Medicaid programs. Here in Oregon, a 6% provider tax and the federal match provides about a quarter of total funding for the Oregon Health plan. That tax is now going down to 3.5%. Now, I realize this is complicated, but can you tell me simply how that would affect CareOregon?
Hunter: As you mentioned, it’s a huge portion of the overall spending that the Oregon Health Authority has available to use for Medicaid. As those dollars come down, it will be a burden on the state to then say, ‘Can we as a state raise the revenue or move monies around to fill that gap? Or do we have to reduce benefits or remove people from the rolls?’ So at the end of the day, it really will be about what tough choices does the state have to make to serve a population with less funds overall.
Norcross: Is there anything in this bill, as you understand it, that could be beneficial for CareOregon or for anybody who’s on the Oregon Health Plan?
Hunter: We are tasked with being good stewards of the funds that are given to us, whether they’re state funds or federal funds. So to the extent that there are parts of the bill which will have the federal government assisting states to identify people who are enrolled in multiple states and those kinds of things: identifying real fraud, waste and abuse, not those things they claim are fraud, waste and abuse. But if they can identify real waste, fraud, abuse, we’re all about helping them to do that and make sure that the system works as smoothly as possible.
I think in the context of the entire bill, the rural hospital fund that they talk about will be really, even more necessary because of the hits that will come. It won’t fill the gaps done and the damage done to rural hospitals, particularly in blue states like ours, but I think that’s one positive they got in there to try to minimize the damage.
But there’s very little in this bill that I think is positive, and more than anything else, budgets are more than just numbers, they represent intent. For far too many leaders in this country, the priority isn’t on serving the population, making sure people get the care they need. It’s about using dollars for other things like tax cuts. And I think in the long run, that will come back to haunt us, but it’s something we’ll have to deal with.
Norcross: You mentioned when we started speaking that the message to OHP recipients is, nothing is going to change right now, no change in service — but there will be changes, and they will go into effect eventually. I’m wondering now that you know what this bill is, now that you know what you’re facing, how are you preparing right now?
Hunter: The current situation in health care in Oregon and in many places across the country is already fairly dire. In partnership with the state, we believe that in 2026, we’ll have rates that will allow us to provide the benefits asked of us. But there are a lot of ancillary things that we’ve done to get upstream on the health curve and make communities stronger that we won’t be able to do any longer.
Like The Hawk’s Eye apartments we funded in Seaside, Oregon, which is actually full for the first time now: residential supportive transitional housing for members, housing for providers who are coming, new to town to have temporary housing — it’s huge for the communities. But going forward, those are the kind of projects we will not be able to do any longer, and it will hurt our communities.
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