Tomorrow the federal government stops paying for the medicalization of children through Medicaid. Oregon has decided its taxpayers will pick up the bill, while making sure nobody looks too closely at what the money buys.
The federal cutoff
A rule from the Centers for Medicare & Medicaid Services, CMS-2451-F, takes effect October 13, 2026. It bars federal Medicaid money for puberty blockers, opposite-sex hormones and surgeries on anyone under 18, and federal CHIP money for anyone under 19. Children already on hormones get federally funded doses for up to six months to taper off. Mental health care is still covered. States can still pay with their own money.
Oregon: 600 kids, state dollars
The Oregon Health Authority says about 600 Oregon Health Plan members under 18 receive services affected by the rule, and their coverage will not change, spokesperson Franny White told the Oregon Capital Chronicle. Starting October 13, the state will pay for their drugs and surgeries directly with state-only funds through its fee-for-service "Open Card" program, according to the Chronicle and an OHA provider bulletin. The agency plans to ask lawmakers for a budget adjustment next year to cover the cost.
Oregon points to its 2023 law, House Bill 2002, as the reason it has to keep paying.
Not checking the law
That same law requires regulators at the Department of Consumer and Business Services to examine every covered insurer for compliance by January 2027 and report to lawmakers by December 31. Those exams have now been delayed.
Jason Horton, a spokesperson for the department's Division of Financial Regulation, said the work would require "detailed carrier, provider and individual claims information."
"Given recent federal actions directed at people who provide and receive this care, we have reason to believe an exam by this date could put Oregonians' private health information at risk," he wrote to the Chronicle. He said the work will resume when "it can be done confidently without putting patients and providers at risk," and that HB 2002's coverage requirements remain in effect. He declined to say what information he thinks would be at risk.
The Oregon Health Authority has also dropped an earlier effort to measure how many providers its regional Medicaid insurers have for these services. When the Chronicle requested records of that analysis, the agency said in September there were none.
The bottom line
Oregon will keep funding these procedures for hundreds of children, while declining to collect the records that would show who is being treated, how, and with what results.
Oregon is also one of 20 states, plus the District of Columbia and Pennsylvania's governor, suing to overturn the federal rule. The suit was filed September 2 in federal court in Massachusetts. As of today, no court has blocked the rule.