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PacificSource plans not to renew a contract with Medicaid-funded Oregon Health Plan for services in Lane County.
This story was updated at 2 p.m. Sept. 19 to include information from Oregon Health Authority.
More than 90,000 people in Lane County who are enrolled in Medicaid-funded Oregon Health Plan may lose their current coverage through PacificSource.
That represents about 70% of the nearly 131,000 people in the county who rely on Medicaid for health care.
The Springfield-based insurer faced a Sept. 18 deadline to renew its contract as a coordinated care organization with the Oregon Health Authority, the state government’s health agency. Coordinated care organizations, like PacificSource Community Solutions, manage networks of providers and care for people who are low-income.
As first reported by health news outlet The Lund Report, PacificSource’s decision came reluctantly. In a statement to Lookout Eugene-Springfield, Vice President of Medicaid Programs Erin Fair Taylor said the insurer hopes to continue discussions with the Oregon Health Authority on alternatives. Otherwise, it will stop serving Lane County on Jan. 1, 2026.
“We did not come to this decision lightly, and we are deeply disappointed that we have not yet reached a path forward,” Taylor said. “It became clear that continuing participation under current terms would undermine our ability to effectively serve the people who rely on us and put the long-term sustainability of our organization at risk.”
Each year, the Oregon Health Authority sets rates that reimburse care organizations like PacificSource Community Solutions. This year, the agency proposed a rate that was too low to cover the increased number of Oregon Health Plan members, executives with insurance companies said. Further, those rates vary by county based on available services and the health needs of local populations.
PacificSource compared the Oregon Health Authority’s proposed rates with expected costs in each region and found the largest funding shortfall in Lane County, according to PacificSource spokesperson Lauren Thompson.
PacificSource will continue serving Oregon Health Plan members in eight other counties.
People who use PacificSource Community Solutions will not experience immediate disruptions, according to Oregon Health Authority spokesperson for Medicaid, Amy Bacher.
The authority has a process to ensure members maintain their Coordinated Care Organization coverage and will continue that work in the coming months, Bacher said. She did not elaborate on what would happen Jan. 1 if PacificSource exits.
Bacher did not respond to questions about the capacity of Trillium, the county’s other care organization, to take on more members.
Clinics across Lane County serve Oregon Health Plan members, including
government-run Community Health Centers of Lane County. County leadership is still evaluating the potential impact, spokesperson Jason Davis said. Their first and main priority is maintaining care for patients.
Eugene, Springfield and nearby communities face a worsening shortage of health care access and providers.
Years of consolidation — including Optum’s 2020 purchase of Oregon Medical Group, which left thousands of patients searching for primary care — have compounded the problem. The strain has spilled into emergency departments, where patients face lengthy wait times as leaders scramble for solutions.
