Section 9 of Senate Bill 770 (SB 770), signed into law in 2019, directed the state of Oregon to engage in an analysis to help policymakers develop policy around a public option or Medicaid buy-in model for Oregon. The goal of the public option is to improve affordability and increase access to healthcare to help the state continue to move toward universal coverage. The public option could be available to all state residents,i or could be more narrowly targeted to subsets of the overall population. In particular, uninsured and underinsured populations have been identified as having specific needs that may benefit from a public option. These populations will be explored in more detail in this report:

• Lower-income population, whose incomes fluctuate between Medicaid and Marketplace eligibility (the “churn population”) and are susceptible to losing coverage

• Uninsured population, who are ineligible for tax credits and cannot afford coverage, including those with offers of employer insurance, people ineligible for federal assistance due to immigration status, and those with incomes above 400% of the federal poverty level (FPL)

• Tax-credit-eligible consumers, who struggle to afford existing coverage options