ACA repeal could be devastating to long term care in Oregon

The Oregon Department of Human Services has published a fact sheet about the potential repeal of the Affordable Care Act. The fact sheet considers possible impacts to the services provided by Aging and People with Disabilities and the Office of Developmental Disability Services. Read the fact sheet in its entirety below:

ACA Impact to APD and DD

Fact Sheet

Affordable Care Act Repeal – Potential Impact to APD & ODDS

Long Term Care and the Affordable Care Act in Oregon:

Oregon has implemented the “K State Plan Option” (CMS’ 1915(K)) as our mechanism for providing Home and Community Based long term care to eligible Oregonians. The K Option is part of the Affordable Care Act and provides the state with an additional 6% Federal Match.

  • Aging and People with Disabilities (APD) serves approximately 30,000 individuals in long term care with 17,000 of those receiving services and supports in their own homes. APD also serves people in Residential Care Facilities, Assisted Living Facilities, Memory Care Facilities and Adult Foster Homes.
  • Office of Developmental Disability Services (ODDS) serves approximately 7,500 children and 18,000 adults with intellectual and developmental disabilities in Oregon. Most people with I/DD receive vital services in their home of their family home. Residential services are also available in Group Homes, Supported Living settings and Adult Foster Homes. Every service is designed to support people as they live, work and recreate in their local communities.

What Repeal of the Affordable Care Act Could Mean:

The 1915(K) State Plan Option provided an additional 6% in federal matching funds for states to provide home and community based services in lieu of institutional-based long term care. Since this is such a massive piece of legislation, we do not know whether Congress intends a complete repeal or only a repeal of issues that are on the public’s radar as comprising “Obamacare”. Here’s what we know:

  • There have been discussions with the Oregon Health Authority on the impacts associated with the Medicaid expansion population, but the long term care impact has not been discussed to date.
  • If the Affordable Care Act were to be repealed in its entirety, the impacts to Oregon’s long term care financing would be devastating. In the two biennia since Oregon implemented the 1915(K), over $350M in additional federal funding has been received. The loss of this funding would mean potential cuts or loss of services for vulnerable adults and people with disabilities over time.

For more information, contact:
Ashley Carson-Cottingham, Director of Aging and People with Disabilities, at: or
Lilia Teninty, Director of the Office of Developmental Disability Services, at:

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