Oregon Gov. Tina Kotek on Tuesday, Oct. 13, signed Executive Order 26-27, directing state agencies to take immediate steps to preserve affordable health care as federal policy changes threaten coverage and add pressure to state budgets and providers. The order asks agencies to identify ways to reduce costs and stabilize the individual and small-group insurance markets. It also calls for stronger emphasis on primary care and prevention, enforcement of timely-payment rules for providers, reduced administrative work for primary care clinics and changes to state purchasing of high-cost prescription drugs. Agencies are also directed to simplify Oregon’s Medicaid pharmacy benefit and monitor coverage losses among residents who remain eligible for health care but are affected by new federal policies. The governor’s office said H.R. 1, the federal law commonly known as the “Big Beautiful Bill,” cuts Medicaid funding and does not extend enhanced federal health insurance subsidies. It warned that the changes could make it harder for eligible Oregonians to obtain and afford coverage, while increasing financial and administrative pressures on states, providers and families starting Jan. 1, 2027. About 97% of Oregonians currently have health insurance, according to the governor’s office. Kotek said the state should act on measures within its control to keep people insured and provide more stability for health care providers. “Primary care clinicians are the backbone of our health care system,” said Dr. Eric Wiser, president of the Oregon Academy of Family Physicians. He said regular primary care can help manage chronic illness and prevent some emergency department visits and hospitalizations, and called the order an important response to the federal cuts. Oregon Medical Association President Reva Ricketts-Loriaux said administrative demands and delays in payment can take resources away from clinics and time away from patients. She said the order’s focus on reducing that burden could help patients maintain access to care and clinicians remain in practice. Kotek’s office also pointed to state actions to curb insurance costs. The Oregon Reinsurance Program has reduced individual-market rates by 6% to 8% annually, according to the office, and the Division of Financial Regulation reduced rate increases by 10.7% for the 2027 plan year. The order follows Kotek’s renewed request that the Trump administration give states more time to implement Medicaid changes. The executive order directs state agencies to take steps within Oregon’s authority; it does not reverse the federal law or guarantee that coverage losses will be prevented.