By Louise Norris
February 25, 2014
On February 18, four and a half months after open enrollment began, Cover Oregon’s website was finally functional enough for insurance agents and navigators to be able to process enrollments start to finish online. Although the site is not yet available for the general public to enroll online, the fact that electronic enrollment is possible at all is a huge improvement after months of relying on paper applications. By February 21, Cover Oregon had successfully enrolled 700 people using the online system – a tiny fraction of their total enrollment thus far, but a big step in the right direction.
Programmers are still scrambling to fix the glitches that remain in the Cover Oregon system so that it can be used by the general public to enroll on their own. And Oregon lawmakers are calling for an investigation into what went wrong with the exchange and how federal funds were spent along the way, further intensifying the pressure on Cover Oregon’s managers and IT team.
As of mid-February (just prior to the online enrollment launch) 35,247 people people had enrolled in private plans through Cover Oregon, all via paper applications processed manually by hundreds of employees hired after it became apparent that online enrollment was going to be significantly delayed. An additional 76,578 people had enrolled in Medicaid through the exchange, and more than 123,000 people had also enrolled directly through Oregon Medicaid, bringing the state’s expanded Medicaid enrollment to just under 200,000.
Despite the fact that Cover Oregon was the only exchange relying solely on paper applications for the first four months of open enrollment, its total enrollment numbers are around the middle of the road when compared with enrollment in other states – all of which have been using much more efficient online applications for months.
In late December, Cover Oregon pulled its advertising after spending $8 million so far to publicize the embattled exchange. On January 18, the Oregonian released a detailed report publicizing the fact that some officials in Oregon had been voicing concerns about the exchange as early as the fall of 2011.
Virtually all of the existing 2013 individual policies in Oregon were eligible for renewal into 2014. Moda Health Plan Inc. and PacificSource Health Plans allowed existing policies to extend until the end of March. And seven carriers allowed 2013 policies to be renewed until the end of 2014: Regence BlueCross BlueShield of Oregon, Kaiser Foundation Health Plan of the Northwest, Providence Health Plan, LifeWise Health Plan of Oregon, Health Net Health Plan of Oregon Inc., Time Insurance Co. and John Alden Life Insurance Co. The renewal of 2013 plans into 2014 gave many Oregon residents in the individual market some breathing room as they wait for Cover Oregon’s website to improve.
The Oregon Medical Insurance Pool – a state run high risk pool – closed at the end of December, but the state implemented a temporary medical insurance program that will automatically cover risk pool members who were not able to enroll in an exchange plan with a January 1 effective date. The temporary plan will exist until March 31, and gives high risk pool members up to three additional months of coverage as they transition to a new Cover Oregon policy.
The Oregon legislature authorized a state-run health insurance exchange in 2011, and the exchange developed a formal business plan, which the Legislature approved in February 2012 as a final go-ahead for the exchange. The U.S. Department of Health and Human Services (HHS) gave conditional approval to Cover Oregon in December 2012. The exchange has a 2014 budget of $105.7 million, which will be covered with federal grant money, and $62.4 million budget in 2015 according to a Cover Oregon spokesperson.
Cover Oregon is overseen by a nine-member board of directors, two of which are non-voting members. The board receives input from the Individual and Employer Consumer Advisory Committee. The 19-member committee holds monthly meetings, which are open to the public. The Consumer Advisory Committee was mandated by the legislation that established the state’s exchange. Committee members are selected by the board and must include individuals or employers who will use the exchange, individuals who will enroll in state medical assistance through the exchange, minority groups, and representatives of organizations that will people purchase insurance through the exchange. All geographic areas of the state must be represented.
Cover Oregon is acting as “active purchaser,” meaning it limits the number of health insurers that can participate in the exchange. Participating insurers are required to offer a bronze, silver and gold plan and have the option to offer additional plans.
In July 2013, the Oregon Department of Insurance approved rates for insurance policies that will be offered through Cover Oregon. Individuals can choose from among 110 options from 11 carriers, while small groups have 73 options from eight carriers.
According to Kaiser’s State Health Facts, about 17 percent of Oregon’s under-65 population is uninsured. Cover Oregon officials expect about 237,000 people to purchase health insurance through the exchange in 2014.
State Exchange Profile: Oregon
The Henry J. Kaiser Family Foundation overview of Oregon’s progress toward creating a state health insurance exchange.
Let your Oregon governor and legislators know how you feel about the state’s proposed health insurance exchange.Oregon Governor John Kitzhaber