Posted: 5:16 a.m. Wednesday, Jan. 15, 2014
By Marissa Evans and Mary Agnes Carey
Two officials from the Oregon governor’s office were on a mission in D.C. Tuesday — trying to get a federal go-ahead to compensate individuals who purchased insurance on their own because of the breakdown of the state’s health care exchange.
Sean Kolmer, the governor’s health policy adviser, and Dan Carol, director of multi-state and strategic initiatives for Gov. John Kitzhaber’s administration, said they would meet with officials at the Department of Health and Human Services and seek permission to give tax credits to consumers caught between the glitch-ridden exchange website and their need for health care coverage beginning Jan. 1. To be eligible, Oregonians would need to have to have attempted to sign-up for a plan through Cover Oregon but wound up purchasing a health plan outside of the exchange to ensure continuing coverage.
“They had to be somewhere in the queue, and the only reason they went outside the market was because (Cover Oregon) wasn’t helping them (sign-up),” Kolmer said of the criteria to qualify.
Kolmer said that he understood from HHS that other states hope to provide similar compensation but said he didn’t know which states.
About 170,000 people signed up for health insurance beginning in January through Cover Oregon or the Oregon Health Plan, the state’s version of Medicaid, according to a press release on the exchange website. Of those, about 20,000 people received private coverage and more than 35,000 joined OHP. More than 114,500 people enrolled directly in the Oregon Health Plan through the Oregon Health Authority.
But Cover Oregon has been a headache for consumers and officials alike. The state has paid Oracle Corp. $92 million so far to build its exchange site, only to have to give up on the website and turn to processing paper applications. Months later it’s still not working as it should. Kolmer said the state isn’t paying the company now unless it gets the website fully functioning and “working end to end” by March 31, when open enrollment ends. The state is withholding $18 million so far in payments.
Due to the technical problems, Oregon state officials have been discussing a variety of fixes and some officials, including Republicans in the legislature, have called for joining the federal exchange instead of the state continuing to run its own. But the state currently is considering using “some of the federal [exchange] technology” rather than joining the federal exchange, said Ariane Holm, a spokeswoman for Cover Oregon.
An Oregon official said that converting to a federal exchange was not discussed when state representatives met Tuesday with HHS.
Although the state has set up an interim process that allows people to shop for and enroll in health care, it isn’t what state officials envisioned, Kolmer said. “It obviously streamlines the process, but it doesn’t make it as easy as everyone would love for it to be.”
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communications organization not affiliated with Kaiser Permanente.