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Thursday, November 21, 2013

Oregon Struggles To Work Out Health Exchange Glitches

Rocky King, director of Cover Oregon — the state’s health insurance exchange — went before a pair of legislative panels yesterday and told lawmakers that the online enrollment process will likely not be working before the Affordable Care Act’s first enrollment period ends on March 31st.

Why is Oregon having such trouble getting its online enrollment up and running?

Kristian Foden-Vencil, a reporter for Oregon Public Broadcasting, joins Here & Now’s Meghna Chakrabarti to explain.




Well, now on to healthcare. We're going to check in on two states that are running their own health insurance exchanges. Washington State's health plan finder is working pretty well, but things are rather different across the Columbia River in Oregon.

ROCKY KING: We know that Oregonians are frustrated. The staff is frustrated. Our contractors are frustrated. Individual citizens are frustrated.

CHAKRABARTI: That's Rocky King, director of Cover Oregon, the state's health insurance exchange. And yesterday was not a good day for Mr. King. He had to go before a pair of state legislative panels and explain that the exchange's online enrollment process will likely not be working before the Affordable Care Act's first enrollment period ends on March 31.

KING: I no longer hope. I've taken that word out of my language. I'll - when I see it, I'll believe it, and until that time I will bring on whatever resources are necessary and do whatever I can to make sure that Oregonians can get coverage.

CHAKRABARTI: Well, as of this week, Oregon's insurance exchange has enrolled a whopping zero people. Joining us is Kristian Foden-Vencil, who covers health care for HERE AND NOW contributor Oregon Public Broadcasting. Kristian, welcome.


CHAKRABARTI: So first of all, I understand that Cover Oregon has had so many problems with its website that it's resorted to asking people to look at paper applications because the online portal is failing. Tell us more about that.

FODEN-VENCIL: Yeah, basically they started the 1st of October, and we're very excited here in Oregon about the Affordable Care Act. It passed in the state fully, you know, with both parties. And so they say, oh, yeah, we'll go to the website. And then gradually it just didn't work. People were getting very frustrated. They'd go in there, they couldn't enroll.

And so what they've said now basically is forget the website, just go to paper. You know, there's a 20-page application. You can click on the website and download it. You fill it out either electronically or on paper, and then you just send it back to them via snail mail, or you can send it back online. They can also fax it, but Cover Oregon only has one fax machine, so yeah.

CHAKRABARTI: One fax machine, OK. So I understand that the website is supposed to up and running sometime before the end of the year. But is that going to leave people enough time to meet a January 1 signup deadline that's coming, you know, fast and furious?

FODEN-VENCIL: Yeah, it's not. Basically Oracle, who has set this up for Oregon, has said that, you know, we hope to get it maybe December 7, December 16, but the deadline is December 4. So in order with the paper applications to get it processed by that January, we have to have it in December 4, which means basically what I said before.

They're saying, you know, don't worry about the website. The important thing is to get insurance. So just do it the old-fashioned paper way.

CHAKRABARTI: Right. So Kristian, you mentioned Oracle, and that is the software company that is running or helping to run the exchange's website there in Oregon and basically has botched it up. And I see that Cover Oregon is $1.7 million over budget, and it plans on withholding five percent of the payment due to Oracle because of that. Do they know why the system is not working?

FODEN-VENCIL: Yeah, they've got a couple ideas, and obviously the feds have had their problems, so we're kind of on the piggyback of that. But really Oregon's - it's an eligibility issue. So here we were so excited about the exchange that we made it much more complicated. Not only can you get - you'll eventually be able to get tax deference and single individual insurance, but also we have the Oregon Health Plan, which is Oregon's version of Medicaid, and the Healthy Kids Initiative.

So they kind of made this one-stop shop for insurance, and they just made it way too complicated. And what they're telling me is, you know, we put in scenarios and families, and most of the time it goes through, and that's OK. But, you know, 20 percent go wrong, and so we can't switch it on with that 20 percent going wrong.

So eventually even, they told me, what we're going to end up doing is you're going to get one of three decisions, a yes, a no or call us and give us more information still, and this is after a 20-page application, so...

CHAKRABARTI: Well, in the last couple seconds that you and I have, Kristian, Oregon has, you mentioned, fully embraced the Affordable Care Act. Governor John Kitzhaber himself is a former emergency room physician, and the state, as you mentioned, has launched in the past several innovative health insurance experiments. So this is a painful irony that so far they've been able to enroll zero people in the new exchange. How is that sitting with Oregonians?

FODEN-VENCIL: Yeah, it's not sitting well. But I think a lot of people understand that, hey, this is about getting insurance. It's not really about a website. So that's what the state's message has been: Forget the website, just do it on paper, and if you do it by December 4, you will get insurance by January 1.

And I've got to tell you a lot of people who are looking for insurance are very excited about that. The worry is the young invincibles who try the website, it doesn't work, well, I'll forget it, I won't join. And that kind of weakens the pool of people who you can get insurance for and makes it more expensive.

CHAKRABARTI: Kristian Foden-Vencil covers health care for Oregon Public Broadcasting. Kristian, thank you so much.

FODEN-VENCIL: Thank you. Transcript provided by NPR, Copyright NPR.

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