Oregon

2019 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

Between my son being sick for the past 4 days (he's better now, thanks!), losing my internet connection for 2 days (it's back up now, thanks!) and just generally being swamped with work, I don't have time to give these stories the attention they deserve, but they're all worth checking out:

Health Insurance: Enrolling Rural America

Americans living in rural areas will be a key target as states and nonprofit groups strategize how to enroll more people in health law insurance plans this fall.

Though millions of people signed up for private insurance or Medicaid in the first year of the Affordable Care Act, millions of others did not. Many live in rural areas where people “face more barriers,” said Laurie Martin, a RAND Corp. senior policy researcher. Brock Slabach, a senior vice president at the National Rural Health Association, said “the feds are particularly concerned about this.”

More legislators want to shut down Cover Oregon

The headline certainly seems like a Bad Thing, as does the opening paragraph...

Shift in Oregon Health Plan cuts funds to Eugene shelter program

EUGENE — One of the last resorts for mentally ill people in Eugene suffering a crisis will be closed this month after a change in state health care policy took one-third of a shelter's money.

Bummer. See? Obamacare is hurting people...wait, what's that??

Lane County public health spokesman Jason Davis says the expansion of the Oregon Health Plan means there are fewer indigent, uninsured mentally ill people who need short-term crisis housing.

With fewer clients forecast to be in indigent programs, the state is reducing contracts with agencies.

Oh. Never mind.

Reminds me of the "joke" that if Barack Obama cured cancer, Republicans would attack him for hurting oncologists.

For awhile there I was concerned that Oregon's uglier-by-the-minute legal/technical headaches had caused them to stop bothering with regular updates; fortunately, they seem to be back on track again, updating both QHP and Medicaid numbers:

September 1, 2014
Update: Private coverage and Oregon Health Plan enrollment through Cover Oregon

Medical enrollments through Cover Oregon: 353,120
Total private medical insurance enrollments through Cover Oregon: 100,758

Oregon Health Plan enrollments through Cover Oregon: 252,362*

*OHP enrollment data is current as of August 13, 2014. An updated number will be posted soon.

Dental enrollments 
Total private dental insurance enrollments through CoverOregon: 20,572

Net enrollments 
Net private medical: 78,683
Net private dental: 14,502

Net QHPs are down 31 due to what I presume is normal net attrition, but total enrollments have gone up by another 745 people.

Medicaid expansion, meanwhile, has shot up by another nearly 12,000 people.

Huh. OK, exactly 1 day after I snarkily speculated that Cover Oregon is unlikely to release an enrollment update anytime soon due to their increasingly-ugly legal (and technical) battles with Oracle Corp., take a guess what just happened this morning...

August 25, 2014
Update: Private coverage and Oregon Health Plan enrollment through Cover Oregon

Medical enrollments through Cover Oregon: 340,621
Total private medical insurance enrollments through Cover Oregon: 100,013   

Oregon Health Plan enrollments through Cover Oregon: 240,608*

*OHP enrollment data is current as of August 6, 2014. An updated number will be posted soon.

Dental enrollments 
Total private dental insurance enrollments through CoverOregon 1: 20,018

Net enrollments 
Net private medical: 78,714
Net private dental: 14,299

On the one hand, the total QHP number has jumped an impressive 3,103 over a 19 day period, or 163/day, so good on them.

In spite of their amazingly successful manual workaround process (which has enrolled 465,000 people in either private or Medicaid coverage), Oregon's website debacle continues to fester. Even so, until recently they've ironically been one of the most reliable state exchanges when it comes to publicly posting updated enrollment data. New detailed data has been posted pretty much once a week since the crazy days of March/April on a regular basis.

That all came to a screeching halt just over 3 weeks ago; the last update out of CoverOregon was August 6th. Again, this is still much better than most other states which only publish updates monthly or not at all, but for Oregon it's been worrisome for me, since they're one of only a handful of states giving that info out at all during the off-season.

Yeah, yeah, I know the title is lame, but it's not easy to find alliterative synonyms for "ugly" and "unpleasant" starting with "O"...

Anyway, a few days after Oracle sued Oregon for $23 million in unpaid bills over the CoverOregon exchange debacle, the state has counter-sued the tech company...for a whopping $5.5 BILLION...including "Whoa...heavy, dude!" charges by the state Attorney General such as racketeering:

In the aftermath of what was likely the most spectacular failure among state-run Affordable Care Act health exchange site launches, the state of Oregon has filed a lawsuit against Oracle America Inc. over the total failure of the Cover Oregon exchange. “Oracle’s conduct amounts to a pattern of racketeering activity that has cost the State and Cover Oregon hundreds of millions of dollars,” Oregon Attorney General Ellen Rosenblum wrote in a civil complaint filed August 22. The lawsuit seeks over $5.5 billion in damages from Oracle, plus legal fees.

The complaint comes after Oracle filed its own lawsuit against the state’s health exchange for failure to pay for services rendered in early August. Oracle’s attorneys claimed that Oregon Governor John Kitzhaber had defamed the company in a “smear campaign” while failing to take responsibility for the failure of state management of the project and not paying Oracle for additional work done.

Whoops...found even more slightly-outdated ACA-related articles worth noting...

OREGON: Cover Oregon officials hope to repair broken state health insurance exchange for 2016

For those who assume Cover Oregon will go away when the federal government takes overthe state exchange's job of enrolling people in health coverage, think again.

Even as Oregon works on hooking up to the federal website by November, some Cover Oregon board members hope the engagement with Uncle Sam will be only a one-year affair.

I found one quote in particular to be a bit of an eyebrow-raiser:

But the idea is controversial on both sides of the political aisle in Salem.

"Hell, no," says Sen. Brian Boquist, R-Dallas. He thinks Oregon should leave the job to the federal exchange and Cover Oregon as a stand-alone agency should go away. "Cover Oregon, the whole structure is bad from beginning to end. I don't trust the federal government. But I do trust the federal government more than I do the state of Oregon."

I've been too busy with my day job (I do have one, you know...) to post much lately, but plenty of ACA-related news has piled up, so I'm clearing off my desk with some quick bits:

KENTUCKY: Women leading Kentucky health: Kynect’s Banahan excited to reach even more people

First in a series of profiles about KY women in charge of the state exchange:

Energy exudes from Carrie Banahan when she talks about her work with others to bring affordable health care to more than half a million Kentuckians.

“I worked all my life to see this happen, that we can provide affordable health insurance to people, and it has actually happened,” she said. “I am thrilled that we are actually helping people in Kentucky. It is the highlight of my career.”

Banahan is executive director of the Kentucky Health Benefits Exchange, which the state has branded as Kynect, partly to avoid identification with the pejorative nickname Obamacare. She shares the credit for its success.

Hmmm...another unusual slowdown for Oregon; total QHPs are only up 873 since 7/28, and net QHPs are actually down 63, presumably due to purging of unpaid enrollments and cancellations of existing policies. Medicaid enrollments, meanwhile, are up another 499.

August 6, 2014
Update: Private coverage and Oregon Health Plan enrollment through Cover Oregon

Medical enrollments through Cover Oregon: 337,518
Total private medical insurance enrollments through Cover Oregon: 96,910      

Oregon Health Plan enrollments through Cover Oregon: 240,608
 

Dental enrollments 
Total private dental insurance enrollments through CoverOregon: 19,489

Net enrollments 
Net private medical: 82,305
Net private dental: 15,605

Oregon is, I believe, the 5th state to release their approved ACA exchange premium rates for 2015, after Rhode Island, Connecticut, California and Mississippi. Like most of the others, it's a mixed bag, with some companies raising their rates by up to 10% but others reducing theirs by as much as 20% (or even 26% for the small group market, although that's not the one that I'm primarily looking at).

About 80,000 Moda Health members who buy their own insurance will see their monthly premiums climb an average 10.6 percent next year, while many other insurers are dropping their rates to compete.

Insurance rate decisions were issued by the Oregon Insurance Division Thursday and announced today, showing a tighter range of premiums in the individual market for people not covered by employers or Medicare.

Moda's once market-leading rates have jumped to middle of the pack. For a silver plan, a 40-year old in Portland can find four insurers with lower premiums approved by the state.

Oregon continues to post impressive enrollment numbers considering their never-working website. Total QHPs are up another 922, Net QHPs are up 185 and Medicaid enrollments are up 12,517 over the past week:

July 28, 2014
Update: Private coverage and Oregon Health Plan enrollment through Cover Oregon

Medical enrollments through Cover Oregon: 336,146
Total private medical insurance enrollments through Cover Oregon: 96,037          

Oregon Health Plan enrollments through Cover Oregon: 240,109
 

Dental enrollments 
Total private dental insurance enrollments through CoverOregon 1: 18,794

Net enrollments 
Net private medical: 82,368
Net private dental: 15,218

Once toothless, Cover Oregon board tackles an uncertain future

...After taking political heat for the exchange's technological failure, the appointees of Gov. John Kitzhaber are taking on a more significant role, transforming the agency for the future. At a time when critics of the agency say it should go away, it's the bureaucratic equivalent of an existential moment for an agency considered crucial to federal health reforms.

... The state's planned 2015 partnership with the federal exchange is called a "supported state-based" exchange. But it's supposed to be a temporary fix before setting up a full-fledged state-based exchange. It allows Oregon to keep insurer fees of about 2.5 percent of premiums for itself until the state resurrects its own website.

Vermont Health Connect shakes up practices, adds personnel

VERY interesting news out of Oregon. On the one hand, the gross QHP enrollment figure, which had been cut in half from 300/day down to 156/day is back up to over 200/day, right in line with the rebounds from Hawaii and Minnesota!

On the other hand, unlike last week when the net enrollment figure dropped from 280/day down to a measely 10 in an entire week, the number today is actually lower than it was a week ago!

July 14 NET enrollments: 82,637; July 21 NET enrollments: 82,183...a drop of 454 people.

July 21, 2014

Update: Private coverage and Oregon Health Plan enrollment through Cover Oregon

Medical enrollments through Cover Oregon: 322,707
Total private medical insurance enrollments through Cover Oregon 1: 95,115 
Oregon Health Plan enrollments through Cover Oregon: 227,592

Net private medical: 82,183

Hmmm...OK, first it was Hawaii with the QHP total actually going down from 6/28 through 7/05. Then Minnesota reported a huge drop-off in their off-season enrollment rate, from about 52 per day from April through the end of June to just 2 per day for the first 13 days of July.

Now we have Oregon's latest update. While the total QHP figure has grown by 1,092 over the past week, the paid QHP number has only gone up by...10. That's right: Just 10 in the past week, or just over 1 person per day...down from over 300 per day in the off season until now.

(As an aside, new Medicaid enrollments are also slowing down, with just another 290 people being added to the program). 

July 14, 2014

Oregon continues to rack up impressive QHP numbers, although their daily average is definitely slowing down as we move farther from their "extended-extension period". Even so, their net enrollments are still up another 1,258 since 6/24, while Medicaid enrollment has gone up just 1,221. My suspicion for the Medicaid enrollment drop-off (also noted by contributor deaconblues) is that they've simply run out of Medicaid-eligible people in the state...which makes sense seeing how they've added 355K people to the program since January (227K via the exchange + another 128K via their "fast track" program), when the Kaiser Family Foundation estimated that there were only 260,000 uninsured people even eligible for Medicaid to begin with!

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