Oregon went “all in” on health reform, firmly embracing the Affordable Care Act. They launched a very successful Medicaid expansion — a $2 billion federal experiment to prove the state could save money by managing patients’ care better, and, of course, the state’s own online marketplace to sell Obamacare insurance.
But that last point has been a huge problem.
The Cover Oregon board decided on Friday to ditch its troubled website and join up with the federal HealthCare.gov exchange instead.
The Oregon site launched with high expectations, but after six months and about $250 million spent, Oregonians still can’t use the website to sign up for coverage on their own. They have to use a navigator.
The reasons for the ensuing problems are multiple: The state wanted a website that could enroll everyone from individuals to businesses owners, Medicaid recipients and children, too.
Then the contract Cover Oregon drew up with the software giant Oracle to build the site didn’t link payment with producing a working website.
So Cover Oregon’s board made a choice on Friday. Instead of spending another $80 million dollars to try and fix its troubled website, it would sign up with the feds for about $5 million and be assured of a working system.
“Of course we’re very disappointed,” says Dr. George Brown, a Cover Oregon board member. “People have worked very hard to make this work. And I think there’s been significant success if you look at the numbers of people who’ve been enrolled both through the qualified health plan as well as Medicaid.”
He’s right. About 240,000 people did manage to enroll through Cover Oregon, although many of them had to do it with pen and paper instead of their mouse and keyboard.
But switching to the federal exchange may cause some headaches of its own. The 70,000 Oregonians who signed up for individual insurance may have to do so all over again, says Clyde Hamstreet, Cover Oregon’s third chief in five months.
“Let me say this, nobody has to re-enroll now. What we have to do in November, we’ve got to work out yet,” Hamstreet says. “It might be that some companies will have to do it and others won’t. We have to work that out yet.”
He says November’s important because that’s when the enrollment window opens again, and he says, the system has to be working.
Oregonians may have other problems with the federal exchange, too.
For example, five of the 16 health insurance companies currently doing business in the state don’t have the computer interface needed to work with the federal exchange.
So will they go through with the expense of setting one up? Or will they stop doing business in Oregon? That’s unclear.
Also, navigators who’ve been trained to help people sign up for Cover Oregon will now have to be retrained for healthcare.gov.
Meanwhile, cuts are being discussed for an as yet unspecified number of the 460 people employed at Oregon’s exchange, according to Hamstreet.
“Cover Oregon certainly is going to be around for 2014. We have a lot of work to do,” Hamstreet says. “Exactly what Cover Oregon is going to look like in 2015, I think is too early to say.”
And remember, all of this talk is for health plans that in certain cases do next to nothing. Begging the question, what are we really doing with all this money? Is the ACA really going to fix American healthcare? Or is this another distraction to keep us from talking about the facts?
From a physician perspective, the most looming obstacle standing between a majority of necessary healthcare is insurance itself. So why we’re pouring money into these enormous systems just to sell more of it makes doctors like us shake our heads.