An Exchange races to be ready

Oregon’s ambitious health insurance marketplace races to meet federal reform deadlines |


Nationwide, millions of people have benefited from the Affordable Care Act, gaining free access to preventive services including cancer screenings and discounts on prescriptions. The real muscle of the law, though, kicks in the new year. That’s when the law calls for insurance for everyone, regardless of a pre-existing condition or age. Health marketplaces will offer tiered insurance plans to individuals and small businesses employing 50 or less.

What is this “free” stuff. None of it is free. Either it’s built into the premium you’re paying or someone else is paying for it.

In Oregon, more than 200,000 people initially are expected to sign up through Cover Oregon. While premiums will jump for some initially, supporters hope competition will tamp down health care costs over the long haul.

Where does this magical competition come from? There are plenty of websites now where people can shop for insurance. There already IS competition.

“This is essentially a three- to five-year project that we are trying to do in a year and a half,” says King, who for 20 years headed the state’s insurance program for people denied insurance due to pre-existing conditions such as kidney failure.

Yes and that is scary. I guess the good part, at least for Oregon, is they seem to have a good team.

Typical time to navigate the health insurance forms and purchase a plan: 35 minutes for a well-informed, prepared person; two hours for the uninitiated.

That’s no improvement over now when people have to answer pages of medical questions. Now it’s pages of other red tape.

Getting back to readiness, the tasks described below do seem fairly daunting…

That only hints at the complexity of setting up Oregon’s health marketplace. The 200,000 expected users will have different needs, different incomes, and will choose their insurance plan accordingly. In all, 15 insurers, have applied for preliminary approval to offer bronze, silver, gold or platinum plans with sliding costs and benefits. Many will offer catastrophic plans to young people, as well as stand-alone dental.

The website must do a lot of heavy lifting. It will screen for eligibility for the low-income Oregon Health Plan, calculate tax credits people can receive, and share information between various agencies, insurance companies, small businesses, tribes and individual consumers. Already, insurers are setting up online connections with Cover Oregon, though their final plans and rate requests aren’t due to the state until April 30.

and of course…

Cover Oregon’s own deadline to finish programming hits in April, but they’re running behind, King says as he watches the work. He wants four months of testing done well before October, when enrollment begins.

The last sentence sums it up…

People will get on there and say ‘this is too complex,'” he says. “And we’ll say ‘yes, and we’re here to help you through it.”

Hey.. “We’re from the government and we’re here to help”


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