PORTLAND — For thousands of Oregonians who already have health insurance, the new year will bring new insurance policies that cover more — and, in some cases, cost more.
And finding a cheaper alternative won’t be as easy as officials had hoped, as Cover Oregon, the state’s new online health insurance marketplace, still isn’t fully running.
Roughly 168,000 Oregonians buy their insurance individually, rather than getting coverage through an employer or government program. Of those, about 145,000 have plans that do not meet minimum requirements of the Affordable Care Act, said Cheryl Martinis, a spokeswoman for the Insurance Division of Oregon’s Department of Consumer and Business Services.
The new health care law, sometimes called Obamacare, requires that all health insurance policies provide a certain level of coverage beginning Jan. 1. There are some exceptions, however. About 23,000 Oregonians have “grandfathered” insurance plans that don’t meet the minimum requirements but will continue anyway.
Insurance companies are not required to notify Oregonians with “grandfathered” plans, according to Martinis. But a representative from LifeWise — the company with the majority of these plans — said those customers will be notified by mail.
In recent weeks, thousands of Oregonians have received letters from their insurance companies informing them that their current plan will be replaced at the start of next year.
Those who do nothing will not face a gap in coverage. Instead, they’ll be automatically enrolled by their current insurance company in whichever new plan is most similar to the one they have now.
That plan could cost more money. In some cases, a lot more money.
Choosing a different plan or provider could be cheaper. And about 400,000 Oregonians will qualify for financial assistance to help afford health insurance.
The new health care law provides subsidies and tax credits for people who aren’t offered insurance by their employers and who make less than $45,960 for a single person or $94,200 for a family of four.
“I think our biggest concern is that people understand their options, see if they qualify for financial help and find the coverage that best fits their needs,” wrote Martinis, the insurance division spokeswoman, in an email.
That’s easier said than done, however.
This is where the complicated new health care law gets even more sticky. The way officials spoke about Obamacare, people believed they would have all of the necessary information available at the same time, so they could browse new plans while understanding how much financial help was available to them.
Instead, consumers have been notified that their old plans are ending — and, in many cases, informed that their replacement plan will cost a lot more — without being able to calculate available subsidies and easily compare new plans.
Cover Oregon, the state’s new health insurance exchange created as part of the Affordable Care Act, was supposed to provide an online hub for all of this information, a sort of Orbitz or Expedia for health insurance. Currently, visitors to the site can enter information such as their age, ZIP code and household income to compare available insurance plans and estimate whether they qualify for financial aid. But the site does not yet allow people to enroll directly in a new plan or sign up for subsidies. This matters because the exchange is not only important for its comparative shopping purposes. To take advantage of financial assistance, consumers have to enroll in their insurance plans through Cover Oregon.
The trouble is, the website isn’t fully working yet. When the health insurance marketplace launched on Oct. 1, officials warned consumers that the site wouldn’t be wholly functional until later in the month. Now November has arrived, and officials have stopped offering any timeline at all.
“We have a clear plan to get the online system up and have already made great progress,” said Rocky King, executive director of Cover Oregon, in a prepared statement Thursday. “We want to reassure Oregonians that technological setbacks will have no impact on their ability to enroll in an insurance plan that meets their needs and budget.”
For Oregonians looking for a new plan to take effect Jan. 1, however, the Dec. 15 enrollment deadline is fast-approaching.
In the meantime, Cover Oregon officials are urging consumers to fill out an application with a certified insurance agent or community partner, who can be found by visiting www.coveroregon.com or by calling 1-855-CoverOR . Consumers may also submit an application on the Cover Oregon site.
Low-income Oregonians who receive an enrollment letter may choose the “Fast Track” enrollment for the Oregon Health Plan and Healthy Kids, the state’s version of Medicaid, and sign up for coverage without going through Cover Oregon. About 260,000 letters were mailed and more than 62,000 people have already signed up.
More than 17,000 people have submitted applications to Cover Oregon for insurance coverage. Until the website is fixed, those applications will be processed by hand.
“We do not anticipate having to process all the paper applications we have received by hand, but we are not going to rush out a site that doesn’t meet our standards,” wrote Michael Cox, a spokesman for Cover Oregon, in an email.
Many LifeWise customers will find themselves on a slightly different timeline that may give them time to wait for Cover Oregon to get up and running. Approximately 8,800 Oregonians have individual insurance policies through LifeWise that will last through March 31.
Deana Strunk, a spokeswoman for LifeWise, said that’s because all of the company’s individual policies have the same annual renewal date which happens to fall in September.
When the state was planning the Obamacare rollout, it made an exception for individuals with these plans so they wouldn’t be re-enrolled and then face a new enrollment period the following month.
Those individuals have until March 31 to choose a new plan or be automatically enrolled in a similar one. Strunk said these customers will receive notices in the mail beginning later this month.
With all of the national attention on Obamacare and upcoming changes to individual policies, insurance companies say they’re bracing for plenty of confusion. Echoing the advice of state officials, they urge people to turn to their insurance agent or insurance company — or Cover Oregon’s hotline — with questions.
Colleen Thompson, a spokeswoman for PacificSource, said about 2,500 of the company’s Central Oregon customers have been notified that their current plans will end with the calendar year.
“There’s a misconception that Cover Oregon is the only path to individual coverage, and we’re helping people who clearly won’t qualify for tax subsidies enroll now, either direct with us or through an insurance agent,” Thompson wrote in an email. “They don’t need to enroll through Cover Oregon.”