Oregon may move to federal exchange

Cover Oregon’s board will hear recommendation Friday

By Tara Bannow / The Bulletin / @tarabannow

The leaders behind Oregon’s embattled health insurance exchange now appear poised to scrap the project and move to the federal exchange.

Alex Pettit, Cover Oregon’s interim chief information officer, explained before the exchange’s technology committee in Durham on Thursday that attempting to fix the exchange in time for 2015 open enrollment, which begins Nov. 15, would cost $78 million, and working under such an aggressive time line would present substantial risk.

Sending Oregonians on private plans to the federal exchange, by contrast, would cost the state $4 million to $6 million, and Pettit said that platform would be ready take on new enrollees before November. In that scenario, the Oregon Health Authority would retain control of eligibility and enrollments under the state’s Medicaid program, the Oregon Health Plan, but would cut off the flow of enrollees that are coming in through Cover Oregon.

“The one door through is the thing that we give up,” Pettit said at the meeting.

Cover Oregon’s board of directors will hear the recommendation at its meeting today in Durham, a Portland suburb.

Still unknown is whether the more than 70,000 Oregonians who enrolled in private plans through Cover Oregon this year will need to re-enroll through the federal exchange to secure coverage in 2015. Responding to a question on that point at the committee meeting, Pettit said he’s traveling to Washington, D.C., next week to determine what the state’s options are.

“The direct answer is ‘I don’t know,’” he said, “and I‘d rather say ‘I don’t know’ and tell you I’m going to explore things and see what we can do. I do hear that that would help a great deal to you all.”

Oregon has put $248 million in federal grants toward its exchange, which was built by Oracle, but it’s the only one in the nation in which people still cannot enroll online.

Cover Oregon tasked consulting firm Deloitte with assessing the cost of bringing the website to full functionality before Nov. 15. Doing so would require 390,000 hours of work at $200 per hour and, even then, the portal would not be able to accommodate changes in circumstance that affect enrollment, the company found.

The move to the federal exchange would have significant implications for insurance carriers. Although 11 out of 16 insurers on Cover Oregon already have developed interfaces with the federal exchange, the five who don’t will need to develop those components, which Pettit said is “no small body of work.”

“For those five, they will need to make a business decision as to whether they’re going to connect up or not,” he said.

Liz Baxter, chairwoman of Cover Oregon’s board, said at the meeting that all 16 carriers will have work to do if the state moves to the federal exchange because the Centers for Medicare & Medicaid Services will require they go through a full development program, test cycle and certification cycle to ensure everything will go smoothly.

Pettit assured that some of the technology the state is currently using to enroll people into the Oregon Health Plan could be adapted if Cover Oregon were to go to the wayside, and the costs of doing so would be eligible for a 10 to 90 percent federal match.

As for 2014 enrollments, Oregonians must submit their applications for health insurance to Cover Oregon by April 30 to avoid a potential federal tax penalty for not having insurance.

More than 242,000 Oregonians have enrolled in plans through Cover Oregon, roughly 70,000 of those enrolled in private plans and another more than 172,000 into OHP.

— Reporter: 541-383-0304,

tbannow@bendbulletin.com