PoliticoObamacare in Oregon: A failed exchange
By JENNIFER HABERKORN | 3/31/14 5:10 AM EDT
Oregon and Washington state strongly embraced Obamacare and opened their own health insurance exchanges. The states are similar, not just geographically but politically, economically and demographically. As the first enrollment season winds down, Washington has some of the best results in the country. Next door, Oregon’s exchange website is still broken.
SALEM, Ore. — Oregon had all the right ingredients for a sparkling Obamacare success story: a Democratic doctor as governor, an eager Legislature and a history of health care innovation.
It ended up with Obamacare’s biggest technological disaster.
CoverOregon.com, the state’s equivalent of HealthCare.gov, is the only insurance exchange in the country on which people still cannot buy coverage entirely online. The flaws are so deep that Gov. John Kitzhaber concedes the state may give up on its own exchange and move to the federal HealthCare.gov next year. The challenges were so persistent that the state received federal permission to add a full month to its open enrollment season. The deadline for most of the country to become covered is 11:59 p.m. Eastern time Monday; here, enrollment will run through April.
The finger-pointing and political posturing have escalated as the exchange story has unfolded. Now, as states like Washington to the north and California to the south celebrate their progress, Oregon’s controversy is in full eruption. Kitzhaber, who is running for reelection this fall, faces mounting questions over whether he could have stopped the disaster. And the exchange board is hunting for its third leader since December.
Oregon — a liberal state with an independent, hipster culture that embraces handlebar mustaches, composting and vintage shops — set sky-high expectations for what it could do with the Affordable Care Act. But Oregonians involved with the build-out interviewed here described a process that went awry early on: exchange designers who overreached, a contractor that didn’t complete the job and state officials who didn’t recognize the calamity unfolding right in front of them. That simple vision of expanding health care morphed into a byzantine mess of broken technology and political recrimination.
The glimmer of good news in Oregon’s Affordable Care Act story is that the exchange has managed to get health coverage to about 175,000 people, about 52,000 in private insurance and the rest in Medicaid, according to the most recent figures. Another 130,000 got Medicaid through a separate fast-track sign-up system. Compared with other states, Oregon did land in the middle of the pack on insurance coverage, partly because of sustained community outreach efforts. One recent analysis by the Kaiser Family Foundation ranked the state 29th out of 50.It could have been outstanding
A scathing outside analyst report released this month shows that Cover Oregon suffered a cavalcade of mistakes early on: poor management and governance; bad communication; flawed planning and goals; and a strained, inadequately structured relationship with Oracle, its contractor, that failed to align expectations and payments.
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