Oregon's on-again, off-again state exchange relationship is...on again??

There are 12 states which operate their own full ACA exchanges, including their own board of directors, marketing budget, bylaws and tech platform for their enrollment website. 34 states have offloaded just about all of that to the federal exchange, HealthCare.Gov.

And then there are five states which are in between: They have their own state-based exchange...but their tech platform is basically piggybacked onto the federal exchange: Arkansas, Kentucky, Nevada, New Mexico and Oregon.

Nevada and Oregon had such major technical problems at launch that they scrapped their sites after the first year and moved to the Mothership. Hawaii also scrapped their exchange site after the second or third year, but they shut down their entirestate-based exchange and moved everything to HC.gov). Nevada announced that they're giving their own full exchange a second shot this November.

Arkansas and New Mexico originally intended on moving off of HC.gov onto their own full exchange platform, but never got around to doing so...although New Mexico also announced last fall that they're finally going to do so next year. Kentucky started out with their own full state-based exchange ("kynect"), which worked perfectly fine from day one...only to be moved to the federal platform after three years because new GOP Governor Matt Bevin decided he didn't like it.

Oregon, meanwhile, seems to be pretty indecisive about the subject. They launched their own exchange (which cost upwards of $300 million at the time) with much pomp & circumstance in 2013...only to have it completely melt down and have to be scrapped after they were never able to get it to work the first year.

In 2016, the state considered giving their own full exchange a second chance:

Oregon is considering proposals by four companies to provide a new software platform for the state’s health insurance marketplace.

The state uses the federal insurance exchange, and state officials began to explore other options after the federal government decided to begin charging insurance companies a fee to use the exchange in Oregon.

That apparently never went anywhere further at the time, as the state stuck with HealthCare.Gov for the 2017, 2018 and 2019 Open Enrollment Periods.

A year ago, however, the subject came back up again last May:

...with rising fees to use the federal site and limited flexibility, state health officials are now mulling whether it might be time to relaunch the state’s own healthcare insurance exchange.

“The question is whether there is some alternative that would actually be cheaper, or at least competitive in price, that might also give Oregon flexibility,” said Jesse O’Brien, policy director for the Oregon State Public Interest Research Group and a member of the exchange’s Marketplace Advisory Committee. “Having no control over the system, it’s already clear over the past few years, that it’s not the optimal situation.”

...Because fees are charged as a percentage of premiums sold through site, and premiums are rising year over year, the amounts paid by the insurance plans and ultimately by consumers are growing even faster.

...and again, I didn't hear anything else about it for nearly a year, until yesterday:

The Oregon marketplace issued a technology RFI to help assess the feasibility of transitioning to a full state-based marketplace https://t.co/RCNrOR0ci4

— Rachel Schwab (@RachelE_Schwab) April 23, 2019

Sure enough:

Request for Information overview

The Oregon Health Insurance Marketplace (Marketplace) is requesting information about an integrated online health insurance marketplace technology platform and associated consumer assistance center. This request is being issued as part of a value analysis to determine the cost-effectiveness and feasibility for Oregon of a transition to a fully state-based marketplace. There is no anticipated date for a transition at this time.

Background, timelines, and documents

This request is divided into two parts. Part one is intended to gather information about existing online health insurance marketplace platforms that are currently in use by at least one state-based marketplace (SBM). Information on systems whose real-world operability has not been proven is neither requested nor desired.

Part two is intended to gather information about consumer-assistance solutions (including call centers) for state-based marketplaces. A high level of integration and interoperability with the health insurance marketplace platform is desired, but direct affiliation/integration with the health insurance exchange platform is not required.

Respondents are invited to provide information in response to one or both parts of this request.

More details are contained in the RFI documents (see links below)

Vendor questions and answers will be posted to this page, as well as in the Oregon Procurement Information Network (ORPIN) website entry for this RFI, according to the schedule below.

Timelines

  • ORPIN notice number: DCBS-1186-19
  • Request for Information (RFI) issued: Friday, April 5, 2019
  • Deadline for submission of questions (via email only): ): Friday, April 19, 2019, at 5 p.m. PST
  • Deadline for questions/answers posted on ORPIN and on this page: Friday, May 3, 2019
  • Deadline for submission of response (via email only): Friday, May 31, 2019, at 5 p.m. PST
  • Questions and RFI responses should be emailed to Victor Garcia at victor.a.garcia@oregon.gov.

Assuming they finally go ahead and pull the trigger on this, it wouldn't actually be launched until next November at the earliest, the same time New Mexico's is scheduled to go live.

My advice: Go for it! Just make sure it works this time :)