START OF 2018 OPEN ENROLLMENT PERIOD

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Oregon

In spite of their amazingly successful manual workaround process (which has enrolled 465,000 people in either private or Medicaid coverage), Oregon's website debacle continues to fester. Even so, until recently they've ironically been one of the most reliable state exchanges when it comes to publicly posting updated enrollment data. New detailed data has been posted pretty much once a week since the crazy days of March/April on a regular basis.

That all came to a screeching halt just over 3 weeks ago; the last update out of CoverOregon was August 6th. Again, this is still much better than most other states which only publish updates monthly or not at all, but for Oregon it's been worrisome for me, since they're one of only a handful of states giving that info out at all during the off-season.

Yeah, yeah, I know the title is lame, but it's not easy to find alliterative synonyms for "ugly" and "unpleasant" starting with "O"...

Anyway, a few days after Oracle sued Oregon for $23 million in unpaid bills over the CoverOregon exchange debacle, the state has counter-sued the tech company...for a whopping $5.5 BILLION...including "Whoa...heavy, dude!" charges by the state Attorney General such as racketeering:

In the aftermath of what was likely the most spectacular failure among state-run Affordable Care Act health exchange site launches, the state of Oregon has filed a lawsuit against Oracle America Inc. over the total failure of the Cover Oregon exchange. “Oracle’s conduct amounts to a pattern of racketeering activity that has cost the State and Cover Oregon hundreds of millions of dollars,” Oregon Attorney General Ellen Rosenblum wrote in a civil complaint filed August 22. The lawsuit seeks over $5.5 billion in damages from Oracle, plus legal fees.

The complaint comes after Oracle filed its own lawsuit against the state’s health exchange for failure to pay for services rendered in early August. Oracle’s attorneys claimed that Oregon Governor John Kitzhaber had defamed the company in a “smear campaign” while failing to take responsibility for the failure of state management of the project and not paying Oracle for additional work done.

Whoops...found even more slightly-outdated ACA-related articles worth noting...

OREGON: Cover Oregon officials hope to repair broken state health insurance exchange for 2016

For those who assume Cover Oregon will go away when the federal government takes overthe state exchange's job of enrolling people in health coverage, think again.

Even as Oregon works on hooking up to the federal website by November, some Cover Oregon board members hope the engagement with Uncle Sam will be only a one-year affair.

I found one quote in particular to be a bit of an eyebrow-raiser:

But the idea is controversial on both sides of the political aisle in Salem.

"Hell, no," says Sen. Brian Boquist, R-Dallas. He thinks Oregon should leave the job to the federal exchange and Cover Oregon as a stand-alone agency should go away. "Cover Oregon, the whole structure is bad from beginning to end. I don't trust the federal government. But I do trust the federal government more than I do the state of Oregon."

I've been too busy with my day job (I do have one, you know...) to post much lately, but plenty of ACA-related news has piled up, so I'm clearing off my desk with some quick bits:

KENTUCKY: Women leading Kentucky health: Kynect’s Banahan excited to reach even more people

First in a series of profiles about KY women in charge of the state exchange:

Energy exudes from Carrie Banahan when she talks about her work with others to bring affordable health care to more than half a million Kentuckians.

“I worked all my life to see this happen, that we can provide affordable health insurance to people, and it has actually happened,” she said. “I am thrilled that we are actually helping people in Kentucky. It is the highlight of my career.”

Banahan is executive director of the Kentucky Health Benefits Exchange, which the state has branded as Kynect, partly to avoid identification with the pejorative nickname Obamacare. She shares the credit for its success.

Hmmm...another unusual slowdown for Oregon; total QHPs are only up 873 since 7/28, and net QHPs are actually down 63, presumably due to purging of unpaid enrollments and cancellations of existing policies. Medicaid enrollments, meanwhile, are up another 499.

August 6, 2014
Update: Private coverage and Oregon Health Plan enrollment through Cover Oregon

Medical enrollments through Cover Oregon: 337,518
Total private medical insurance enrollments through Cover Oregon: 96,910      

Oregon Health Plan enrollments through Cover Oregon: 240,608
 

Dental enrollments 
Total private dental insurance enrollments through CoverOregon: 19,489

Net enrollments 
Net private medical: 82,305
Net private dental: 15,605

Oregon is, I believe, the 5th state to release their approved ACA exchange premium rates for 2015, after Rhode Island, Connecticut, California and Mississippi. Like most of the others, it's a mixed bag, with some companies raising their rates by up to 10% but others reducing theirs by as much as 20% (or even 26% for the small group market, although that's not the one that I'm primarily looking at).

About 80,000 Moda Health members who buy their own insurance will see their monthly premiums climb an average 10.6 percent next year, while many other insurers are dropping their rates to compete.

Insurance rate decisions were issued by the Oregon Insurance Division Thursday and announced today, showing a tighter range of premiums in the individual market for people not covered by employers or Medicare.

Moda's once market-leading rates have jumped to middle of the pack. For a silver plan, a 40-year old in Portland can find four insurers with lower premiums approved by the state.

Oregon continues to post impressive enrollment numbers considering their never-working website. Total QHPs are up another 922, Net QHPs are up 185 and Medicaid enrollments are up 12,517 over the past week:

July 28, 2014
Update: Private coverage and Oregon Health Plan enrollment through Cover Oregon

Medical enrollments through Cover Oregon: 336,146
Total private medical insurance enrollments through Cover Oregon: 96,037          

Oregon Health Plan enrollments through Cover Oregon: 240,109
 

Dental enrollments 
Total private dental insurance enrollments through CoverOregon 1: 18,794

Net enrollments 
Net private medical: 82,368
Net private dental: 15,218

Once toothless, Cover Oregon board tackles an uncertain future

...After taking political heat for the exchange's technological failure, the appointees of Gov. John Kitzhaber are taking on a more significant role, transforming the agency for the future. At a time when critics of the agency say it should go away, it's the bureaucratic equivalent of an existential moment for an agency considered crucial to federal health reforms.

... The state's planned 2015 partnership with the federal exchange is called a "supported state-based" exchange. But it's supposed to be a temporary fix before setting up a full-fledged state-based exchange. It allows Oregon to keep insurer fees of about 2.5 percent of premiums for itself until the state resurrects its own website.

Vermont Health Connect shakes up practices, adds personnel

VERY interesting news out of Oregon. On the one hand, the gross QHP enrollment figure, which had been cut in half from 300/day down to 156/day is back up to over 200/day, right in line with the rebounds from Hawaii and Minnesota!

On the other hand, unlike last week when the net enrollment figure dropped from 280/day down to a measely 10 in an entire week, the number today is actually lower than it was a week ago!

July 14 NET enrollments: 82,637; July 21 NET enrollments: 82,183...a drop of 454 people.

July 21, 2014

Update: Private coverage and Oregon Health Plan enrollment through Cover Oregon

Medical enrollments through Cover Oregon: 322,707
Total private medical insurance enrollments through Cover Oregon 1: 95,115 
Oregon Health Plan enrollments through Cover Oregon: 227,592

Net private medical: 82,183

Hmmm...OK, first it was Hawaii with the QHP total actually going down from 6/28 through 7/05. Then Minnesota reported a huge drop-off in their off-season enrollment rate, from about 52 per day from April through the end of June to just 2 per day for the first 13 days of July.

Now we have Oregon's latest update. While the total QHP figure has grown by 1,092 over the past week, the paid QHP number has only gone up by...10. That's right: Just 10 in the past week, or just over 1 person per day...down from over 300 per day in the off season until now.

(As an aside, new Medicaid enrollments are also slowing down, with just another 290 people being added to the program). 

July 14, 2014

Oregon continues to rack up impressive QHP numbers, although their daily average is definitely slowing down as we move farther from their "extended-extension period". Even so, their net enrollments are still up another 1,258 since 6/24, while Medicaid enrollment has gone up just 1,221. My suspicion for the Medicaid enrollment drop-off (also noted by contributor deaconblues) is that they've simply run out of Medicaid-eligible people in the state...which makes sense seeing how they've added 355K people to the program since January (227K via the exchange + another 128K via their "fast track" program), when the Kaiser Family Foundation estimated that there were only 260,000 uninsured people even eligible for Medicaid to begin with!

There's a TON of amazing news out of Oregon today, but I only had room for the most stunning one in the title above. Trust me, this is chock full 'o goodness:

For all the hits Oregon has taken over their website, they continue to calmly, quietly, manually add more and more people to their exchange rolls:

Medical enrollments through Cover Oregon: 315,825
Total private medical insurance enrollments through Cover Oregon 1: 89,744              

Oregon Health Plan enrollments through Cover Oregon: 226,081

Net private medical: 81,369
Net private dental: 15,461

This is a net increase of another 1,029 QHPs and another 14,151 Medicaid enrollees since June 12...or up 21,436 QHPs since the end of Open Enrollment on 4/19 (330 per day on average).

It's worth remembering that Oregon started the year with only about 559,000 uninsured people in the entire state. Add in the 128,434 "Fast Track" Medicaid enrollees and you have a whopping 444,000 people covered one way or the other.

OK, it's difficult to get a bead on how Oregon has been performing since the end of open enrollment, because they bumped theirs out 2 weeks beyond most other states. Even so, they've added 19,214 additional QHP enrollees since the 4/19 HHS report, or over 350 per day.

Interestingly, there's been no change at all in their reported Medicaid enrollment; I'm assuming they just didn't include that data this week since it's changed some every other time.

June 12, 2014
Update: Private coverage and Oregon Health Plan enrollment through Cover Oregon

Medical enrollments through Cover Oregon: 299,452
Total private medical insurance enrollments through Cover Oregon: 87,522
Oregon Health Plan enrollments through Cover Oregon: 211,930

Dental enrollments 
Total private dental insurance enrollments through Cover Oregon 1: 17,751          

Net enrollments 
Net private medical: 80,340
Net private dental: 15,574
 

Four important stories about the technical situation status on various ACA exchange websites:

Idaho moving forward with state-run Obamacare exchange

Officials in Idaho say they’re undaunted by the well-documented failures of Obamacare exchanges in neighboring states and are moving  full-steam ahead with plans to launch their own web portal this November.

While executives at Cover Oregon and Nevada Health  Link abandon their state-run websites and turn to the federal exchange (HealthCare.gov), Your Health Idaho is headed in the opposite direction.

The state relied on the federal website for the open-enrollment period that ended in mid-April because it had less than 200 days last year set up its own web-exchange when state lawmakers authorized the project. It was one of two states — New Mexico is the other — that had to wait a year for its own site, and exchange officials say the delay has been a plus as they meet with other states to discuss what went right or wrong during Obamacare’s first round.

It's rather ironic that Oregon, which had a disastrous exchange website which it's abandoning in order to join the federal exchange, still continues to post their enrollment data on a regular basis (pretty impressive numbers at that, by the way--another 10,204 added to Medicaid in the past week or so), while the federal exchange, which has been running smoothly for months now, has decided to stop posting their own updates. In any event...

Medical enrollments through Cover Oregon: 297,712
Total private medical insurance enrollments through Cover Oregon 1: 85,782                

Oregon Health Plan enrollments through Cover Oregon: 211,930

Dental enrollments 
Total private dental insurance enrollments through CoverOregon 1: 17,578          

Net enrollments 
Net private medical: 78,970
Net private dental: 15,476

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