Has Oregon managed to cut their total uninsured by 65% with a completely broken website??? (UPDATE: Yep, it looks like it)

Hat Tip To: 
Icowrich, deaconblues

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.

Now, perhaps I'm misunderstanding the math here, but assuming 57% of the QHPs were uninsured (using the recent KFF.org estimate...around 46,400 people) and assuming about 90% of the new Medicaid enrollees were uninsured (which seems likely; heck, it's probably 100% of the "fast track" crowd), it suggests that Oregon has reduced their total uninsured number by at least 365,000 people...or 65% of the total eligible uninsured population...ALL WITHOUT A FUNCTIONING EXCHANGE WEBSITE.

UPDATE: I just noticed that in the Medicaid quote below, there's a specific reference by state officials to "300,000 new Medicaid patients who gained coverage this year". This wasn't meant as a precise count, of course--they were just making the point that the system is being hit with a huge number of new people--but it does give a bare minimum number for newly insured on the Medicaid side (300K / 354K = 85%). So yes, assuming 57% of the QHPs are also newly insured, that's at least 62%.

Meanwhile, remember all the fuss awhile back about whether or not expanding Medicaid increased or decreased Emergency Room visits (thus either cutting expensive ER costs for hospitals, or, if not, hurting one of the pro-expansion talking points)?

Well, in the state of Oregon, at least (which jumped the gun on expanding Medicaid under a state-run program a year before the ACA expansion kicked in), it seems we have an answer:

SALEM — Still smarting from the spectacular failure of the state’s online health insurance exchange, Oregon on Tuesday announced that a separate piece of Gov. John Kitzhaber’s health reforms is at least partly succeeding at improving care for Medicaid patients.

Oregon enlisted so-called coordinated care organizations two years ago to oversee care for Medicaid patients. Kitzhaber secured almost $2 billion from the federal government on the promise that the program, unique to Oregon, would lead to better care and lower costs, in part by better managing chronic diseases and preventing avoidable hospital visits.

A report issued by the Oregon Health Authority on Tuesday provided the first full-year data since the state’s 15 coordinated care organizations started seeing patients. It showed emergency room visits for Medicaid patients dropped by 17 percent in 2013 from two years earlier, and hospitalizations for heart and lung problems also were down.

The story wisely ends with an important caveat, however:

Kitzhaber and state health officials have repeatedly warned that the numbers for 2014 will take a step backward because of an influx of 300,000 new Medicaid patients who gained coverage this year under the federal health care law. Many of those patients sought care in the emergency room because they didn’t yet have a primary-care doctor, and some face complicated health conditions because of years without insurance coverage.

In other words: Some short-term costs may go up in some ways because thousands of people are actually, you know, receiving medical treatment (note to Republicans: this is a GOOD thing), but long-term costs will definitely go down because those same thousands of people are actually, you know, able to receive preventative treatment instead of being rushed into the ER with a heart attack, stroke, seizure, etc. at 10x the treatment cost (note to Republicans: this is ALSO a good thing).

UPDATE x2: Thanks to Amy Fried for bringing my attention to another Oregon Medicaid story from Modern Healthcare which is even more specific about how many Medicaid enrollees are new to the system:

First, standards are being raised. Second, Medicaid expansion has brought 340,000 more people into the program since January and it is unknown what the effect of this will be, Coyner said.

Yup, I think we're looking at a 62 - 66% drop in the uninsured rate in Oregon alright.

 

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