Oregon: Yep, they're still seriously thinking about giving a state-based exchange another shot (by 2023?)
I noted yesterday that Virginia is the latest state to consider jumping onboard the State-Based Exchange train, joining Nevada, New Mexico, New Jersey, Pennsylvania, Maine and possibly Oregon in making the move. Every time I've mentioned Oregon, however, I've had to put a bit of an asterisk on it because I wasn't quite sure whether or not their shift back to their own full tech platform was still a go or not.
Like Nevada, Oregon did have their own full exchange once upon a time. Back in the first ACA Open Enrollment Period from 2013-2014, both states were among those which ran their own exchange websites. Nevada's was developed by Xerox; Oregon's was developed by Oracle.
In both cases, the websites cost gobs of money...and were utter disasters, to the point that both states scrapped the whole thing and moved back home to the Mothership of HealthCare.Gov. Both Nevada and Oregon then promptly sued their respective vendors for gross negligence (or whatever the appropriate term was for charging hundreds of millions of dollars for a big technological turd).
Since November 2014, residents of both NV & OR have been enrolling via HC.gov...but that's about to change in Nevada, where, a year and a half ago, they decided to re-launch NevadaHealthLink.com for the 2020 Open Enrollment Period, using a completely new vendor and new software.
With six years of technological advances and a ton of real-world experience under their belt from observing what has and hasn't worked in other states, Nevada is feeling much more confident this time around, and the new exchange website cost a fraction of what the original one did all those years ago.
That brings me back to Oregon...which has been considering giving their own full exchange a second shot for far longer than Nevada, but they seem to be far more hesitant about actually committing to doing so:
Faced with a new user fee from the federal government, Oregon may switch back to running its own health insurance marketplace — but not build it from scratch like the disastrous first time around.
The U.S. Department of Health & Human Services has proposed a 1.5 percent user fee for next year, ramping up to 3 percent after that, said Patrick Allen, director of the Department of Consumer and Business Services.
...Allen said the department is putting out a request for proposals later this month for the individual and small business marketplaces. The responses will be due in January, before the February short legislative session. If moving to a new state system doesn’t pencil, Oregon may decide to stick with the federal system, Allen said.
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, Healthcare.gov, 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.
...On Monday, however, Morawski said the state will not rush to decide whether to make another attempt at launching its own state insurance exchange. “We’re going to be on healthcare.gov for sure for 2017,” Morawski said.
..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.”
...Oregon exchange officials said health plans paid an estimated $16 million in fees for the 2018 open enrollment period, and expect to pay somewhere between $25 and $30 million for 2019.
Those price hikes have spurred discussion among staff and advisory committee members whether the state is still getting its money’s worth in using the federal exchange, or whether acquiring its own technology might be cheaper.
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.
...all of which leads up to today, via the Portland Business Journal:
Oregon considering a switch back to state-based health insurance exchange
Oregon is one of six states considering switching to a state-based marketplace platform for health insurance, according to a new report from the Robert Wood Johnson Foundation and Urban Institute.
...The Oregon Department of Consumer and Business Services, which oversees the Oregon Health Insurance Marketplace, issued a request for information from vendors about their capabilities in the areas of eligibility, enrollment and call center technology. DCBS received 10 responses to the request, which the agency will use to judge the cost-effectiveness and feasibility of switching to a state platform, said Elizabeth Cronen, communications and legislative manager for the Oregon Health Insurance Marketplace.
Unfortunately, it sounds like it's still gonna be quite some time before any such move is made no matter what:
...Oregon's current contract with the federal government began on Jan. 1, 2018 and runs through Jan. 1, 2023.
...“We will continue to collaborate with our legislature and our stakeholders as we consider all options,” said Chiqui Flowers, administrator of the Oregon Health Insurance Marketplace. “In the meantime, Oregonians can still sign up for private health insurance and access financial assistance to help lower costs at HealthCare.gov. Open enrollment begins Nov. 1 and the deadline to sign up for coverage is Dec. 15.”
Ah, well...at least they'll have plenty of time to prepare for the 10th Annual ACA Open Enrollment Period on November 1st, 2023, anyway...