Oregon’s Health Exchange Plows Ahead Despite Unknowns

December 19, 2012 -- With the nod of approval from the Centers for Medicare & Medicaid to run a health insurance exchange, Cover Oregon is plowing forward toward implementation. It’s scheduled to have a Web-based, one-stop marketplace up and

running by next October, while coverage for the uninsured and small businesses will be available in January 2014.   Meeting that October deadline is a daunting challenge, Rocky King, executive director, told the board at its monthly meeting last week. Among the tough tasks is building a consumer-friendly Web site that also interfaces with carriers’ IT; marketing to target populations, some of whom don’t use computers; and launching a call center that will be flooded with queries from the get-go.   Not everything will be in place by next October, said King who reminded the board that the exchange is a five-year project. Tweaks will be made “as we go along,” he added.   The exchange has received letters of intent from insurers interested in participating, and they have until December 31 to submit their applications. “We think we’ll have good plan choices from across the state,” said spokesperson Lisa Morawski, adding that the names of those insurers will be announced next spring, once they’ve been certified.   When its federal grants end in 2014, the exchange must become financially self- sustaining. The latest projections indicate there could be between 169,900 and 344,400 people purchasing coverage through the exchange by then, while those figures could rise to 296,600 and 471,200, respectively, by 2016.   Dealing with public misinformation, resistance, and lack of awareness is critical to the success of the exchange. That point was underscored by Lee Mercer with the Main Street Alliance of Oregon. Speaking at Cover Oregon’s December 13 board meeting, he said the alliance’s survey of 350 small rural businesses found 80 percent of respondents said they were unaware of the exchange, and 55 percent didn’t realize they could recoup a tax credit by providing coverage to their employees. Once told how the exchange worked, most respondents were interested, he said, but not in the tax credits. Many surveyed oppose Obamacare.   Also, a significant number of Oregonians are unaware of legislation on the exchange, said Elizabeth Baxter, board chair. “Getting these folks to step one” will be a challenge, she said.   Making certain the exchange is easy to use so consumers can understand the differences among the health plans is essential, said John Mullin, representing the Human Services Coalition. “The test of any system is how easy it is for those with the least access to use.”   It’s also important to build strict quality of care measures, hold insurers accountable for improved care, and drive a hard bargain with insurers so they cover diverse communities, according to other testimony.   “A lot of these issues we will address, we just may not address them on day one,” said Morawski after the meeting. “But we’re on the same page [as the testifying consumer advocacy groups] in terms of where we want to go.”