Update: The article has been appended with comments from Cover Oregon staff.
Oregon consumers who purchase insurance on the individual market could be headed for a very tight window to ensure they’ll keep coverage, but so far few decisions have been made to mitigate these concerns or change course from the original window.
In the second year of the Affordable Care Act, the window for open enrollment for individual health plans was designed to be cut in half -- from six months to three months -- and Cover Oregon has made no immediate plans to change this, despite forcing all of its 97,000 consumers to re-enroll because of the switch to the federal website.
Prior to the healthcare law, people could sign up at any time and be screened for coverage by an insurance company, with as many as one-fifth of people rejected for coverage because of so-called pre-existing conditions. Now anyone can get covered, but the Obama healthcare law was designed to have a tight enrollment window to limit the number of people who wait until they’re sick to get health insurance.
The next open enrollment runs from Nov. 15, 2014 to Feb. 15, 2015, but the window is actually much narrower for people who already have coverage. To ensure coverage on Jan. 1, they may have to sign up on healthcare.gov as early as Dec. 15.
Insurance agent Dan Neils of Agape Insurance in Oregon City told The Lund Report that he’d like to see the 2014 plans extended through Feb. 15 or Feb. 28. That way, consumers would have more wiggle room before switching to a 2015 plan.
Neils signed up 250 people for 2014 plans, and he foresees a flood of consumers all coming into his office around the Thanksgiving holiday, desperate to sign up in a very short timeframe.
“You can also count on the Federal Exchange crashing the first week from the millions of folks all going on week one,” he said.
Neils spoke with a fellow insurance agent in Montana, which opted to use the federal exchange from the start, and said the problems with healthcare.gov are in many ways the opposite of those with Cover Oregon. “You’re supposed to do it in one sitting, but there’s lots and lots of problems with the federal exchange,” he said.
On Cover Oregon, the problems have been largely on the front end, with consumers unexpectedly relying on a manual enrollment system. With the federal exchange, a consumer can successfully sign up, but on the back end, insurance carriers and agents have been left with a mess of poorly processed data. “As an agent, she’s still working long days to fix them,” Neils said of his Montana colleague.
Insurance Commissioner Laura Cali told The Lund Report that the state had not chosen to change the terms of these plans or the enrollment period, but Cover Oregon was working on helping consumers get their federal accounts set up before Nov. 15 so that they will be ready when the enrollment period opens.
“It’s something we’re all cued into,” she said.
Cover Oregon spokeswoman Ariane Holm said that the open enrollment dates were set by the federal government and therefore out of their control.
"For current customers who will need to renew their coverage, we will be working to make it as easy as possible. We will be communicating with our current customers to provide clear steps for what they need to do to renew their 2015 coverage at healthcare.gov," Holm said. "Agents are key to helping Oregonians enroll and we hope that they will continue being engaged."
It may not assure consumers worried about potential problems, but given Cali’s history last year -- extending the old insurance plans that don’t follow ACA guidelines when Cover Oregon ran into trouble -- it’s likely that an extension for plans that do follow the ACA could be made if problems come up during the open enrollment.
“I think it is a concern that the window is as tight as it is,” said Jesse O’Brien, a healthcare advocate at the Oregon State Public Interest Research Group.
But O’Brien was more concerned that Cover Oregon have all its ducks in a row so the federal website works smoothly as promised for consumers. He was less focused on a contingency plan that would give people extra time if it doesn’t work. He was also watching closely to see whether there’ll be a big public education campaign so consumers know what to do.
At Agape Insurance, Neils said he was looking at a long holiday season. “Cover Oregon could be a lot more accommodating for people,” Niels said.
Chris can be reached at [email protected].
