Federal Inaction, Stonewalling Create Challenges for Oregon Health Coverage

State officials say they’re hopeful Congress will act before Children’s Health Insurance Program funds dry up, but there’s little hope for improvements to the federally run individual insurance marketplace.

Federal gridlock in Congress and the Trump administration’s efforts to undermine the Affordable Care have, together, put tens of thousands of Oregon children’s health coverage at risk and made it more difficult for adults to purchase insurance for themselves and their families, leaving state officials scrambling.

Congressional authorization for the Children’s Health Insurance Program, which covers about 98,000 children in Oregon, expired at the end of September – but the state still has funds in reserve to keep the program running into mid-November, Oregon Health Authority spokesman Robb Cowie told The Lund Report. And the program has historically had bipartisan support, leaving state officials hopeful that it could be reauthorized before funds run out.

“We have cash on hand that will fund the CHIP program through sometime between the end of October and the middle of November,” Pat Allen, director of the Oregon Health Authority, told the Oregon Health Policy Board on Tuesday.

But there’s virtually no hope that federal officials will bolster the healthcare.gov marketplace, where individuals and families seeking to buy their own plans must shop if they hope to receive subsidies to help pay for insurance. The Centers for Medicare and Medicaid Services has shortened the sign-up window for enrolling in these plans, announced plans take healthcare.gov offline for maintenance repeatedly during this shortened window, and cut funding for TV and radio ads to educate consumers about the site, said Elizabeth Cronen, communications and legislative manager with the Oregon Health Insurance Marketplace.

“Oregon is in a better position than many of the other states that use HealthCare.gov because we have a state-level program—the Oregon Health Insurance Marketplace, which is run by the Oregon Department of Consumer and Business Services—with funding to do our own marketing, outreach, and consumer assistance,” Cronen told The Lund Report in an email. “In the past we’ve not done TV ads, and therefore saved on media costs, because healthcare.gov’s ads would be on the air. This year, we will use our own funding to ad TV and radio to our advertising plan, supplementing the digital, print, and limited radio advertising we’ve done in previous years.”

Even with that outreach, the state still relies on the healthcare.gov website for people to sign up for insurance, and to qualify for subsidies, however.

“For 2018 coverage, open enrollment runs from Nov. 1-Dec. 15. Last year, the dates were Nov. 1-Jan. 31. All our outreach and advertising will emphasize the Dec. 15 deadline,” Cronen said.

“CMS also has announcement multiple time windows when the site will be down for maintenance, often on Sundays between 9 p.m. and 9 a.m.,” she continued. “The Oregon Health Insurance Marketplace has many community and insurance-agent partners who help people enroll in coverage, and those partners will help us encourage consumers to sign up for coverage early, so they don’t get in a bind when the site is down.”

More Hope for CHIP Program

About 98 percent of Oregon children have health coverage, and CHIP plays a key role in that.

“We’re very concerned about Congress’ failure to reauthorize CHIP on time,” Cowie said.

“Oregon receives $250 million per year in CHIP funding,” he said. It would cost the state $6 million per month to backfill lose CHIP funds.

Allen said the Oregon Health Authority is walking a tightrope when it comes to notifying families that depend on CHIP-funded coverage. Because the agency thinks odds are high that Congress will reauthorize the program, it does not want to send out notice of cuts that may not be enacted. But if funds do run out, the agency wants to give people time to respond.

On Wednesday, the U.S. Senate Finance Committee approved a bill that would reauthorize funding for CHIP, bolstering hopes that the program will continue.

“There’s bipartisan support,” said Jeremy Vandehey, interim health policy and analytics division director at the Oregon Health Authority. “The question seems to be around timing.”

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