The Patient Protection and Affordable Care Act (Obamacare) is the much debated federal health insurance law signed by President Obama in 2010. Obamacare has two major components—the expansion of Medicaid, which in Oregon is known as the Oregon Health Plan (OHP), and the requirement in all states to provide access for individual or small group health insurance plans via a health insurance policy exchange, which Oregon calls “Cover Oregon.”
There was wide concern about American citizens losing their right to retain their chosen health insurance policies and physicians when Obamacare was being debated.
To allay such fears, President Obama promised the American public,
“…no matter how we reform health care, we will keep this promise to the American people: If you like your doctor, you will be able to keep your doctor, period. If you like your health-care plan, you’ll be able to keep your health-care plan, period. No one will take it away, no matter what.” Click here
Just last year (2012) President Obama reiterated the promise when he stated,
“If [you] already have health insurance, you will keep your health insurance.” Click here
Oregon’s own Senator Jeff Merkley likewise assured Oregonians with this statement on his website:
“If you like your current health insurance, you will be able to keep it. And you will be able to continue seeing your current doctor. Health care reform would simply give you the choice to change insurance providers if you so choose.” Click here
Even Governor John Kitzhaber joined the chorus of promises to Oregonians who were concerned
about the consequences of the federal health care law and its implementation in Oregon. Governor Kitzhaber said,
“We all felt from the beginning that it was important for the state to implement and operate its own exchange rather than default to the feds. It is going to be a central contributor to the success of our larger health care reform effort, by setting the standards for plans that they reduce cost, that they maintain quality and that everyone has access to the kind of coverage that they need and deserve in this state.” Click here
It has now become clear: the truth about Obamacare is substantially different from the promises our politicians repeatedly made.
Effective January 1, 2014, provisions of Obamacare require most private insurance policies to include a list of medical care benefits that have never been covered in many existing policies. As a result of being out-of-compliance with the federal law’s mandated health coverage requirements, approximately 145,000 Oregonians are having their present insurance policies cancelled. The vast majority of these Oregon policies will be cancelled effective December 31, 2013. Just yesterday the Oregon Insurance Commissioner has reversed her position and joined with the President in granting Oregon health insurance companies the power to extend current policies for another year—to December 31, 2014.
Such a pronouncement is political theater, a partisan maneuver intended to transfer blame from the administration to health insurance companies if they do not retract their cancellation notices and reinstate existing policies. In reality, insurance companies have spent two years calculating policy provisions and premiums to enact Obamacare effective January 1, 2014. The cancellation notices have already been sent and the federal law sets the effective date for January 1, 2014. A Presidential Executive Order or a directive from a state’s insurance commissioner cannot change the course of this out-of-control health care train.
Many of the policies being cancelled can be replaced by new and more expensive policies issued by the same health insurance company. But others, such as the 11,000 Oregonians who previously have been covered in the Oregon Medical Insurance Pool (OMIP), are scheduled to lose their benefits on December 31, 2013. OMIP is a special pool of chronically ill, special risk patients whose medical costs are shared by all the health insurance companies providing health policies in Oregon.
Betrayed are those OMIP patients and other Oregonians who cannot afford to pay substantial Cover Oregon policy premium increases and who are ineligible to receive government subsidies or do not want to accept them. The success of Obamacare and Cover Oregon depends on citizen acceptance of government subsidies to justify the governmental intrusion into the private health care decisions of all Oregonians.
To avoid gaps in health care insurance coverage, resulting from the cancellation of current policies on December 31st, new Obamacare compliant health care insurance policies must be issued effective January 1st. To do so, more than 100,000 Oregon applicants for the new policies must accomplish the following four steps by the cut-off date of December 15, 2013:
1. Complete a complex 20 page application;
2. Determine eligibility for government subsidies of health insurance premiums;
3. Select a policy from multiple options, at premiums that often will be substantially higher
than those paid for present health policies that are being replaced; and,
4. Obtain the insurance coverage from a qualified health insurance company.
It was intended that effective October 1, 2013, all four of these steps were to be completed smoothly, quickly and seamlessly on the www.coveroregon.com website. Unfortunately, the goal exceeded Cover Oregon’s ability to deliver. The facts clearly show Oregon’s insurance exchange was not ready to be implemented. Cover Oregon’s regular Quality Assurance reports and monthly status reports repeatedly showed major inadequacies in the project. Political pressure forced the Cover Oregon technicians to go on-line when they knew or should have known the system was not ready.
The Cover Oregon train wreck was not unforeseen. I sounded an early alarm in a warning sent to the Governor and my legislative colleagues in September 2012.
Thus, Cover Oregon’s inadequacies were identified regularly and its catastrophic failure was fully anticipated. With proper leadership, planning and execution Oregon’s expensive Obamacare disaster could have been avoided.
Nevertheless, to chart a better course for the future, Oregon citizens deserve answers to the following questions:
Why was Cover Oregon allowed to go on-line when it was known it was not ready?
Why were the additional staff not added and trained before October 1, 2013, when it was known the system would not be able to process the applications on-line?
What has been spent so far on Cover Oregon?
How much will it cost to make Cover Oregon’s fully functional?
Where will the money come from to pay for system completion, corrections and manual processing of applications in the weeks and months to come?
How will coverage be provided for those who are uninsured as of December 31, 2013?
Today, only 19,000 written applications have been received, and each of them must be manually processed. In order to process all these applications—which must be completed by December 15th to provide insurance coverage effective on January 1, 2014—between 200 and 400 new employees are frantically being hired and trained.
Not a single Cover Oregon applicant has completed Oregon’s Obamacare health insurance enrollment process. Click here
There has been some confusion in news reports and statements made by various officials about thousands of Oregonians who used to be uninsured and are now being signed up for the Oregon Health Plan/Medicaid. In addition to the private and small group health policies made available through Cover Oregon, Obamacare also allows Oregon to enroll more low-income people onto the Oregon Health Plan/Medicaid program. An estimated 250,000 Oregonians might qualify to now get such Medicaid health coverage.
While Cover Oregon struggles to correct the technical glitches and to hire and train hundreds of temporary employees who will process health care insurance applications manually for individuals and small business groups, the Oregon Health Authority (OHA) has already signed up 70,000 additional low income Oregonians onto the Oregon Health Plan/Medicaid program.
Conclusion. As one of the leaders on the legislature’s budget committee, for more than two years I have been monitoring the various Quality Assurance and progress reports for Cover Oregon. Repeatedly, questions have been raised about the QA’s warnings, and repeatedly assurances were given by the Cover Oregon staff. Those providing legislative oversight repeatedly pointed out the risks of catastrophic failure, but to no avail. In government, as in life, outcomes are what count, not well-intended promises.
We should continue to hold the Governor and the Cover Oregon staff accountable as the Obamacare fiasco unfolds. Oregonians were told this was going to be an effective transition to the new health care law. The process at this point has been a disaster, and I predict the worse is yet to come.
P.S. In all fairness, to help correct the flawed roll-out of Obamacare in Oregon, Cover Oregon will host a series of “Application Fairs” in communities across Oregon. If your health insurance coverage depends on enrolling through Cover Oregon, I highly recommend you gather the suggested materials and attend one of the Application Fairs.