Report on Cover Oregon Consumer Advisory Committee

by Roberta Hall,  Oct. 17, 2014

Despite all the bad news about Cover Oregon, its CAC met Oct. 17, with new Executive Director Aaron Patnode in attendance throughout. As a final comment, he reported that there is NO option for any state NOT to have an exchange, though Cover Oregon likely will be housed under another agency. A brief update concerning 2015 and for details contact member Bobbi Hall at rlhall@peak.org:

Budget will be 12 to 15 million dollars, down from 90 million this year; expanded Medicaid enrollees who entered via Fast-Track (Food-Stamp recipients) will need to apply, but other current enrollees will be sent a form to certify that their financial situation has not changed (or has); most people will apply via Healthcare.gov; new OHP clients can enroll anytime as can tribal members and certain others, but for most, enrollment begins Nov. 15; Navigators as well as Agents are receiving training on the use of Healthcare.gov. This past year approximately 100 small businesses (with 2 to 50 employees) were enrolled; they did not use the website and again will enroll directly but the federal government has told Cover Oregon that internet access must be ready for these businesses before the end of 2015.

Main news is the numbers: Medicaid increased 58% this year, from 614,000 to 976,000; about 77,000 Oregonians enrolled in a Qualified Health Plan. Currently  about 1,694,657 people are in either OHP or Medicare, out of 3,961,514 people so that makes ~43% covered by what is primarily federally-paid health insurance. About 5.1% of the population now lack health insurance (down from 14%) while about 5.5% have private insurance and ~46.5% have group insurance (mostly through employers). Much insurance covers an average of 70% of health care costs, however. 

Letter: On Behalf of Cover Oregon

While advocating for publicly funded universal health care, MVHCA is also taking a keen interest in the roll out of the ACA. Roberta Hall serves on the Cover Oregon Consumer Advisory Committee and keeps us informed of their activities. Here is Roberta's Letter to the Editor Published in the Oregonian on August 30, 2014.

Affordable Care Act: As a member of Cover Oregon's Consumer Advisory Committee, I am concerned that only the costs of Cover Oregon are noted in The Oregonian's coverage ("Cover Oregon bill keeps on growing," Aug. 29). Yet thanks to the Affordable Care Act, individuals are not denied coverage due to pre-existing conditions and offspring are covered on their parents' plans until age 26. More than 300,000 people have received coverage due to expanded Medicaid (Oregon Health Plan). Our politicians lacked the political will to enact universal coverage wherein the costs of enrolling people would be minuscule, and elected to simply reform and keep insurance. Still, Oregon compares very favorably with other states on reducing the uninsured rate and on the low cost of insurance through the exchange. Let's celebrate this, and move ahead.

Roberta Hall

Cover Oregon April Consumer Advisory Committee Notes by CAC and MVHCA member, Roberta Hall

Introduction by Ron Green

Roberta Hall, who sits on the Consumer Advisory Committee of Cover Oregon, is known to many for her interviews aired on KBOO, and for media coverage over the years in the area of health care issues. She has the task this month of reporting her observations that Cover Oregon is asking for input from the community and at the same time that CO doesn’t seem to be taking that input seriously.

In my local paper this morning’s editorial once again cited the problem of Cover Oregon’s website, tying it to the Affordable Care Act as a campaign issue for this fall’s elections. Not surprisingly, the main point of the piece was Governor Kitzhaber’s vulnerability to opposition political ads, rather than answers to questions about Oregonians’ health care. Nevertheless, even local papers are acknowledging that big numbers have been enrolled through the paper system, and that Coordinated Care in Oregon is and will be transformative for all of us in the long run. And despite their desire for a political horse race, reporters and editors are digging a little deeper. Perhaps they’ll eventually start to question some assumptions about for-profit health insurance and what value it brings to the equation.

Bobbi Hall’s report doesn’t deal in spin. Like all of us at MVHCA, she wants to see a truly universal system that covers everyone without silvers and bronzes, eligibilities, deductibles and co-pays. But she works hard on her committee to help Cover Oregon, a market-based compromise of a system, do right by Oregonians who’ve signed up in good faith. When it comes to trusted information about health care transformation, you can rely on her.

Ron Green, Chair

Mid-Valley Health Care Advocates

 

Report by Roberta Hall ; No Especially Good News This Month.

At the Cover Oregon Consumer Advisory Committee April 4, the chair of Cover Oregon’s board, Liz Baxter, said she wants our committee’s help in suggesting changes in how Cover Oregon (the board, the committee, and probably everything else) works. I had a ready suggestion. I said that we are the board’s eyes and ears in the community and we can fill that role; I went on to say what I heard: Too many people who applied in November and December and were judged qualified for the Oregon Health Plan have still, 3 months after presumed enrollment time, received NO enrollment papers. I and another member raised this issue a few more times during other parts of the meeting and what we learned made little sense.
For some reason, once certified, many who applied in 2013, as they were asked to do, have had their papers sent to the Medicaid Management Information System (MMIS) and apparently, from what we were told by a high-ranking policy officer, there they sit. Meanwhile, some people who have used an agent in the last month or six weeks, and been determined for OHP coverage, have received enrollment cards. I asked why, saying that it is an accepted principle that people standing in line are treated in the order they enter, whether it is standing in line to place an order from a take-out restaurant or something else. I asked if the early people could reapply, and was told both by an agent who has helped other people enroll and by the Cover Oregon staff that they CO says they should NOT do it. Clearly, the interface between Cover Oregon and the Oregon Health Authority (which manages OHP) is not working properly and neither group is taking responsibility for the promises made. We were not given any assurance that this "gap" was seen as a problem by Cover Oregon. To me personally, this is more bothersome than many other snafus that have arisen because of the poor management at Cover Oregon.
I asked whether the treatment of the OHP qualified people was because the efforts are being concentrated on the applicants for commercial products, but was told that is not the case. I am bewildered. Humans made this system; humans can intervene to over-ride it, is my view. I must hasten to say that in many other respects, Cover Oregon employees deserve credit for their industriousness, but they, like the public, must be dis-spirited. Despite the problems, more people are being enrolled. The total numbers we CAC members were given Friday the 4th of April are: about 130,000 in OHP on fast track (those who were enrolled in the Food Stamp program and did not go through the exchange); about 141,000 in OHP; and about 59,000 in commercial or private insurance.
Yet the Oregon exchange site is still not working and managers seem intent on not making adaptations to the way they want it to work even though at least one of their consultants, Deloitte Development, has advised doing it, and I believe First Data also wants them to at least consider other options. An Oregonian columnist, David Sarasohn, who often has an ironic twist to his essays, had little of his usual humor in a column that appeared on March 26, in which he reviewed First Data’s research report on what went wrong by suggesting that the CO IT system be dumped. On April 6 he followed this with a report that Maryland, which also has had very serious problems with its launch, has decided to adopt and adapt the system of Connecticut, which is one of several that is working much better. Sarasohn ended: “Oregon doesn’t need to have Connecticut’s system. But it would be good to have Maryland’s deciseveness.”  Given that it is estimated that continuing to try to fix the current system will take  almost 2 years, who can disagree?