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?