Rep. Richardson's Newsletter
November
15, 2013
Cover
Oregon and the Obamacare Crisis
 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.
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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
today 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.
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.
Sincerely,
Dennis Richardson
State Representative
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.
