Cover Oregon Health Insurance Exchange
Cover Oregon Health Insurance Exchange
Health Benefits Solution, Inc 503-922-2903

 

 

Cascade Mountains
CITIES:  Brightwood, Camp Sherman, Cascade Locks, Cascadia, Chemult, Chiloquin, Crescent, Crescent Lake, Detroit, Diamond Lake, Drew, Estacada, Fort Klamath, Gates, Gilchrist, Government Camp, Idanha, Klamath Agency, La Pine, Lakeview, McKenzie Bridge, Mill City, North Umpqua, Oakridge, Prospect, Rhododendron, Sandy, Sisters, Sunriver, Warm Springs, Welches, Westfir, Zigzag
AREAS:  Crater Lake National Park, Deshutes National Forest, Fremont National Forest, Mount Hood National Forest, Rogue River National Forest, The Three Sisters, Umpqua National Forest, Willamette National Forest, Winema National Forest

Central Oregon
CITIES:  Antelope, Arlington, Bend, Brothers, Condon, Culver, Dufur, Fossil, Grass Valley, Hampton, Lonerock, Madras, Maupin, Metolius, Mitchell, Moro, Mosier, Paulina, Post, Prineville, Redmond, Rowena, Rufus, Shaniko, Spray, The Dalles, Wasco

Northeast Oregon
CITIES:  Adams, Arlington, Athena, Baker City, Boardman, Canyon City, Condon, Cove, Dayville, Echo, Elgin, Enterprise, Fossil, Greenhorn, Haines, Halfway, Heppner, Hermiston, Huntington, Imbler, Imnaha, Irrigon, Island City, John Day, Joseph, La Grande, Lexington, Long Creek, Lostine, Medical Springs, Milton-Freewater, Monument, Mt Vernon, North Powder, Oxbow, Pendleton, Pilot Rock, Prairie City, Richland, Seneca, Summerville, Sumpter, Ukiah, Umatilla, Union, Unity, Wallowa, Weston
AREAS Hell's Canyon

Oregon Coast
North Coast
Astoria, Bay City, Beaver, Cannon Beach, Garibaldi, Gearhart, Hebo, Nehalem, Manzanita, Neahkahnie, Oceanside, Pacific City, Rockaway Beach, Seaside, Tillamook, Warrenton, Wheeler
Central Coast
Depoe Bay, Dunes City, Florence, Gleneden Beach, Lincoln City, Mapleton, Newport, Otter Rock, Reedsport, Seal Rock, Siletz, Toledo, Waldport, Winchester Bay, Yachats
South Coast

Agness, Bandon, Brookings, Charleston, Coos Bay, Coquille, Gold Beach,
Lakeside, Myrtle Point, North Bend, Port Orford, Powers, Wedderburn

Portland and Vicinity
Banks, Barlow, Beaverton, Camas, Canby, Clackamas, Clatskanie, Columbia City, Cornelius, Forest Grove, Gaston, Gresham, Happy Valley, Hillsboro, Lake Oswego, Marquam, Milwaukie, Molalla, North Plains, Oregon City, Portland, Rainier, Sandy, Scappoose, St. Helens, Tigard, Troutdale, Tualatin, Vernonia, West Linn, Wilsonville

Southeast Oregon
Adel, Adrian, Burns, Diamond, Drewsey, Frenchglen, Hines, Jordan Valley, Juntura, Lakeview, Nyssa, Ontario, Plush, Vale

Southern Oregon
CITIES Ashland, Butte Falls, Cave Junction, Canyonville, Central Point, Dillard, Drain, Eagle Point, Elkton, Glendale, Glide, Gold Hill, Grants Pass, Jacksonville, Klamath Falls, Malin, Medford, Merlin, Myrtle Creek, Oakland, Phoenix, Prospect, Riddle, Rouge River, Roseburg, Shady Cove, Sutherlin, Talent, Umpqua, White City, Winchester, Winston, Wolf Creek, Yoncalla
AREAS:  Applegate Valley, Illinois Valley


Willamette Valley
Albany, Alsea, Amity, Aumsville, Aurora, Brooks, Brownsville, Canby, Canyonville, Carlton, Corvallis, Coburg, Cottage Grove, Creswell, Culp Creek, Dallas, Dayton, Detroit, Donald, Dundee, Eugene, Falls City, Gates, Gervais, Halsey, Harrisburg, Independence, Jefferson, Junction City, Keizer, Lebanon, Lowell, Lyons, McMinnville, Mill City, Millersburg, Mt.Angel, Molalla, Monmouth, Newberg, Oakridge, Oregon City, Philomath, Salem, Scio, Scott Mills, Sheridan, Silverton, Sodaville, Springfield, Stayton, St. Paul, Sublimity, Sweet Home, Tangerit, Turner, Veneta, Walterville, Waterloo, Willamina, Woodburn, Yamhill

 

 

 

Cover Oregon - Oregon health insurance exchange

The purpose of this webpage is to help share the information on the Oregon Health Insurance Exchange, and the Affordable Care Act signed by President Obama. All information on this webpage is collected and shared from websites currently explaining progression of the Oregon Health Insurance Exchange including but not limited to http://www.CoverOregon.com Please visit this official website for all and current information.
 
 
 
Key dates in the future:

October 2013 Open enrollment starts. This is when you’ll be able to start shopping for insurance plans at www.coveroregon.com

JANUARY 2014: Coverage begins for plans purchased through Cover Oregon


Press Releases

 

Two Portland-based U.S. health research centers will advise doctors, health plans

Published: Thursday, October 18, 2012, 5:55 AM Updated: Thursday, October 18, 2012, 6:43 AM
ohsurasmussen.jpgOregon Health & Science University

For the next five years, the U.S. government will rely on just 11 health research centers to evaluate which medical practices and treatments work best. And two are based less than five miles apart, in Portland.

In August, the Agency for Healthcare Research and Quality announced the results of the latest round contracting for evidence-based practice centers, essentially Uncle Sam's scientific advisors when it comes to medical guidelines such as for mammograms and prostate screening.

As in past years, one winner was based at Oregon Health & Science University, amid the sweeping medical complex at Pill Hill. But for the first time, a second contract went to a network headed by Kaiser Permanente's Center for Health Research, housed in a squat white building across the Willamette River on North Interstate Ave.

It's highly unusual for one city to be home to two centers, so you can forgive a bit of swagger among those involved.

"Pretty good, huh?" says Dr. Evelyn Whitlock, lead investigator of Kaiser's center. "Makes you feel you're in the middle of something important, maybe?"

 

Kaiserbuilding3800.jpgKaiser Permanente Center for Health Research

And more research funds could flow into the city as a result. The OHSU-based center brought in over $50 million over the last 12 years, says Dr. Roger Chou of OHSU, "so that's a significant amount of money."

Having research institutions plugged into the latest science means best practices can trickle down sooner to Oregonians. In the past, the Oregon center helped state officials evaluate drugs for the Oregon Health Plan and develop guidelines on the treatment of lower back pain, among other things. "I think all this stuff has a direct impact on Oregonians," Chou says.

The centers are essentially research networks. Kaiser and OHSU had collaborated in Oregon's only center, based at OHSU, ever since the federal government set up the system of research partners in 1997. But last year, looking ahead at the next round of contracts with AHRQ, they decided it was time for an amicable split.

OHSU was focused on basic science and biomedical research, while Kaiser, a managed care system, was more interested in putting that research to use on things like prevention and health economics. The two had long used their differences as an advantage. But they decided they had each grown enough to go it alone; it was time to seek new partners.

The new OHSU-based Pacific Northwest Evidence-based Practice Center is a partnership with the University of Washington Center for Comparative and Health System Effectiveness Alliance (CHASE Alliance) and Spectrum Research, Inc., of Tacoma, Wash

The other Portland-based center will be called Kaiser Permanente Research Affiliates, a partnership with Group Health Research Institute in Seattle and the research arm of a Minnesota-based health system called Health Partners Research Foundation.

When OHSU and Kaiser Permanente decided to part ways, they did so knowing they were competing for the same round of contracts, and the government was reducing the number of centers from the previous 14. So there was a possibility one would be awarded a contract and not the other.

"There was anxiety," says Chou. "There was also anxiety knowing that they were going to cut some (centers) and not everyone was going to be renewed."

He and Whitlock say Kaiser and OHSU will continue to collaborate on specific studies. In the world of research, it's not unusual to change partners and find yourself competing with old allies for the same research funds.

"You try to put your best foot forward and you have to just kind of wait and hope," says Chou. "And luckily, both of us got the awards."

-- Nick Budnick

 
October 9th, 2012 - We recently published new content on the Oregon Healthcare News web site and you can view it by visiting www.orhcnews.com

The government hopes bundled payments—a lump sum paid, either prospectively or retrospectively, for a specific set of medical services defined by an episode of care—will increase operational efficiencies and bring health care costs down through standard care protocols, greater coordination, and shared accountability. Barbara Letts and Paul Holden of Moss Adams LLP explain why bundled payments may work well for some providers in "Bundled Payments: A Meaningful and Middle-Ground Solution."

Our other content includes:
 
  • Thirteen Oregon domestic health plans recently reported YTD second quarter 2012 financial reports and most plans did worse than the same time period in 2011. See how all the plans did by downloading our spreadsheet of summarized financial results.
  • Check out the Consultant Marketplace to find companies that can help make your organization more efficient and effective.
  • See our Job Board for the best healthcare opportunities in the U.S.
  • Visit our Library to read all articles published on our web site.
  • New! Join one of our Linkedin Groups to receive job posting announcements from our job board as well as from other healthcare recruiters.

Our web site address is www.orhcnews.com

If this link doesn't work then type http://www.orhcnews.com in your internet browser and go directly to our home page.

Please contact me if you have any questions.

Sincerely,

David Peel
Publisher
Email: dpeel@healthcarenewssite.com
Phone: 425-577-1334
www.healthcarenewssite.com

 

October 1st, 2012 - https://orhix.org/NR_10_1_12.php

News Release – October 1, 2012
 

Oregon health insurance exchange unveils new name, website
 

Salem — In one year from today, Oregonians can visit a new marketplace to shop for health coverage. The name for that marketplace, Cover Oregon, was announced today by the Oregon Health Insurance Exchange Corporation. The corporation was formed by the Oregon Legislature to implement a health insurance exchange in Oregon.

“Cover Oregon will provide a new and better way for Oregonians to shop for health insurance,” said Howard “Rocky” King, Cover Oregon executive director. “We are working hard to ensure we can offer meaningful choice in health coverage options and an easy way to compare plans and enroll through our website.”

Cover Oregon will open on Oct. 1, 2013. Through Cover Oregon, individuals, families, and small employers will be able to compare health insurance plans, access financial assistance to help pay for coverage, and enroll in a plan that best meets their needs. Coverage for plans purchased through Cover Oregon begins on Jan. 1, 2014.

In the meantime, Oregonians can learn more by visiting www.CoverOregon.com. The newly launched site features a calculator where individuals can find out if they might qualify for financial assistance through Cover Oregon, schedules for Cover Oregon’s public meetings, and stories about Oregonians’ experience with health insurance.

“Our goal is to design Cover Oregon in a way that meets the unique needs of Oregonians,” King said. “To that end, we encourage you to visit our website to find out how Cover Oregon may be able to help you and how you can get involved.”


Officials say Court won't derail Oregon health law

 
JONATHAN J. COOPER
 

SALEM, Ore. (AP) — No matter what the U.S. Supreme Court decides about the future of the federal health care law, Gov. John Kitzhaber's ambitious Medicaid overhaul will go forward, state officials said Monday.

But if the court throws out the entire federal law — not just the most controversial parts — officials said the ruling could jeopardize a new health insurance exchange, a marketplace where individuals and small business can shop for coverage starting in 2014.

The Supreme Court is expected to rule this month on the constitutionality of the federal health law's individual mandate requiring everyone to have health insurance or pay a fine.

State officials say the ruling will have only a minimal impact on Kitzhaber's plan to create new coordinated care organizations to manage the care of low-income patients on the Oregon Health Plan. The first coordinated care organizations begin operating Aug. 1, and Kitzhaber hopes they'll slow the growth of health care costs by preventing avoidable hospital visits and reducing waste.

"Whatever happens, we're still moving full steam ahead, and we feel like this is going to be essential regardless of the outcome" at the Supreme Court, said Mike Bonetto, Kitzhaber's health policy adviser.

Federal health officials have tentatively agreed to give Oregon $1.9 billion over the next five years to help pay for the transition to the new model of delivering health care. That money would be unaffected by the Supreme Court's decision, officials insist, because it is authorized under federal laws that predate President Barack Obama's 2010 health law.

The Supreme Court's decision has little bearing on the work to build a coordinated care organization, said Jeff Heatherington, chief executive of Family Care, which has applied to cover Medicaid patients in the Portland area.

"I really believe that we'll just continue to go forward on the CCO development," Heatherington said.

The court's impact on a separate Kitzhaber health care initiative is less clear. The Oregon Health Insurance Exchange will provide a place for small employers, along with individuals who don't get health coverage from a job, to compare plans and shop for coverage. The federal law will give many lower-income Americans a subsidy to help pay for coverage.

If the Supreme Court strikes down the entire federal law, the decision would wipe out more than $60 million in grants that are paying for the development of the exchange. The loss of federal funding would make it very difficult to keep the exchange alive, director Rocky King said.

However, if the court slices up the health care law, throwing out the individual mandate and related provisions but leaving alone the rest of the law, the exchange can still work, King said. But prices would probably be higher, he said.

"As long as the subsidy money is there, I can still get enough enrollments to make the exchange work very well," King said.


 

June 19th, 2012 - http://www.thelundreport.org/resource/consumer_groups_begin_showing_support_for_insurance_exchange

Insurance Exchange’s Small Employer Program Takes Shape

Easing administrative burden for employers is a main focus
By:

Amanda Waldroupe

June 19, 2012—The program and technological infrastructure allowing small employers to purchase health insurance through Oregon’s exchange is beginning to take shape. Making the process easy for employers and reducing administrative burden will be key to its success, according to its staff.

Called the Small Employer Health Options Program and colloquially referred to as the “SHOP Exchange,” employers with 50 or fewer employees will be able to compare and purchase health plans. The exchange, which will act as a one-stop shopping place for individuals and small businesses to purchase affordable health insurance in January 2014, could serve as many as 700,000 uninsured individuals and small businesses—or more, if employers and individuals decide they would rather purchase insurance through the exchange.

A survey released on June, commissioned by the Small Business Majority and Kaiser Permanente, found enormous interest in Oregon’s exchange among small businesses. According to the survey, the number of small employers that would offer health insurance once the
exchange gets underway would jump from 26 percent to 42 percent.
“The goal of the small employer is to create what would be the most desirable marketplace in Oregon for small employers and their agents to access health benefits that offer meaningful choice to their employees,” Damien Brayko, the exchange’s staff person working on the project,
said during a board meeting last week.

Much of the program’s design so far, Brayko told board members, is based on market research and numerous conversations with small business owners, insurance companies, and agents about how employers go about purchasing insurance, what they value in health plans, and what they want in terms of choice.

The SHOP Exchange, Brayko explained with no pun intended, will be a lot like a shopping experience. After employers enter basic information about their business, including income and number of employees, they’ll be able to see, sort and compare the various health plans.

“We don’t want to force them into any one path,” Brayko said.

Employers will choose the plans available to employees, and will be the only ones that employees can choose from.

“It’s the employer’s choice for how much choice to allow their employees,” Brayko said.

The Small Business Majority/Kaiser Permanente survey backs up the emphasis Oregon’s exchange is placing on choice: 63 percent of surveyed businesses want their employees to be able to choose among multiple health plans.

Brayko and other exchange staff are working on ways to make the process as streamlined and simple as possible to reduce the administrative burden. That includes making it easy for employers to renew their health plans, and simplifying invoicing and the payment process.

The exchange staff is also taking a close look at ways to notify business owners about their eligibility for tax credits, Brayko said. The Small Business Majority/Kaiser Permanente survey also found that the majority of small businesses, both in Oregon and California, are not aware of the tax credits currently available to them. In Oregon, 55 percent of businesses were either unaware of the tax credit, or did not apply for it.

“We want to inform every small business,” Brayko said, in part because it could help entice businesses to purchase insurance through the exchange.


 
June 12th, 2012 - http://www.oregonlive.com/health/index.ssf/2012/06/what_oregon_small_business_own.html

What Oregon small business owners want from the state health insurance exchange

Published: Tuesday, June 12, 2012, 6:00 AM Updated: Tuesday, June 12, 2012, 8:39 AM
KITZHABER_HEALTH_CARE_18063641.JPGOregon Gov. John Kitzhaber signed legislation creating the Oregon Health Insurance Exchange Corporation on July 1, 2011.
About 30 percent of small business owners surveyed in Oregon said they're likely to use the state health insurance exchange when coverage begins in 2014. That's a higher proportion than the 26 percent offering coverage now, the survey found, suggesting that the availability of the exchange could help increase the number of small companies offering health benefits.

 
Anticipated usage was 49 percent among business owners who are Democrats, compared with 28 percent among those who are Republicans. The survey, commissioned by Kaiser Permanente and the Small Business Majority, gathered opinions from 200 small business owners in Oregon interviewed by telephone in April and May.

 
Health insurance exchanges outlined in the federal Affordable Care Act are regulated online marketplaces for state residents to comparison shop for coverage. Oregon's exchange will serve individuals and businesses with 50 or fewer employees. In 2016, the exchange will open to businesses with up to 100 employees.

 
Among small employers who plan to offer coverage in 2014, 63 percent said they liked the idea of letting small companies set a defined contribution for health insurance and having employees choosing from among all the insurance carriers in the exchange. Oregon's insurance exchange board plans to offer that feature.

 
Many small businesses aren't taking advantage of a new health insurance tax credit because they don't know about it, the survey found. Under the Affordable Care Act, companies with 25 or fewer employees and paying average annual wages below $50,000, can qualify for tax credits worth up to 35 percent of the cost of health coverage. (The tax credit rises to 50 percent in 2014.)

 
Among Oregon small business owners likely eligible for the credit, only 45 percent knew it existed. Kaiser Permanente found a comparable lack of awareness in California.

 
About half of those potentially eligible for the tax credit in Oregon don't offer health benefits. Among these owners, 61 percent said they would be more likely to use the state health insurance exchange to shop for health benefits if they knew their company qualified for the credit.

 
April 16th, 2012 - http://www.thelundreport.org/resource/insurance_agents_to_play_critical_role_in_oregon’s_insurance_exchange

Insurance Agents to Play Critical Role in Oregon’s Insurance Exchange

At the same time, agents will need special training and have to meet specific criteria to become eligible
By:

Amanda Waldroupe

April 16, 2012--The Oregon Health Insurance Exchange wants to train and use insurance agents to help uninsured individuals and small businesses purchase insurance starting in 2014. But questions remain about the role of insurance agents and their impact on consumers who may rely on them for advice.

During the board’s meeting on Thursday, exchange staff member Kim Wirtz explained that using insurance agents will ensure that the exchange will be able to reach people throughout every part of Oregon, and “assure connection with hard-to-reach populations in the most-cost-effective manner.”

Insurance agents help individuals and businesses pick a health insurance plan that best fits that person or business’ needs. They typically work for insurance companies and are paid a commission, by that insurance company, depending upon how many plans they sell. There are approximately 13,000 licensed agents in the state.

Using the agents makes business sense for the exchange, which can use agents to help people find out about the exchange once it begins providing coverage in 2014, and buy insurance through it. That is essential to the exchange’s long-term success: the exchange is currently funded by a federal grant, but it will have to generate enough revenue to be financially self-sustaining starting in 2014.

According to the exchange’s business plan, a 2.52 percent administrative fee will be the source of that revenue. It equates to about $16 charged to each individual participating in the exchange to remain financially self-sustaining. The exchange must have between 100,000 and 125,000 people enrolled by the end of 2015.

The agents working for the exchange, Wirtz said, will be paid by the exchange itself, which will take the commissions from insurance companies and pay them directly to agents. She also said that agents would be given a special training about the exchange and the plans the exchange will offer. The exchange would also develop criteria that would determine whether an agent would work for the exchange.

Dr. George Brown, the CEO and president of Legacy Health System, and Bruce Goldberg, director of the Oregon Health Authority, both voiced concerns about how much the general public knows about insurance and how insurance agents work.

“There is very little the public, excluding those within the industry, understands or knows about how commissions are paid, what they are, and how they’re paid,” Goldberg said, urging the exchange develop a way for people to “Have the ability for anybody to see what commission is paid for service they gave and how.”

Liz Baxter, who chairs the exchange board, questioned whether people would pay the same premiums regardless of whether they use an agent or not. That same concern was voiced last year by Rep. Mitch Greenlick (D-Portland) during an interim legislative session. “I have a problem with people being charged when they don’t use an agent,” he said. ““They ought to know what they’re paying for. It should not be hidden, or buried in the costs.”

That issue, as well as many other parts of the agent program, is “something we do need to work on,” said Wirtz.

Baxter, the executive director of We Can Do Better, asked how agents will be “removed,” or fired, if they do not perform adequately. She also wondered how the exchange could find particular information about an agent, such as if they speak a second language and could do outreach to minority communities.

Agents, similar to a typical subcontractor, will sign a contract with the exchange that will detail their working relationship and responsibilities with the exchange, Wirtz said, adding that the exchange intends to build “a robust profile” about each agent.

 

Image for this story courtesy of The Oregonian


 
April 2nd 2012 - http://www.thelundreport.org/resource/health_insurance_exchange_seeks_public_input_on_specifics

Health Insurance Exchange Seeks Public Input on Specifics

Exchange staff expect that getting specific feedback about particular areas of the exchange will help them craft the exchange
By:

Amanda Waldroupe

April 2, 2012 -- People have until April 13 to submit responses to Oregon’s health insurance exchange about the top three things they consider most important when choosing a health plan. The exchange launched this survey to get constructive feedback from the public as it begins developing the website that people will use to purchase coverage in 2014.

The exchange staff hopes the answers will guide them to understand how people search for insurance plans, distinguish plans from one another, and their priorities in choosing a plan. Thus far, 65 people have submitted comments.

Lisa Morawski, the exchange’s spokesperson, said the exchange is intentionally asking specific questions to help “guide” the exchange’s development throughout 2012. “We felt like there are certain areas that we want public input on,” she said.

Such a public comment process is expected to be more helpful in getting targeted responses, she said. “We thought we’d get more specific comments if we were asking a specific question.”

Specific questions will be asked “on a regular basis” that reflect what staff members are working on as they prepare to get the exchange ready to offer health insurance to individuals and small employers by January 2014.

People can still give broad comments about the exchange on its website, and during board and community advisory committee meetings. People can also sign up to be on the email list and receive updated information including future meetings.

Having a public comment process with specific questions is another way to reach the general public, said Liz Baxter, who chair’s the exchange’s board of directors and is the executive director of the advocacy organization We Can Do Better.

“So far, [the people giving comment] have really been the folks who have been coming to the board meetings,” Baxter said. “We’re trying to find ways to see how we can open it up. It’s not in place of other strategies.”

If people want a say in what the exchange looks like, the time is now, even though they may not see the result of those decisions until the exchange is launched in 2014. “It will be hard to change some of those decisions in the future,” Baxter said.

Consumer advocates praised the decision by the exchange board to seek public comment on particular topic areas. “It helps focus the conversation,” said Jim Houser, the owner of Hawthorne Auto Clinic and a member of its community advisory committee.

John Mullin, the Oregon Law Center’s lobbyist, said the exchange’s public comment process is “more open-ended and inclusive” than typical public comment processes, which simply seek general feedback.

“It is important to engage the middle class in a way that they will feel welcomed to respond,” he said, particularly because families making up to 400 percent of the federal poverty level (for a family of four, approximately $92,000) will be eligible for the tax credits that will be offered to people who buy insurance through the exchange.

Janice Thompson, executive director of the government watchdog agency Common Cause Oregon, also thinks asking such questions during this stage of the game is appropriate. “Given their stage of development, the kind of targeted public input questions they are asking does not seem inappropriate,” she said. “If there are specific questions that are helpful during program development then you’re not going to get those answers through an open-ended comment period.”

But she also said it’s important to have a more general, open-ended public comment period in the future. “Including an open ended comment period on a draft plan provides opportunities to get input on questions that weren’t asked during the initial program development process,” she said.

Image for this story courtesy of The Oregonian


 
March 30th, 2012 - http://www.opb.org/thinkoutloud/shows/oregon-health-insurance-exchange-check-/

Oregon Health Insurance Exchange Check-in

AIR DATE: Friday, March 30th 2012

Oregon is one of many states moving forward with the federally mandated Health Insurance Exchange, an online site for comparing health insurance plans — like how travelocity and orbitz sites compare air fares and travel packages. Oregon was working on an exchange even before Congress passed the Affordable Care Act. We got an update earlier this year from the exchange's executive director, Rocky King, about how close the site was to launching. Now that the constitutionality of the Affordable Care Act is being considered by the U.S. Supreme Court, we asked King back so we could ask: what if . . . ?

What questions do you have about the Oregon Health Insurance Exchange?


March 8th, 2012 - http://www.opb.org/news/article/q-kitzhaber-signs-health-insurance-exchange/

Q&A: Kitzhaber Signs Health Insurance Exchange

OPB | March 08, 2012 8:31 a.m. | Updated: Aug. 14, 2012 2:25 a.m. | Portland, OR

Contributed By:

 

Governor John Kitzhaber signed Oregon's new Health Insurance Exchange into law today. Kristian Foden-Vencil was at the signing in Portland he’s with me now.

Good afternoon Kristian.

Kristian: Hi.

Beth: The Health Insurance Exchange is one of the Governor's key health policies -- both for the 2012 legislature and for his third term in office. Can you remind us what the 'Health Insurance Exchange' is?

Kristian: Yes. Essentially, President Obama's health care reform asks states to set up their own health insurance exchanges.

Think of them like a 'Travelocity' or 'Expedia' website. But instead of selling vacations, they allow individuals and small businesses to comparison shop for health insurance.

The hope is the exchanges will give small customers the kind of buying power bigger businesses enjoy.

Just to be clear. If you have a job with health insurance, you're not going to need the exchange. But if you're self employed and you want to get coverage, you'll go to the website, or call them up or drop in.

It's a little like a whole new government agency. About 25 people have been hired so far, but to bring in the 300,000 Oregonians who're likely to sign-up in the first year, there could be 150 employees at some stage.

That said, the exchange is not expected to cost the state anything. It'll be paid for by adding a surcharge to the insurance plans that are purchased on the exchange.

Beth: What does the bill Kitzhaber signed Thursday actually do?

Kristian: Well, it's really just another step in the road. The bill that actually set up Oregon's exchange was passed in 2011. A board of directors was chosen and they've wrestling with things like what benefits each insurance company has to offer -- if they want to be on the exchange.

Now, the way to think of it is that the board of directors drew up a business plan. The legislature and now the Governor have given that plan the green light.

So, they'll now have to start setting everything up, like buying all the computers they need.

Beth: What did the governor say as he signed it into law?

Kristian: Well he called it a great day for Oregon. He said the exchange is going to provide significant benefits to small businesses and individuals. It's going to allow people to compare the quality and cost of insurance plans. And, he says it's going to be a great resource for Oregonians:

John Kitzhaber: "It is going to be a central contributor to the success of our larger health care reform effort, by setting the 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."

Kristian: As you know, changing health care is very contentious.

About 20 states, primarily those that lean conservative, are not implementing their own exchanges.

Instead, they're appealing the Affordable Care Act — the federal overhaul -- up to the U.S. Supreme Court. They particularly don't like the requirement that everybody buy health insurance.

That issue is scheduled for oral arguments later this month.

Meanwhile, Oregon and several other states, are moving forward.

The White House has distributed about $700 million to set up the exchanges. Oregon has received about a tenth of that.

But it's no good going on line to look for the exchange yet. They're not scheduled to start until 2014.

Beth: Thank you Kristian. And by the way, we're going to hear more from you in about half an hour. NPR is running a feature on Oregonians and the medical options they choose at the end of their lives?

Kristian: That's right. Oregon's so-called POLST form allows sick and elderly people to say whether they want the full power of medicine brought to bear during their final days, or whether they'd be happier to stay at home and receive comfort measures only.

14 states have already adopted Oregon's POLST form and another 20 are looking at it.


January 30th, 2012 - http://www.opb.org/thinkoutloud/shows/oregon-health-insurance-exchange/

Oregon Health Insurance Exchange

AIR DATE: Monday, January 30th 2012

If there's one area of life that will never cease to be a topic of conversation, it's got to be your health. Last week week we spoke with the head of the Oregon Health Authority about what they mean when they talk about "transforming" health care.

Now we're moving on to the latest on health insurance. The federal governmnent is providing cash for states to set up health insurance exchanges. Oregon was moving on this idea even before it was mandated by federal law. The idea is simple: you should be able to go online, key in some information and come away with a substantive comparison of what kind of health insurance coverage you could buy for what money.

In order for it to go forward, Oregon lawmakers must approve the business plan that the Oregon Health Insurance Exchange (ORHIX) is submitting. The 2012 short session of the legislature begins Wednesday. If it all goes as planned, ORHIX executive director Rocky King says they could have a functioning system to test by about this time next year, with the grand opening in October 2013.

Have you had difficulty in the past deciding on health insurance? If you're currently in the market to buy health insurance, what do you hope the new system will provide?

GUEST:

  • Rocky King: Executive director of the Oregon Health Insurance Exchange
 
January 12th, 2012 - http://www.thelundreport.org/resource/consumer_groups_begin_showing_support_for_insurance_exchange

Consumer Groups Begin Showing Support for Insurance Exchange

Last session, when Senate Bill 99 passed the Legislature, consumer groups expressed disappointment because the exchange wouldn’t have the ability to negotiate insurance rates
By:

Amanda Waldroupe

January 12, 2012 — Leaders of some of Oregon’s most progressive consumer groups signed onto a letter this week advocating for six priorities the staff and board of directors of Oregon's health insurance exchange should have this year as they work to create the exchange.

They include leveraging the buying power of individuals and small businesses to improve the quality of insurance plans and lower costs; accountability and transparency; offering more than one insurance plan; consumer-friendly enrollment processes, and the ability for as many Oregonians as possible to use the exchange.

Rick Bennett, the lobbyist for AARP Oregon, voiced his organization’s strong support when the exchange board met yesterday to discuss the business plan that goes before the Legislature next month.

“We believe that this exchange [has] a tremendous opportunity to provide benefit to our citizens,” Bennett said. “We want to be as supportive as we can of your work.”

For organizations such as AARP Oregon, this represents an about face from what occurred last year when Senate Bill 99, which created the exchange, worked its way through the Legislature. The other organizations include the Oregon Center for Public Policy, Oregon Health Action Campaign, Children First for Oregon, the Oregon Primary Care Association and OSPIRG.

At the time, those organizations refused to support that bill because there were no assurances the exchange would be able to negotiate rates with insurance companies.

“We wanted to see a very strong piece of legislation passed. We were disappointed, and in the end, we could not actually come to support the bill,” Bennett said. “That’s in the past.”

The exchange will become a one-stop shopping place for uninsured individuals and small businesses to learn about, compare and purchase affordable healthcare coverage. It will become operational in January 2014.

“If the exchange is done right, it can help consumers find affordable coverage, and better coverage,” said Laura Etherton, OSPIRG’s healthcare advocate. “We have a lot of hope. It could be top notch.”

Etherton, and other consumer groups, view the exchange’s work as critical this year. Aside from finishing the business plan, its board and staff are laying out the groundwork for developing the web infrastructure needed for consumers to easily navigate and compare plans, as well as other components.

With healthcare costs and insurance rates quickly rising, Etherton said the exchange will play a key role in determining whether costs will continue to rise to the point of collapsing with no one able to afford coverage.

Because of rising rates and premiums, “Individuals and small businesses are hanging on by their fingernails,” Etherton said.

If the exchange can permanently lower rates and, thereby, healthcare costs, it could be a game changer, she added. The worse case scenario is that the exchange turns into a “fancy website making it easier to sell insurance.”

Now Etherton and other consumer advocates seem more convinced that’s unlikely to happen. “It’s clear the exchange is heading in a good direction,” she said.


 
 
Press Releases:
October 1st, 2012 News Release "Source from CoverOregon.com"

Oregon health insurance exchange unveils new name, website
 

Salem — In one year from today, Oregonians can visit a new marketplace to shop for health coverage. The name for that marketplace, Cover Oregon, was announced today by the Oregon Health Insurance Exchange Corporation. The corporation was formed by the Oregon Legislature to implement a health insurance exchange in Oregon.

“Cover Oregon will provide a new and better way for Oregonians to shop for health insurance,” said Howard “Rocky” King, Cover Oregon executive director. “We are working hard to ensure we can offer meaningful choice in health coverage options and an easy way to compare plans and enroll through our website.”

Cover Oregon will open on Oct. 1, 2013. Through Cover Oregon, individuals, families, and small employers will be able to compare health insurance plans, access financial assistance to help pay for coverage, and enroll in a plan that best meets their needs. Coverage for plans purchased through Cover Oregon begins on Jan. 1, 2014.

In the meantime, Oregonians can learn more by visiting www.CoverOregon.com. The newly launched site features a calculator where individuals can find out if they might qualify for financial assistance through Cover Oregon, schedules for Cover Oregon’s public meetings, and stories about Oregonians’ experience with health insurance.

“Our goal is to design Cover Oregon in a way that meets the unique needs of Oregonians,” King said. “To that end, we encourage you to visit our website to find out how Cover Oregon may be able to help you and how you can get involved.”


June 28th, 2012 News Release "Source CoverOregon.com"

Health Insurance Exchange prepares to serve Oregonians next year

Salem – Starting in October 2013, Oregonians will be able to shop for health insurance in a new way. The Oregon Health Insurance Exchange will be a central marketplace where individual consumers and small employers can easily compare plans, enroll, and receive help paying for coverage.

Today, the U.S. Supreme Court ruled to uphold the Affordable Care Act, which provides the start-up funding necessary for the Exchange to be ready for open enrollment and provides Oregonians with tax credits and other financial assistance to help pay for plans through the Exchange.

“The Exchange will help make insurance more accessible for Oregonians, including the more than 600,000 who are uninsured,” said Howard “Rocky” King, executive director of the Oregon Health Insurance Exchange. “We are committed to continue working with consumers, small employers, insurance carriers, and others to ensure we develop an Exchange that meet’s Oregon’s unique needs.”

The Exchange has recently added a calculator on its website where Oregonians can estimate how much they may be able to save through the tax credits and other assistance that will be available through the Exchange in 2014. The calculator is available at http://www.orhix.org/calculator.php.

In addition to connecting Oregonians with financial assistance, the Exchange will provide:

  • Ability to compare plans “apples to apples” and sort plans by criteria that is important to individual consumers.

     
  • Trusted information and assistance. The Exchange will provide information on how to best use health benefits to improve health as well as a network of specially trained customer service staff, insurance agents, and community partners that will help guide Oregonians in all parts of the state.

     
  • Seamless eligibility and enrollment process. With a single application, Oregonians can find and enroll in the health plan that best meets their needs.

     
  • Innovative plan options and simplified plan administration for small employers. Small employers with 50 or fewer employees can allow their employees to choose an insurance company and plan through a defined contribution model.

For details on how the Exchange is preparing for open enrollment, visit the Exchange timeline at: http://www.coveroregon.com/pdfs/orhix_roadmap.pdf.

For more information about the Exchange, including public meeting schedules and contact information, visit http://www.coveroregon.com.


May 16th, 2012 News Release "Source from HHS.gov website
FOR IMMEDIATE RELEASE
May 16, 2012
Contact: HHs Press Office
(202) 690-6343

More states work to implement health care law

Illinois, Nevada, Oregon, South Dakota, Tennessee and Washington receive grants to establish Affordable Insurance Exchanges

Health and Human Services (HHS) Secretary Kathleen Sebelius announced today that Illinois, Nevada, Oregon, South Dakota, Tennessee and Washington will receive more than $181 million in grants to help implement the new health care law. The grants will help states establish Affordable Insurance Exchanges. Starting in 2014, Affordable Insurance Exchanges will help consumers and small businesses in every state to choose a private health insurance plan. These comprehensive health plans will ensure consumers have the same kinds of insurance choices as members of Congress. Including today’s awards, 34 states and the District of Columbia have received Establishment grants to fund their progress toward building Exchanges.

HHS also issued two guidance documents today to help states build Affordable Insurance Exchanges.

“States across the country are implementing the new health care law,” said Secretary Sebelius. “In 2014, consumers in every state will have access to a new marketplace where they will be able to easily purchase affordable insurance.”

Today, the Department released:

  • New resources for states: The six new Exchange Establishment grant awards to Illinois, Nevada, Oregon, South Dakota, Tennessee and Washington total more than $181 million. This round of awards brings the total of Exchange-related grants provided to states over the last two years to more than $1 billion. Illinois, Nevada, Oregon, South Dakota and Tennessee today have been awarded Level One Exchange Establishment grants, which provide one year of funding to states that have begun the process of building their Exchange. Washington is the second state to be awarded a Level Two Establishment grant, which is provided to states that are further along in building their Exchange and offers funding over multiple years.

    In 2010, 49 states and the District of Columbia received Exchange Planning grants totaling more than $54 million; in 2011, seven states received more than $249 million in Early Innovator grants; and to date, 34 states and the District of Columbia have received more than $856 million in Establishment grants.

    States can apply for Exchange grants through the end of 2014, and these funds are available for states to use beyond 2014 as they continue to establish Exchange functionality. This ensures that states have the support and time necessary to build the best Exchange for their residents.

    To see a detailed state-by-state breakdown of grant awards and what each state plans to do with its Exchange funding, visit our new map tool on HealthCare.gov - http://www.healthcare.gov/news/factsheets/2011/05/exchanges05232011a.html

  • New guidance for states: Today’s guidance includes an Exchange Blueprint states may use to demonstrate how their Affordable Insurance Exchange will work to offer a wide range of competitively priced private health insurance options. The Blueprint also sets forth the application process for states seeking to enter into a Partnership Exchange. If a state chooses to operate its own Exchange or a Partnership Exchange, HHS will review and potentially approve or conditionally approve the Exchange no later than Jan. 1, 2013, so it can begin offering coverage on Jan. 1, 2014. To see the state Exchange Blueprint, visit http://cciio.cms.gov/resources/other/index.html#hie
  • Exchanges in every state: Consumers in every state will have access to coverage through an Affordable Insurance Exchange on Jan. 1, 2014. If a state decides not to operate an Exchange for its residents, HHS will operate a Federally-facilitated Exchange (FFE). This guidance describes how HHS will consult with a variety of stakeholders to implement an FFE, where necessary, how states can partner with HHS to implement selected functions in an FFE, and key policies organized by Exchange function. To see the guidance on the FFEs, visit http://cciio.cms.gov/resources/regulations/index.html#hie

The Department will conduct implementation forums in the coming months to work with states and stakeholders on their questions and the work to be done in building Exchanges. The Department will also engage in consultation with Tribes, Tribal Governments, and Tribal Organizations on how Exchanges can serve their populations.

For more information on these implementation forums, visit http://cciio.cms.gov/resources/factsheets/index.html#hie

For more information on Exchanges, including fact sheets, visit http://www.healthcare.gov/exchanges.


March 9th, 2012 News release "Source Oregon.gov"
 
Governor Kitzhaber signs bill to create new health insurance marketplace
(Salem, OR) —
Governor Kitzhaber on Thursday signed HB 4164, which paves the way for the Oregon Health Insurance Exchange, a central marketplace where individuals and small employers can shop for insurance plans and access federal tax credits to help pay for coverage.

HB 4164 approves the Business Plan for the Exchange, which will be available to Oregonians in October 2013 through an easy-to-use website, toll-free phone number as well as through insurance agents and community-based organizations.

“The Health Insurance Exchange is a key part of health reform in Oregon,” said Governor Kitzhaber. “Not only will the Exchange provide Oregonians with the ability to compare plans apples to apples, it will set standards for plans that focus on improving health and quality and lowering costs.”

The Exchange will offer innovative health plan options for small employers that are simple to administer, making it easier for them to offer coverage to their employees.

“Offering health insurance to their employees is extremely challenging for Oregon’s small businesses,” said Governor Kitzhaber. “The Exchange will allow employers to offer more choice to their employees and access expanded federal tax credits to help pay for premiums.”

The Exchange will continue to seek public input through its Board of Directors meetings and website (http://www.orhix.org/) as it implements its Business Plan and prepares for October 2013 open enrollment. By January 2013, the Exchange must receive federal readiness certification. Enrollment in Exchange plans will begin January 1, 2014.

HB 4164 is one of 38 bills signed by Governor Kitzhaber following the end of the February legislative session.
September 21st, 2012 News release "Source Oregon.gov"

Governor Kitzhaber applauds Senate confirmation of Oregon Health Insurance Exchange Board

Liz Baxter to serve as its Chair
 

(Salem, OR.) - Governor Kitzhaber today applauded the Senate for confirming his nominees to the Oregon Health Insurance Exchange Board.

"I am pleased the Senate confirmed this talented and diverse group of Oregonians whose range of experience will serve the state well in our efforts to improve the delivery of health care by ensuring that individuals and small businesses have access to affordable, quality health insurance in the private market," said Governor Kitzhaber.

The Board will oversee the development of Oregon's Health Insurance Exchange, a central marketplace where individual Oregonians and small employers can compare the quality and value of insurance plans on an apples-to-apples basis and easily enroll in coverage that is affordable. The Board of Directors will submit a formal business plan for the Exchange no later than February 1, 2012, for approval by the Legislature.

Health Insurance Exchange Board Members:

Chair: Liz Baxter, Executive Director of We Can Do Better, a non-profit organization focused on improving health care and health outcomes for Oregonians.

Vice Chair: Teri Andrews, of Corvallis, Owner of CG Industries, a small business in Albany

Bruce Goldberg, M.D., Director of Oregon Health Authority

Teresa Miller, Administrator of the Insurance Division, Oregon DCBS

Ken Allen, Executive Director of Oregon AFSCME Council 75

Aelea Christofferson, Owner of ATL Communications, a small business in Bend

Jose Gonzales, Principal Broker of Tu Casa Real Estate Corporation, a small business in Salem

Gretchen Peterson, Vice President of Human Resources of Hanna Anderson in Portland

Dr. George Brown, Chief Executive Officer of Legacy Health System