Defenders of the Affordable Care Act have often pointed to the state health-care exchanges for examples of the law’s success, especially in New York and California, which account for more than 40 percent of all sign-ups.
There’s one state exchange, however, that is lagging far behind its peers.
The Beaver State’s exchange, Cover Oregon, has succeeded in signing up 44 people, according to federal data. No, not 440 — that would about equal the performance of Hawaii’s exchange — but less than 50, even though Cover Oregon claims it has enrolled 730. The poor-performing exchange has suffered setback after setback.
What caused the problems? It wasn’t resistance from the state government, a criticism commonly leveled at states that have failed to set up their own exchanges. Democrats control both chambers of the legislature, and Democratic governor John Kitzhaber was an emergency-room physician for 14 years. Nor was it a lack of funding. A bouncy commercial for the exchange may declare that Oregonians are “free to be healthy,” but the exchange has been far from cost-free: All told, the state has spent over $300 million in federal grant money on Cover Oregon.
Many of the exchange’s problems have to do with its website. After taking over the website from the Oregon Health Authority in May, the exchange discovered it had serious flaws. In mid November, the exchange’s former executive director, Rocky King, told a pair of legislative panels that contractors had insisted the site was 80 percent complete, but in fact only a tenth of it had been built correctly. The site would not be tested in full until the fall, a situation that King compared to trying to test a model railroad with a section of track absent.
When exchange officials finally had the site tested in September, they discovered that it still wasn’t ready, but they assured the public otherwise. According to acting executive director Dr. Bruce Goldberg, who took over Cover Oregon when King took a three-month medical leave, the site won’t launch until the end of January.
The site has proven so difficult to get right partly because of its scope. Cover Oregon envisioned its site as a single portal through which Oregonians could enroll in Medicaid, commercial insurance plans, and a smattering of public-assistance programs. Currently, it’s unable to sign anyone up online through a portal. Users must print out a 19-page paper application, which they can send in via fax or mail (these paper applications can be submitted online — but only if one is using Internet Explorer). Even then, signing up can be a chore.
During the questioning by the legislative panels, one Democratic lawmaker, state representative Brian Clem, complained that he had been unable to fax in an application because the exchange’s fax line was busy each of the five times he and his family had tried it. He had been attempting to sign up his mother-in-law, who has Lou Gehrig’s disease and had lost her insurance. The exchange added dozens of fax lines a few days later.
But even if the exchange receives a paper application and everything is in order, it will join roughly 65,000 other paper applications that the exchange has already received. Cover Oregon has processed fewer than 10,000 such applications, even after hiring 400 temporary workers specifically to handle the task.
Then, if the application has errors — and in a press briefing Tuesday morning, Goldberg revealed that nearly half of them do — the exchange will follow up with the applicant so that he can correct the errors. Dr. Goldberg says that, so far, the exchange has accidentally sent out applications for revision to incorrect addresses at least four times, revealing applicants’ personal information to a third party. The exchange blamed the mistakes on a process that made it possible to pick up the wrong application from a shared printer.
For Cover Oregon, it seems that when it rains, it pours — or rather, freezes.Water pipes burst this past Sunday in the building that processes applications, forcing a temporary work stoppage and providing an apt metaphor: Oregonians have been soaked.
— Sterling Beard is an editorial associate at National Review.