Skip to content

Health Care Reform:

Health Insurance & Affordable Care Act

Oregon Exchange Still Struggling

continued...

The paper application is 20 pages long and asks for everything from names and the number of people in your household, to pension contributions and alimony payments.

Cover Oregon’s Fauver says applicants need to fill it in and send it back. "And then we do an eligibility determination in house, on their behalf." 

That means Cover Oregon staff comb through documents that show at what income level someone becomes eligible for individual insurance with a tax break or for Medicaid. The sproadic functionality of the federal government’s website means this eligibility check is a problem. But Cover Oregon’s software is also troublesome. 

"When we run a test case, a test household to determine eligibility, most of the time it works just fine. But there are times when it doesn't,” says Fauver. “It tends to happen more often with more complex households."

So Fauver says, when the computer system is working, applicants are going to get one of three responses: Eligible, not eligible or pending -- meaning further communication with Cover Oregon staff is necessary. "We need to get to a place that we are assured that when the system gives a determination, that it’s correct."

Cover Oregon hopes to avoid what happened to their northern neighbors. Washington State's exchange recently informed 8,000 applicants that they did not, in fact, qualify for as large a tax credit as they'd been told.

But back at Cover Oregon, let's say everything is fine and an applicant is eligible for a tax credit. Then, says Fauver, "We send them a packet that includes the amount of the tax credit; the different plans that are available to them; and the costs of those plans-and a form that they can fill out to say, I want plan A. Then they sign that form and send it back to us."

All of this on paper.

Cover Oregon's current guess on when the site will be fully running is by the end of November. So far, it has a stack of 7,300 paper applications, with more coming in each day. It has 45 days to process each one, but it hopes to do it quicker.

Thu, Oct 31 2013

Loading …
URAC: Accredited Health Web Site TRUSTe online privacy certification HONcode Seal AdChoices