Policy: Entitlements

Cover Oregon woes could mean delays for sickest

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Politics,Associated Press,Oregon,Medicare and Medicaid,Entitlements

PORTLAND, Ore. (AP) — A month after Oregon's problem-plagued online health insurance marketplace has failed to enroll a single person, concerns are mounting that some of the most vulnerable Oregonians may face a break in coverage if they don't enroll within the next month and a half.

To date, the state has received just 4,260 paper applications as part of the national health care overhaul law, and the Cover Oregon website still can't tell people what subsidies they are eligible to receive.

Though Cover Oregon officials say they're working to resolve the problems, they declined to name a date when they expect the website will be functional and they could not explain how they plan to enroll thousands of people within a short time span. Oregon has an estimated 600,000 uninsured, though officials say about 200,000 are expected to sign up through 2014.

The situation is most dire for about 11,000 Oregonians who are part of the state's high-risk insurance pool — a program for those rejected by private insurance carriers because of pre-existing conditions such as cancer, diabetes, or severe heart conditions.

These sickest of residents will see the state's insurance pool dissolve by year's end, because denying coverage due to pre-existing conditions is no longer allowed under the Affordable Care Act.

If they don't meet a Dec. 15 deadline to enroll, they will find themselves without health insurance on Jan. 1.

"When you're chronically ill, you have medical needs, you have a lot of specialists you need to go to on a regular basis. In our case, it could be tragic if we miss the Dec. 15 deadline," said Lake Oswego resident Cynthia Johnson, 57, a breast cancer survivor who also has chronic fatigue syndrome and is insured through the pool.

Thousands of other Oregonians who have private health insurance could see their plans expire by the end of December and could be moved by their carrier into a plan with lesser benefits and higher costs — unless they use the exchange to enroll in a new plan.

This week, the Obama administration granted a six-week extension for Americans to sign up for coverage and avoid the tax penalties. And although open enrollment lasts until March 31, anyone who wants their new insurance to start Jan. 1 must abide by the Dec. 15 deadline.

For now, trained insurance agents and application assisters at government and nonprofit organizations are helping people with the paper application process.

Oregon Medical Insurance Pool administrator Don Myron said the program is working with Cover Oregon on how to speed up enrollment for its members. Mailing them hard copies of the application and offering more help with filling them out may be another option, Myron said.

But some of those insured through the pool may be too sick to open mail or to realize they must meet a deadline, Johnson said. They also will need more time to review their options — many will be shopping for insurance for the first time in years.

Johnson, who works as a part-time self-employed consultant, said she hasn't filled out an application yet, because she's waiting until Cover Oregon's online glitches are fixed.

"It's exciting to be able to finally get insurance," Johnson said. "I have faith that Cover Oregon will figure out how to enroll us."

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