Highlight on Oregon: HealthCare.gov 2016 Oregon enrollment has highest increase of any state

The Oregon Department of Consumer and Business Services (DCBS)  has announced that Oregon had the largest rate of increase in 2016 enrollment of any state that uses the federal health insurance marketplace. The Oregon DCBS reports that more than 147,000 Oregonians signed up for health insurance through HealthCare.gov during the open enrollment period that ended January 31, 2016. Oregon’s enrollment for 2016 is about 31 percent higher than last year, when about 112,000 people signed up. Seventy percent (about 103,000) of those who enrolled in 2016 are receiving advance premium tax credits averaging $256 per month to help pay for their premiums.

State Marketplace

The Oregon DCBS, which also runs the Oregon Health Insurance Marketplace, also reports that the Oregon Senate confirmed Governor Kate Brown’s appointees to the Oregon Health Insurance Marketplace Advisory Committee on Monday, February 15, 2016. The advisory committee will provide guidance and feedback to the Oregon DCBS about issues affecting Oregon’s health insurance marketplace, such as outreach, customer feedback, and insurance plan affordability. In addition, it will provide annual reports to the Oregon State Legislature and hold open meetings that provide a forum for public discussion.

Consent Order Issued

The Oregon DCBS issued a consent order on February 8, 2016, that outlines a plan for Moda Health Plan, Inc., (MHP) to stabilize its financial position and continue to serve its customers. As a result, the department has lifted a January 27, 2016, order of supervision and MHP will resume selling and renewing health insurance policies to both individual and group customers in Oregon.

On January 27, 2016, the Division of Financial Regulation at the Oregon DCBS announced that it had issued an order of supervision to MHP because of concerns over its financial condition. The order prohibited MHP from issuing new policies or renewing current policies in the individual market, and from adding new groups. The order also required the company to obtain sufficient capital and present a business plan to DCBS that clearly demonstrated that it could operate in sound financial condition going forward.

As of September 30, 2015, MHP had enrollment of about 244,000 Oregonians in the commercial market, including 95,000 in the individual market, 16,000 in the small group market, and 129,000 in the large group market. Moda also has members in the associations and trusts market. In addition, Eastern Oregon Coordinated Care Organization (EOCCO), which serves Oregon Medicaid members and is owned by MHP, serves 48,000 Medicaid members.

The steps outlined in the consent order will generate more than $170 million for MHP, providing sufficient capital and surplus to continue operations. That means all MHP policyholders—including those who have individual, group, Medicaid, and Medicare supplement plans—will be able to keep their plans. All premiums, cost-sharing, networks, and benefits will remain the same.