After over a year of set-backs, glitches, unanticipated costs, and missed deadlines, the fate of the website for Oregon’s health insurance exchange, Cover Oregon, may soon be sealed. On April 10, 2014, the board of the health insurance exchange was scheduled to meet and some sources have predicted that, at that time, the board could make the decision to put an end to the project that has been in the works since August of 2011. Earlier reports have indicated that the number of bugs in the system have risen rather than fallen, the cost and time needed to resolve the website’s remaining issues are significant, and, still, Cover Oregon remains the only exchange in the country that does not provide the opportunity for complete self-enrollment in a single-sitting on its website. The Governor of Oregon, John Kitzhaber, has maintained that the issue with Cover Oregon is a technical one, not a policy one, and that the issues have not prevented the state from using alternative avenues to enroll individuals for health coverage. A review of the evolution of the website since its inception, however, shows that the decision to “scrap or salvage” the exchange may not be an easy one.
Bugs and Other Failures
According to a report released in February of 2014, when coveroregon.com opened for business on October 1, 2013, it was not a fully functioning website. According to recent reports, the same is still true, as the website does not allow individuals to enroll in coverage and determine eligibility for tax credits at the same time. Specifically, oregonlive.com has reported that officials from Cover Oregon stated that in order to fix the exchange online the number of serious bugs would have to be cut down to 13, yet since that statement the number of serious bugs recorded is approximately 300.
In addition to strictly technical problems, at least three major players in the Cover Oregon executive hierarchy, including the chief information officer (CIO), have resigned since the start of 2014. Although Rocky King, the former executive director purportedly resigned for health reasons, Aaron Karjala, who was the top information manager as the CIO, and Bruce Goldberg, the top healthcare administrator and the acting director of Cover Oregon, both turned in resignations near the end of March without giving such personal reasons. According to another report by oregonlive.com, after the Oregon Health Authority (OHA) turned over a “deeply flawed, largely unfinished project to a Cover Oregon team that was understaffed and ill-prepared for a rescue mission…” in April of 2013, Karjala and King attempted to internally address these issues rather than broadcast the problems. After Governor Kitzhaber accepted Goldberg’s resignation, he publicly encouraged the Cover Oregon executive board to remove Karjala and Triz delaRosa, who is the chief operating officer. Relatedly, Carolyn Lawson, the chief information officer of the OHA, also recently resigned and then in a five-page notice of tort liability letter to the state claimed that she was forced into that resignation, made to participate in a cover-up of the failures of the exchange, and defamed.
Time and Money
Initially, Oregon contracted with Oracle Corporation to design, develop, and implement the state-based Marketplace. After the failures of the initial plan had become abundantly clear and Oracle had been blamed for many for those failures, Oregon enlisted Deloitte Development, the authors of the February report, to determine what the next step should be and the costs of the potential alternatives. According to that analysis, it would cost over $40 million and take at least two more years to carry out the initial scheme for the exchange using Oracle’s technology. In the alternative, the state could terminate that plan and revert to using the federal exchange, as many other states have opted to do thus far, which was estimated would cost only four to six million. Further, in its “scrap or salvage” debate oregonlive.com referenced Oregon’s officials’ doubts as to the chances of the system ever working out, noting that state Senator Alan Bates (D-Memford) said that “political insiders are giving the exchange only 60 to 70 percent change of being up and running by November.” Yet, this report also noted the disadvantage of switching gears this late in the game: “moving to the federal exchange means abandoning years of work and settling for a less consumer- and agent-friendly system, one that doesn’t enroll qualified people directly into the Oregon Health Plan as intended.”