Oregon could end up paying more after switching its health insurance platform

The switch to a state-based health exchange from the federal platform could cost Oregon about $3 million more a year

Insurance News

By Lyle Adriano

The Oregon Department of Consumer & Business Services (DCBS) said that the state’s decision to switch to a state=based health insurance platform from its current federal exchange could cost Oregon approximately 10% more a year, reported bizjournals.com.

The agency projected that the change would cost about $3 million more a year.

In a meeting held May 9, the Health Insurance Marketplace Advisory Committee (HIMAC) considered the DCBS’ findings regarding the relative cost and other issues that could arise from switching health insurance platforms for 2018. A consensus on whether the state should go with a private vendor to establish a health insurance platform or stick with a known quantity was not reached, however.

The DCBS is set to present its findings and recommendations, as well as feedback from the HIMAC, to state Legislature later this month.

Four vendors—hCentive, Vimo inc., Softheon Inc. and New Fields Technologies LLC—submitted their RFPs to the Department of Administrative Services in their bid to help lay down the new health insurance platform. According to the analysis by the DCBS, one of the proposals failed to meet the minimum requirements for the RFP, and as a result was eliminated.

The DCBS called for the proposals to determine the cost-efficiency of developing in-house health insurance technology versus continuing on with the federal exchange. Although the federal government has offered HealthCare.gov to the state at no extra charge, fees will be added to insurance plans on federal exchanges next year.

The analysis found that the main advantages of sticking with healthcare.gov are that the system is proven, participating insurers are already connected with it, and the enhancement of the system lies solely on the federal government.  The analysis also argued that the federal call center “adequately handles most consumer issues.”

Alternatively, switching to another platform allows the state to customize its settings to meet its own needs. There would be direct access to data, allowing the state to develop its own reports and updates. The analysis, however, pointed out that there could be a risk of bugs and insufficient IT resources.

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