The online insurance exchange that Oregon established under Obamacare law will not allow residents to sign up for coverage on their own when enrollment begins nationwide on Oct. 1, state officials say.
The state is the first to say it won't be open for all comers by that date, raising concerns that other states running their own "Obamacare" exchanges might also be struggling.
The decision by Oregon, an enthusiastic supporter of the Affordable Care Act, gives ammunition to opponents who have warned of an Obamacare "train wreck."
Instead of enrolling in health insurance online themselves, at least through mid-October Oregonians will need the help of an insurance broker or an aide trained by the state to log on, Cover Oregon spokeswoman Lisa Morawski said on Friday.
They also will need assistance to see what policies are available, and to determine which federal subsidies they might be eligible for.
"This approach will give Cover Oregon the ability to iron out the technology, customer service and other internal processes during the first few weeks of October before consumers begin applying on their own," Morawski said. "It also will prevent the system from being overloaded in its first weeks."
Experts working with the state exchanges, as well as the Government Accountability Office and the inspector general of the U.S. Department of Health and Human Services (HHS), have warned that the massive effort to build new online insurance marketplaces in all 50 states may not be ready by Oct. 1.
Efforts to get people without health insurance to buy a policy through their state exchange, as required under the Affordable Care Act, have emphasized that the process would be fast and easy: log on, enter personal information such as address and income, and in real time the system would show you a list of available policies and tell you what they would cost after federal subsidies.
HHS spokeswoman Joanne Peters said, "There will be a marketplace open in every state on October 1, where families can comparison shop for quality, affordable health coverage."
The delay, Cover Oregon chief information officer Aaron Karjala told Reuters, reflects "concerns about the capacity of the exchange as a whole, not just the technology but also the people."
"We're not worried about IT capacity," he said. "We have enough to run the stock exchange."
Instead, officials worry that too many people trying to enroll in coverage will phone the state's Obamacare call center, which has about 50 full-time employees and plans for up to 100 more.
About 550,000 state residents are uninsured.
"The largest choke point and the biggest constraint is the limited number of people in the call center," Karjala said. "People might need a lot of help" when they try to enroll, "which could mean fairly long calls."
Oregon has trained about 1,000 agents and about 800 community partners, Morawski said. Each will be given a secured account allowing them to log on to Cover Oregon and help someone buy insurance.
"This strikes me as something that most states probably would want to do, because they don't want bad stories in the press about how the exchange didn't work and people were disappointed - which is virtually inevitable in the early weeks," said Joe Antos of the conservative American Enterprise Institute.
"So this seems to be a pretty prudent move on Oregon's part. They can say they did everything in their power to avoid leaving Joe Public baffled by an admittedly complicated system."
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