One state delays key ACA provision. Will more follow?

Oregon is the first state to announce that it will be ready on Oct. 1

Oregon's state-based health insurance exchange will launch on Oct. 1 as planned, but state residents will not initially be able to enroll in coverage on their own, according to state officials.

Under the Affordable Care Act (ACA), open enrollment in the exchanges was scheduled to start on Oct. 1 to give U.S. residents time to sign up for coverage before it takes effect on Jan. 1, 2014.

However, Oregon last week became the first state to announce a delay to its exchange, prompting concerns that other states might also be struggling to finish work on their exchanges before open enrollment begins. Altogether, 14 states and the District of Columbia are running their own exchanges.

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Officials at Cover Oregon said that the state will limit access to the new website for up to one month in order to address complications and continue to beta-test the website.  

Amy Fauver—chief communication officer for Cover Oregon—said that state residents still would be able to shop for plans and enroll in coverage beginning Oct. 1, but they will need to visit a trained agent's office or find one willing to come to their house to log on to the system. Officials said residents also will need assistance to determine whether they qualify for federal subsidies.

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Cover Oregon said it will list agents and community partners who can help individuals enroll in coverage. Officials say they have trained about 1,000 agents and 800 community partners to help individuals enroll in coverage. According to the Wall Street Journal, the agents will receive commissions for helping customers, but customers will not have to pay a fee for the service.

Lisa Morawski—a spokesperson for Cover Oregon—said, "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." She added, "It also will prevent the system from being overloaded in its first weeks."

Cover Oregon CIO Aaron Karjala said the delay reflects "concerns about the capacity of the exchange as a whole, not just the technology." Karjala added, "The largest choke point and the biggest constraint is the limited number of people in the call center." He noted, "People might need a lot of help" during enrollment "which could mean fairly long calls."

Despite the changes, Morawski said the agency expects 217,000 people to enroll in coverage through the exchange (Begley, Reuters, 8/9; Weaver, Wall Street Journal, 8/9; Karlamangla, Oregonian, 8/8).

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