10/2/2014

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KATU Investigators

Cover Oregon says state likely won't be affected by federal court ruling

Cover Oregon says state likely won't be affected by federal court ruling

PORTLAND, Ore. – Cover Oregon officials said they don’t believe Oregon will be affected by a federal appeals court’s ruling on Tuesday that has the potential to deal a severe blow to the Affordable Care Act in states that are part of the federal exchange.

The Washington, D.C. court ruling in Halbig v. Burwell – if it stands on appeal - would mean that only state-based exchanges could issue tax credits to offset premiums for private insurance plans. Meanwhile, in Virginia, another appeals panel unanimously came to the opposite conclusion, ruling that the Internal Revenue Service correctly interpreted the will of Congress when it issued regulations allowing consumers in all 50 states to purchase subsidized coverage.

In late April, the Cover Oregon board opted to move to the federal exchange after the failure of its website.

But states’ decisions aren’t as simple as choosing to be part of the federal exchange or running their own. There is a spectrum of possibilities that allow the states to customize their level of control and responsibility.

Oregon chose to transition to becoming a “supported state-based exchange,” which allows it to keep some control of aspects of eligibility determination, appeals and other processes. 

“The D.C. Circuit Court of Appeals ruled that the federal government cannot subsidize insurance premiums in states that did not establish their own marketplaces,” Cover Oregon spokeswoman Arianne Holm said in an email. “Oregon established its own marketplace in 2011. Our understanding is that since Oregon's health insurance exchange is designated as a state-based marketplace in 2014, and a supported state-based marketplace in 2015, this ruling does not affect Oregon.”

But when a KATU reporter pressed Cover Oregon Executive Director Aaron Patnode on the issue, he admitted there is no guarantee.

"I haven’t had conversations with anyone at the state level to really evaluate or understand with 100 percent certainty what the implications are for Oregon," Patnode said. "Once we learn more about it, we'll evaluate what we need to do in order to change if we have to, but I don't anticipate we will."

Patnode said the state is still weighing whether or not to move back to a fully independent exchange. 

“When Oregon negotiated this status with the feds, they said we will do this with you – this is a way for you to lick your wounds and get strong again,” said Cover Oregon chief policy officer Nora Leibowitz .

No decision has yet been made on whether the state will transition back to running its own exchange for open enrollment in the fall of 2016, or if more time will be necessary.

KATU's Erica Nochlin and The Associated Press contributed to this report.

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