Family struggles to sign up for insurance through Cover Oregon

Family struggles to sign up for insurance through Cover Oregon »Play Video
A mother applied for health insurance through Cover Oregon for her and her three children. She and one of her sons got insured but her other two sons didn't.

PORTLAND, Ore. --  With a broken website, it can be hard enough for one person to follow the enrollment process through the state's health insurance exchange, Cover Oregon, which is processed solely with paper applications. But the On Your Side Investigators learned that some of those problems can multiply considerably when you have a whole family seeking coverage.

A mother reached out to KATU for help after she applied for health insurance through Cover Oregon by mid-December but learned this month that two of her three children were not insured.

The Cover Oregon website is a state-run online marketplace where Oregonians can find and purchase health insurance, but it's had arguably one of the worst rollouts in the country. Despite a grand vision, an earlier start and millions of dollars from the government, the website has been in shambles since its Oct. 1 launch date. To this day, not a single person has been enrolled online.

When it became clear that the troubled website jeopardized enrollment, Cover Oregon hired more than 500 temporary workers to process paper applications. The hires were a backup plan while Cover Oregon staff fixed the bugs in the website. But the subsequent switch to hand-processed paper forms has left an untold number of applications in processing limbo.

The mother who reached out to KATU did not want to reveal her name but said she's a single mother of three boys: seven, four and 20 months. Despite signing up her entire family on one application before the deadlines, she recently learned that only she and her oldest son were enrolled in the Oregon Health Plan, Oregon's version of Medicaid. Her two youngest sons were not insured.

Assessing eligibility for state assistance is a requirement of the Cover Oregon process.

"I would rather give up my coverage for my children and I didn't understand how I could qualify and not them," the mom said.

The On Your Side Investigators went to Cover Oregon for answers.
 
Cover Oregon Spokesman Michael Cox said, "In general terms, if a family applies for health coverage, even though they apply using one application, we determine eligibility independently."

In other words, Cover Oregon looks at each person's eligibility individually rather than lumping it in under one application.
    
"And (we're) working on getting that done now," Cox said about the family's application.

Ultimately, Cox pointed to a problem with the addresses on the mom's application. He said the mom's youngest boys were listed as having a different address than the rest of the family, which led to the lack of insurance for the youngest boys. Cox said Cover Oregon is working to get the whole family coverage and sent her case to the Oregon Health Authority Tuesday night to re-process her case.

Cox said it could take a few more days before her policy reflects the correction but insists she is covered by the Oregon Health Plan. By law, he continued, her coverage under the Oregon Health Plan is retroactive to the date she applied. This is the case even if you have not yet received your member ID card.

But thousands of applicants just like this mother have been caught up in the paper process and some argue that fixing their delays and problems would be a breeze if Cover Oregon had processed their applications online instead. Cox defended the current process as sufficient and beginning to improve.

"Folks refer to this process as the paper process but it's really not, it's actually a hybrid process," Cox said. "Much of the work we do behind the scenes is actually automated and it's using the technology that's eventually going to be rolled out."

According to an analysis of new government figures by The Associated Press on Tuesday, Oregon is third from last when it comes to enrollments in private coverage when compared to 13 other states and the District of Columbia that built their own exchanges. Cover Oregon enrolled 2.8 percent of the state's 651,000 uninsured in private insurance during the first three months of the exchange, according to the analysis. That translates to more than 18,000 people.

Cox denied that analysis and says Cover Oregon's enrollment numbers are in the middle of the pack.

If you have immediate questions about the Oregon Health Plan or your health benefits, please call 1-800-273-0557 or 711 (TTY), from 8 a.m. to 5 p.m., Monday through Friday. The Client Services Unit (CSU) is closed on holidays. ​​​

Having problems reaching Cover Oregon?

Your best bet is to keep calling Cover Oregon (1-855-268-3767) and, if you have an agent, ask them for help as well.


Full coverage of the troubled Cover Oregon website: