Beleaguered Cover Oregon plagued by phone problems

Beleaguered Cover Oregon plagued by phone problems »Play Video
Bob Kikes listens to one of Cover Oregon's jingles while he waits for a customer service representative to answer. He's spent hours waiting to hear a live voice.

PORTLAND, Ore. -- What now?

First, Cover Oregon, the state's healthcare marketplace, couldn't get its website working; it's still not operational. Now there are problems with the phone lines. They're so overloaded, that in some cases, calls won't even connect.

Bob Kikes knows. The Northeast Portland man suffers from coronary artery disease. He's dependent on four expensive medications. He’s currently part of the Oregon Medical Insurance pool. That's the state's high-risk pool that will shut down at the end of the month.

For Kikes and 4,000 other people like him, it's critical that they can complete the process of choosing new insurance through Cover Oregon by Jan. 1, 2014.

"I'm very apprehensive about (Cover Oregon's) ability to get this done," confesses Kikes.

To understand Kikes' frustration, consider what's happened over the last couple of weeks.

After being unable to apply online, Kikes sent his paper application to Cover Oregon on Nov. 15. It then took the state three weeks to mail him the actual enrollment packet. Two days later, he sat on the phone for nearly four hours, waiting for someone to answer his questions. All the while, he heard jingle after jingle about just how great the state's marketplace is: "Long live Oregonians. We're free to be healthy."

"It made me even more cynical, because it gave the outward appearance that everything was great and everything was going to be wonderful," says Kikes. "Yet behind the scenes, everybody is scrambling."

On Tuesday, as instructed, Kikes tried to choose his new insurance plan online, but he kept getting error messages. Since then, he's submitted his choices via fax and express mail. On Wednesday, he tried to check on his status, but the phone lines were so overloaded, his call wouldn't even connect. Hours later, he finally got through to a Cover Oregon representative, who was unable to verify his status.

Michael Cox, spokesman for Cover Oregon, says when phone calls come in, they line up, or cue, in the system. When the cue fills, additional calls won't connect properly and customers get messages that indicate the phone line is invalid.

In response to the problem, Cox says Cover Oregon has changed how calls are routed to improve flow. It's also trying to put a plan into place that would increase capacity. He says average wait times have improved from 40 to 20 minutes.

Once Kikes' enrollment is processed by Cover Oregon, he still won't have insurance. In the next few days, the state needs to transfer all his information to his new insurance provider, Providence. Then Providence has to send him another round of paperwork, and he has to send them payment. All that needs to be accomplished in just 12 business days for Kikes to have coverage by Jan. 1, 2014.

"My biggest worry is having some kind of significant medical event and not having any kind of insurance coverage," worries Kikes.

The latest numbers released by Cover Oregon indicate that a total of 13,096 customers have been enrolled – 10,672 in the Oregon Health Plan and 2,424 in commercial plans.