Gov. hand-picks Oregon Health Authority official to lead Cover Oregon transition

Gov. hand-picks Oregon Health Authority official to lead Cover Oregon transition
Tina Edlund

SALEM, Ore. -- In what seems like a revolving door of officials at Cover Oregon, the state's problem-plagued health insurance exchange, there's a new name to learn: Tina Edlund.

Edlund was hand hand-picked by Gov. John Kitzhaber to head Cover Oregon's transition to the federal exchange, KATU learned Wednesday.

The website for Oregon's state-run exchange proved so problematic, a Cover Oregon Board announced two weeks ago the $248 million project has been dumped in favor of using HealthCare.Gov technology.

Edlund is acting director of the Oregon Health Authority, the agency originally responsible for creating Oregon's health insurance exchange and running the state's Medicaid program.

Wednesday, the OHA director's office sent an email written by Edlund to all employees, which reads in part:

"Governor Kitzhaber has asked me to serve as the Transition Project Director, moving health plan eligibility and enrollment functions from Cover Oregon to the federal exchange and OHA.

"I have accepted this new role, but I confess the decision was a difficult one. I care deeply about this agency and the work being done here."
 
On Tuesday, Edlund along with Cover Oregon's interim managers and a representative from the Governor's office, testified before a state legislative IT committee about their plans to transition to the federal exchange. The group has been working with officials at the Center for Medicare and Medicaid Services (CMS), the federal oversight agency for health insurance exchanges.

Last week, Cover Oregon's interim director, Clyde Hamstreet, and Oregon's chief information officer, Alex Pettit, flew to Washington D.C. to discuss the transition with CMS.

Following the hearing Tuesday, Edlund talked to a group of reporters.

"We've had some very productive discussions with CMS and we're continuing to talk about what the structure looks like going forward," she said.

KATU learned that, because HealthCare.Gov enrolls people only in private health plans, Oregonians found eligible for Medicaid will be redirected to OHA, which will help enroll them in the Oregon Health Plan, Oregon's version of Medicaid.

Pettit said Oregon will continue using the current technology for Medicaid enrollments but it will have to improve on the system. Pettit estimated improvements would cost about $35 million.

Edlund also said the federal government would pay 90 percent of those costs and of the costs of switching to the federal exchange. In total, Oregon has spent $248 million of the $305 million it received from the federal government to build the website.

According to OHA's website, Edlund has worked for 25 years in health services research and health policy with the Oregon Division of Medical Assistance Programs, Providence Health System, the Oregon Health Policy Institute, and with the Office for Oregon Health Policy and Research.

Edlund became the acting director of OHA on December 2, 2013 when then-director Bruce Goldberg assumed the executive director position at Cover Oregon. Goldberg took that role when Cover Oregon's first executive director, Rocky King, resigned for medical reasons.

Then last month, Gov. Kitzhaber announced he'd accepted Goldberg's resignation on the same day Kitzhaber released the results of a sobering investigation into the troubled Cover Oregon website.

Edlund's name also came up in December 2013, when she announced the resignation of OHA's chief information officer, Carolyn Lawson.

Lawson was an IT expert who was in charge of building the site. Publicly, Lawson resigned for "personal reasons" but the On Your Side Investigators uncovered emails that show Lawson later complained to an OHA official that she was forced to leave under false pretenses.

It's a fallout that could come back to haunt her.

Four months later, Lawson filed notice that she was considering suing the state for wrongful discharge, defamation and other charges. Edlund was named as one of the possible defendants, as were Goldberg, Rocky King, former director of Cover Oregon, and OHA spokeswoman Patty Wentz.

KATU learned OHA's Chief Operating Officer, Suzanne Hoffman, will step in as interim OHA director in Edlund's place. This will be effective Monday, May 12.