Health | Local

Oregon Begins Implementation Of Federal Health Care Plans

OPB | Nov. 1, 2010 11 p.m. | Updated: July 17, 2012 1:06 a.m. | Portland, OR

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Oregon unveiled part of its plan for implementing the federal health overhaul this week.


When the federal government banned health insurance companies from denying coverage to children with pre-existing conditions, two of Oregon’s largest insurers stopped offering “child-only” policies.

Regence BlueCross BlueShield of Oregon and HealthNet were worried parents would only sign-up their kids once they became sick — thus undercutting the premise of insurance.

The state’s fix is an enrollment window — from November 1st to December 31st — so parents can’t wait until illness strikes.

Oregon Insurance Division spokeswoman, Cheryl Martinis, doesn’t think the window is too inconvenient.

Cheryl Martinis: “Most children are going to have options, even outside these new enrollment periods. We have high risk pools. It would be a twisted set of circumstances that will make it hard for a child not to get insurance.”

But the new enrollment window doesn’t seem to be enough to make insurers offer child-only policies again.

Samantha Meese is a spokeswoman for Regence BlueCross BlueShield.

Samantha Meese: “For a century we’ve provided health insurance to thousands of children and families in our service area and our experience tell us the best way to provide coverage to those members is through family policies. Therefore we are no longer offering individual policies to applicants under 19, except as part of a family policy.”

But the enrollment window hasn’t been completely ignored by Blue Cross.

Meese says the company will allow parents who have coverage to enroll their kids during the enrollment times.

Samantha Meese: “Regence is going to go ahead and participate in the open enrollment period, and during that time we will not apply any health screening criteria to individuals under the age of 19 on family applications.”

These enrollment windows don’t apply to most Oregonians, who get their health insurance from their employers.

Oregon Insurance Division spokeswoman Cheryl Martinis estimates a few thousand people need to know about the new restrictions.

Cheryl Martinis: “A little over 200,000 people, around 6 percent of all Oregonians have individual policies to begin with. So it’s a small percentage of that small percentage, who are going to have children, under age 19, who aren’t already covered.”

And she says, in Oregon, kids do have options. For example, they can get coverage through the Oregon Healthy Kids program or through the state’s high-risk pool.

Insurers also have to accept children who’ve just been born or adopted or gone through a coverage ending event — like divorce or the death of a family member.

Once this enrollment window closes — at the end of December — another enrollment window is scheduled to open in February.

The process is just one of many steps for implementing the federal healthcare plan. Its aim is that by January 2014, insurers must accept everybody — regardless of health — and in exchange everybody has to buy insurance.

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