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Q&A: Kitzhaber Signs Health Insurance Exchange

OPB | March 8, 2012 8:31 a.m. | Updated: June 7, 2013 10:25 a.m. | Portland, OR

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Governor John Kitzhaber signed Oregon’s new Health Insurance Exchange into law today. Kristian Foden-Vencil was at the signing in Portland he’s with me now. 

Good afternoon Kristian.

Kristian: Hi.

Beth: The Health Insurance Exchange is one of the Governor’s key health policies — both for the 2012 legislature and for his third term in office. Can you remind us what the ‘Health Insurance Exchange’ is?

Kristian: Yes. Essentially, President Obama’s health care reform asks states to set up their own health insurance exchanges.

Think of them like a ‘Travelocity’ or ‘Expedia’ website. But instead of selling vacations, they allow individuals and small businesses to comparison shop for health insurance.

The hope is the exchanges will give small customers the kind of buying power bigger businesses enjoy.

Just to be clear. If you have a job with health insurance, you’re not going to need the exchange. But if you’re self employed and you want to get coverage, you’ll go to the website, or call them up or drop in.

It’s a little like a whole new government agency. About 25 people have been hired so far, but to bring in the 300,000 Oregonians who’re likely to sign-up in the first year, there could be 150 employees at some stage.

That said, the exchange is not expected to cost the state anything. It’ll be paid for by adding a surcharge to the insurance plans that are purchased on the exchange.

Beth: What does the bill Kitzhaber signed Thursday actually do?

Kristian: Well, it’s really just another step in the road. The bill that actually set up Oregon’s exchange was passed in 2011. A board of directors was chosen and they’ve wrestling with things like what benefits each insurance company has to offer — if they want to be on the exchange.

Now, the way to think of it is that the board of directors drew up a business plan. The legislature and now the Governor have given that plan the green light.

So, they’ll now have to start setting everything up, like buying all the computers they need.

Beth: What did the governor say as he signed it into law?

Kristian: Well he called it a great day for Oregon. He said the exchange is going to provide significant benefits to small businesses and individuals. It’s going to allow people to compare the quality and cost of insurance plans. And, he says it’s going to be a great resource for Oregonians:

John Kitzhaber: “It is going to be a central contributor to the success of our larger health care reform effort, by setting the setting the standards for plans that they reduce cost, that they maintain quality and that everyone has access to the kind of coverage that they need and deserve in this state.”

Kristian: As you know, changing health care is very contentious.

About 20 states, primarily those that lean conservative, are not implementing their own exchanges.

Instead, they’re appealing the Affordable Care Act — the federal overhaul — up to the U.S. Supreme Court. They particularly don’t like the requirement that everybody buy health insurance.

That issue is scheduled for oral arguments later this month.

Meanwhile, Oregon and several other states, are moving forward.

The White House has distributed about $700 million to set up the exchanges. Oregon has received about a tenth of that.

But it’s no good going on line to look for the exchange yet. They’re not scheduled to start until 2014.

Beth: Thank you Kristian.  And by the way, we’re going to hear more from you in about half an hour. NPR is running a feature on Oregonians and the medical options they choose at the end of their lives?

Kristian:  That’s right.  Oregon’s so-called POLST form allows sick and elderly people to say whether they want the full power of medicine brought to bear during their final days, or whether they’d be happier to stay at home and receive comfort measures only.

14 states have already adopted Oregon’s POLST form and another 20 are looking at it.

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