Oregon’s failed exchange launch has been one of the most intriguing stories of the Obamacare rollout, and we now know a lot more about what went wrong after Gov. John Kitzhaber today released an independent review of the state's enrollment Web site.
While HealthCare.gov overcame major tech problems and has been running pretty well since early December, Cover Oregon still hasn’t managed to launch an online enrollment portal. That’s even though the state was awarded more than $300 million in federal grants and was one of first states to approve an exchange.
The $228,000 review, ordered three months ago, was based on interviews with 67 stakeholders and more than 3,200 documents. It found two major themes contributing to the botched rollout:
- Lack of communication. From the report: "The lack of a single point of authority slowed the decision making process and contributed to inconsistent communication, and collaboration across agencies was limited at best. In addition, communication with oversight authorities was inconsistent and at times confusing or misinterpreted." In a press conference, Kitzhaber noted there was tension and mistrust among the agencies leading up to the failed launch.
- Unrealistic optimism. There were signs early on that the project wasn't ready, but Kitzhaber said the review found an "unrealistically high sense of optimism" about the Oct. 1 launch. "Although there are numerous sources of documented communication regarding project status, scope issues, and concerns about system readiness, there does not appear to be a formal acceptance by the Cover Oregon leadership of issues significant enough to affect the success of the October 1 launch until August 2013," the report found.
Federal auditors at the Government Accountability Office earlier this month announced they would conduct their own review of where Cover Oregon went so wrong. Another federal report earlier this month said the exchange board and main IT contractor Oracle shared the blame, according to The Oregonian.
Things have gotten a bit ugly in the state. Cover Oregon's first executive director resigned in January, a former Oregon IT official may sue for wrongful termination, and the state might join up with HealthCare.gov.
Meanwhile, the exchange is starting to clean house. Interim exchange director Bruce Goldberg is expected to leave next month, and he today resigned his post as head of the Oregon Health Authority. Kitzhaber said he also urged the exchange board to hire new technology executives at a crucial time for the insurance marketplace. Oregon is still weighing whether to rescue its exchange technology, use technology from another state or even join the federal exchange before the enrollment period starting in November.
"There's a range of options, and there's a certain degree of urgency," Kitzhaber said.
Kitzhaber said he spoke to HHS Secretary Kathleen Sebelius earlier this week about options for getting more people enrolled in coverage. With the enrollment period about to end, Oregon leaders are hoping the Obama administration will let the state extend the signup period another month.
"We're looking at all the options, and I expect to have an announcement as early as next week," Kitzhaber said.
Despite all its problems, Cover Oregon has signed up 49,000 people in private coverage, which places it in the middle of the pack for enrollment. But the signup rates undoubtedly would have been much better for the exchange if it had a working Web site.