As reported by The Oregonian, nearly 4,000 applicants enrolled in a state program that provides undocumented immigrants with pregnancy services were instead fully enrolled in Obamacare.
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Nearly 4,000 applicants for a state program that provides undocumented immigrants with pregnancy services were instead enrolled in full Oregon Health Plan coverage, contrary to federal law, thanks to problems with the Cover Oregon health insurance exchange.
State officials say they discovered the problem several weeks ago and are correcting it.
The pregnancy program goof, however, is just one of many little-known problems that Oregon Health Plan members, providers, care groups and state officials have wrestled with as Oregon’s system for enrolling people undergoes chaotic change.
It’s the flip side of the Cover Oregon debacle, where much of the attention has focused on the travails of people applying for private or commercial insurance.
Two thirds of Cover Oregon’s enrollments — more than 70,000 — have gone into the low-income Oregon Health Plan, the state’s version of Medicaid. Combined with other enrollments since Oct. 1, OHP membership has swelled by more than 200,000, or about a third — a favorite talking point of state officials.
Many of those enrollments, however, have not gone smoothly:
- Thousands of OHP enrollees were labeled as individuals rather than family members, meaning some families were split between care organizations – creating needless hassles for parents seeking care.
- For months, the state grappled with inaccurate Medicaid coding, crucial to securing accurate federal matching funds.
- Department of Human Services workers who used to help clients afflicted by erroneous information now face difficulties doing so because their responsibilities have been transferred to Cover Oregon.
Some of the problems with OHP enrollments are due to limitations with the Cover Oregon exchange information technology. Others stem from flaws in the many “workaround” band-aid systems set up to patch for problems with the exchange. Officials say they are working through these issues slowly and attribute them to standard growing pains.
“It never works perfectly the first time out,” said Kathleen Paul, an Oregon Health Authority manager who has worked on the Cover Oregon information-technology project.
The Cover Oregon health insurance exchange was designed to communicate electronically with the Oregon Health Authority, which has a system for tracking Oregon Health Plan members.
That interface failed to work, however, and in late November Cover Oregon set up a backup system by which new OHP enrollee information is sent to the Oregon Health Authority, where state workers upload the data manually.
The information was sent over incorrectly and in an incomplete fashion until a few weeks ago, Paul said Friday. That resulted in 3,800 applicants for the Citizen/Alien-Waived Emergent Medical program receiving full OHP benefits instead. The program is set up for immigrants who are either undocumented or haven’t met the residency requirement for Medicaid.
“We were just getting people into the services,” Paul said, adding that the state will finish fixing the problem in the coming week.