Oregon

 

Thirteen years ago, during the very first ACA Open Enrollment Period, Oregon was one of 15 states which attempted to operate their own fully state-based marketplace SBM) under the new law, calling it "Cover Oregon."

Cover Oregon was, along with several of the other original SBMs in Nevada, Maryland, Hawaii and (surprisingly) Massachusetts, a complete and utter failure. They flushed a stunning $248 million down the drain on a website portal which, put simply...didn't work. Like, at all. From April 2014:

Cover Oregon poised to switch to federal insurance exchange

Alex Pettit, the state's top information-technology official, recommended Cover Oregon move to the federal exchange at an advisory committee meeting Thursday.

Oregon should pull the plug on the beleaguered Cover Oregon health insurance exchange and switch to the federal exchange, a technological advisory committee recommended Thursday.

The move is considered almost certain to be adopted by the Cover Oregon board, which meets Friday.

Originally posted 6/05/26

The past couple of weeks have been pretty brutal for the Oregon health insurance market.

On May 21st, Providence Health Plan announced that they were shutting down pretty much their entire insurance division across Oregon (which also impacts some people in Washington and California):

Providence Health & Services plans to exit most of its Oregon health insurance business next year, citing rising costs, tougher regulation and intensifying competition from national insurers — a move that will force hundreds of thousands of Oregonians to find new coverage.

...Providence Health Plan, based in Portland, is Oregon’s third-largest health insurer, covering more than 421,000 Oregonians. It also covers over 13,000 members in Washington and 4,800 in California.

Just five days ago, Providence Health Plan of Oregon announced that they're shutting down pretty much their entire health insurance provider division next year:

...Providence will stop offering most plans through Providence Health Plan, including individual, family and employer coverage, as it seeks to strengthen its financial footing and refocus on delivering care rather than operating an insurance arm.

...Providence Health Plan, based in Portland, is Oregon’s third-largest health insurer, covering more than 421,000 Oregonians. It also covers over 13,000 members in Washington and 4,800 in California. 

Today, this was followed by another blow to the Beaver State's health insurance market. Via Nick Budnick of The Lund Report:

And the hits just keep on coming: Via The Oregonian:

Providence to end most health insurance plans, forcing hundreds of thousands in Oregon to switch

Providence Health & Services plans to exit most of its Oregon health insurance business next year, citing rising costs, tougher regulation and intensifying competition from national insurers — a move that will force hundreds of thousands of Oregonians to find new coverage.

Leaders of the Renton, Washington-based health system announced the decision Wednesday, saying Providence will stop offering most plans through Providence Health Plan, including individual, family and employer coverage, as it seeks to strengthen its financial footing and refocus on delivering care rather than operating an insurance arm.

IMPORTANT: Premium Alignment is NOT a substitute for making the enhanced ACA tax credits permanent. It does little to help the lowest-income folks who are still better off with Silver plans thanks to robust CSR assistance, and the benefits of it will be mediocre for those over 400% FPL if the enhanced tax credits expire.

Even for those it benefits the most (primarily those who earn between 200 - 400% FPL),  it's a complement to the upgraded subsidies, not a replacement for them.

HOWEVER, it's still hugely helpful to those who know how to take advantage of it, and particularly in the states newly implementing it, it should relieve a huge portion of the pain being caused by the enhanced APTC expiring next month.

Last week I noted that six states have launched window shopping for the 2026 ACA Open Enrollment Period (OEP), allowing residents of the following states to plug their household information into their states ACA exchange website to see just how much their net health insurance premiums are going to increase starting January 1st, 2026:

Today another seven states joined them by activating 2026 window shopping as well:

Originally posted 6/04/25

via the Oregon Division of Financial Regulation:

Oregonians continue to have at least five health insurance companies to choose from in every Oregon county as companies file 2026 health insurance rate requests for individual and small group markets

  • In-depth rate review process just beginning, opportunities for public review and input remain through June 20

June 2, 2025

Oregon health insurers have submitted proposed 2026 rates for individual and small group plans, launching a months-long review process that includes public input and meetings.

Five insurers will again offer plans statewide (Moda, Bridgespan, PacificSource, Providence, and Regence), and Kaiser is offering insurance in 11 counties, giving six options to choose from in various areas around the state. 

Originally posted 1/03/25

Oregon has around ~140,000 residents enrolled in ACA exchange plans, 80% of whom are currently subsidized. I estimate they also have another ~34,000 unsubsidized off-exchange enrollees.

Combined, that's ~173,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 162,000 statewide.

Originally posted 3/13/25

Over the past couple of months I've compiled a master spreadsheet breaking out enrollment in ACA plans (Qualified Health Plans & Basic Health Plans), Medicaid/CHIP coverage (both traditional & via ACA expansion) and Medicare (both Fee-for-Services & Advantage) at the Congressional District levels.

With the pending dire threat to several of these programs (primarily Medicaid & the ACA) from the House Republican Budget Proposal which recently passed, I'm going a step further and am generating pie charts which visualize just how much of every Congressional District's total population is at risk of losing healthcare coverage.

USE THE DROP-DOWN MENU ABOVE TO FIND YOUR STATE & DISTRICT.

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