By Shelby Sebens | Northwest Watchdog
PORTLAND – Roughly 26 percent of uninsured Oregonians are expected to seek the state’s help when the U.S. Affordable Care Act takes effect in 2014. At least that’s what the Oregon Health Insurance Exchange is predicting.
A consultant hired by the exchange – which was enacted into Oregon law last year and is supported by federal dollars – has estimated 26 percent of the roughly 636,000 uninsured Oregonians will enroll in the state program. That’s about 164,050 people at the high end of Wakely Consulting’s estimate for individuals expected to enroll in 2014, according to information provided by the Oregon Health Insurance Exchange to Northwest Watchdog.
That leaves 435,950 who will either pay a tax penalty or get insurance on their own or through their employer. Some of those people – the number of exactly how many was not available – will be exempt from the government penalty because of hardships. About 57,000 small employers (with 50 employees or less) are also expected to enroll in the state’s Small Employer Health Options Program (also known as SHOP) in 2014, according to data from the Oregon Health Insurance Exchange.
The Health Exchange’s own business plan shows predicting how many people will actually enroll in the exchange is difficult. The numbers are based on national models that were modified to reflect Oregon’s insurance market. Making the program, which relies on federal funds for the first two years, self-sustaining by 2016 depends on fees charged to insurers and the collection of fees is dependent on getting at least 100,000 to 120,000 people enrolled n the system, according to the business plan.
The state is preparing to promote the exchange program next year. The goal of the exchange, is to help people find affordable insurance and have easier access to state and federal tax credits for which they might be eligible.
But some, for financial reason or on principle, will opt to pay the government penalty, which increases over time.
“It’s going to cost more to buy insurance than to pay the penalty,” at least in the first year or two, said Amy Fauver, deputy director of the Oregon Health Insurance Exchange. “But you have to look at the risks of being uninsured versus paying and getting a tax credit to help you pay insurance.”
The open enrollment process for 2014 begins in October 2013 and ends in February 2014. Those who don’t enroll will lose that opportunity until the next enrollment process begins.
“If they get sick or injured during that time they may have trouble getting insurance,” Fauver said.
The Congressional Budget Office announced last week that about 6 million people across the country are expected to pay the penalty for not having insurance by 2016, 50 percent more than the CBO originally calculated in 2010 when the act was passed. Some of that estimate increased because of the economy and some of it is due to states opting out of expanding Medicaid coverage.
Fauver did not have the break down in Oregon for how many people might be expected to pay the penalty and the CBO did not calculate that information by state. The penalty for not having insurance will be $695 by 2016 or 2.5 percent of income, whichever is greater.