How Did Oregon Get Its Healthcare Exchange So Wrong?

Oregon ACA

How Oregon’s healthcare exchange became an intergovernmental cautionary tale. Because as the old saying goes, creating intergovernmental programs based on a set of government-regulated standards imposed by the Affordable Care Act ain’t easy.   



An intergovernmental relationship between states and the federal government is no easy task. True, while there are a handful of programs and initiatives that successfully get implemented, most aren’t as seamless or lucky. The Affordable Care Act (aka Obamacare) looks to be no exception.


While that isn’t to say the ACA hasn’t had its share of successes, when you look at ACA’s failed healthcare exchanges, it’s not pretty. For states like Massachusetts, Nevada, and Maryland, they have been the poster children for troubled healthcare exchanges and Republican fodder thus far. Yet there is one stands out among the pack.


Yup, I’m lookin’ at you Oregon!


Out of the 17 states that decided to build their health exchanges, Cover Oregon will definitely not be one of them. On April 25th, Oregon decided to ditch Cover Oregon and embrace the federal market place. This was after the federal government decided that Cover Oregon was just too dysfunctional to fix. So the question stands, how did it get this bad?


That is definitely not a graph that you want to be #1 in...

That is definitely not a graph that you want to be #1 in…


Well to put it bluntly, Cover Oregon’s original enrollment numbers were dismal. Even though Oregon was one of the first states to champion the ACA and create its own marketplace, early technological problems plagued Cover Oregon from the beginning.


While’s technical issues are well documented, Cover Oregon’s website problems were much worse in hindsight. Cover Oregon’s technical problems got so bad at one point that it hired 400 workers to process the applications by hand. And while most healthcare exchanges were able ride out this storm, Cover Oregon was never able to fully recover. In the final days of enrollment, most online health exchanges were able to process individuals in one sitting. Cover Oregon was nowhere near that level of competency. After $248 million was spent on fixing the service, the federal government decided that Cover Oregon wasn’t worth saving.


In a report by the consulting company First Data, they concluded Cover Oregon never had a clear vision of what it wanted to do and how it would reach that goal. What transpired was a constant power struggle between multiple agencies that had different objectives and goals. Due to this lack of central authority, Cover Oregon was never able to properly fix the problems that it had which led to the sorry enrollment numbers.


Like most intergovernmental programs, Cover Oregon became a lesson of what happens when various governmental entities can’t come together to serve the public properly. Sadly, Cover Oregon just became another sad – and SUPER expensive – cautionary tale taught in public administration classes. It did however give us this delightfully vulgar parody of that Cover Oregon ad from Last Week Tonight. So if nothing else, we should all take solace in that.


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  1. Pingback: Insurance Company UnitedHealth Might Quit the Affordable Care Act | The Post Turtle

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