Oregon had no luck with getting its exchange enrollment system to work, but a survey team found that the state residents who managed to get covered seem to be reasonably healthy.
Bill Wright, a representative from the Center for Outcomes Research & Education at Providence Health & Services, gave that assessment in survey results included in a recent Cover Oregon board meeting packet.
The center mailed questionnaires to 9,945 exchange qualified health plan (QHP) users and received 2,114 responses. Wright noted that users of the survey results should recognize that the participants may not be completely representative of the people who bought QHPs through Oregon’s Cover Oregon exchange.
But the answers from the exchange QHP users who did return questionnaires may give some hints regarding how sick or healthy QHP users are overall.
In Iowa, for example, the insurance commissioner has suggested in rate decision comments that 2014 claims experience has been worse than insurers had originally expected.
An analyst at Express Scripts has published pharmacy program data suggesting that QHP enrollees were as likely as other health plan enrollees to use specialty drugs for many conditions, such as transplants or multiple sclerosis, but twice as likely to use specialty drugs for hepatitis C, and four times as likely to use specialty drugs for HIV.
In Oregon, the new survey results may provide some vindication for exchange managers who focused heavily on developing quirky ads that might appeal to young, healthy people. One product was a funny TV ad featuring folk singers.
Cover Oregon’s enrollment system ended up working so poorly that, for 2015, the exchange will use the U.S. Department of Health and Human Services (HHS) HealthCare.gov enrollment system. The exchange pulled its ads while using manual workarounds to try to handle would-be enrollees.
But the survey results suggest that the ads may have helped bring in relatively low-risk applicants. Only 9 percent of the QHP enrollees said they smoke and 85 percent said they think they’re in good, very good or excellent health.
In a comparison group consisting of low-income Oregon residents who were uninsured or had Medicaid, 40 percent of the people polled said they smoke, and only 55 percent said they were in good or better health.
Similarly, when the survey team asked about specific conditions, they found that the QHP enrollees were much less likely to report having the specific conditions.
Only 7 percent of the QHP enrollees said they had diabetes, for example, and 7 percent said they had asthma. In the comparison group, 10 percent said they had diabetes, and 17 percent said they had asthma.