By Jonathan Kaminsky
(Reuters) - Oregon, a state that fully embraced the Affordable Care Act, is enduring one of the rockiest rollouts of President Barack Obama's signature healthcare law, with an inoperative online exchange that has yet to enroll a single subscriber, requiring thousands to apply on paper instead.
Unlike most other states, Oregon set an ambitious course to make its insurance exchange, dubbed Cover Oregon, an "all-in-one" website for every individual seeking health coverage, including those who are eligible for Medicaid.
But instead of serving as a national model, Oregon's experience has emerged as a cautionary tale, inviting comparisons to technical glitches that have plagued other state-run portals and the federal government's website for those states lacking exchanges of their own.
Oregon's online exchange has remained inaccessible to the public, requiring the state to sign up applicants the old-fashioned way, using paper forms. This has made comparison shopping more difficult for consumers and severely slowed the enrollment process.
"Oregonians have questions," state Senate President Peter Courtney, a Democrat, said on Tuesday. "What went wrong with the rollout? How are they going to fix it? When are they going to get it right? Is the website contractor doing everything it can? Our people need to know."
Courtney urged state lawmakers to "ask the hard questions" of officials overseeing the state's healthcare exchange at a pair of legislative hearings on Wednesday.
Appearing at one of those hearings, Cover Oregon Executive Director Rocky King told a joint House-Senate committee that goals set for the state's exchange were overly ambitious given the short time afforded its designers.
"We took a four- or five-year project and tried to condense it into two, two-and-a-half years," King said. "We're not broken, it's just not done."
While he remains "laser focused" on getting the exchange fully functional, his staff is proceeding as if the website will remain offline through the open-enrollment period ending March 31, King said.
FILLING OUT FORMS
In the meantime, the state has resorted to urging would-be subscribers to fill out applications that are between nine and 19 pages long by hand, Cover Oregon spokesman Michael Cox said.
The program also has hired about 400 temporary workers to help process those applications before January 1, when the new plans are due to take effect, Cox said.
As part of that effort, staff members from his office are fanning out to hotel conference rooms and other venues across the state over the next week to help prospective enrollees complete the forms, he said.
Nearly 25,000 individuals and families have so far submitted hard-copy applications, Cox said, with nearly two-thirds of those applicants eligible for Medicaid, a federal-state healthcare plan for the needy.
But none of those applicants has actually been enrolled, with manual processing of the paperwork slowing the process dramatically.
Separately, about 70,000 residents have signed up for Medicaid by responding to letters sent by the state to more than 200,000 people deemed eligible for the program by virtue of their receiving food stamps, Cox said.
By comparison, Oregon's neighbor to the south, California - with a population 10 times larger - enrolled about 31,000 people in an Affordable Care Act plan last month, and added 29,000 in the first 12 days of November.
California has much farther to go, with an estimated 7.3 million adults and children lacking insurance in 2011, compared with 560,000 counted as uninsured that year in Oregon.
Jesse Ellis O'Brien, a healthcare advocate with the Oregon State Public Interest Research Group, which pushed for the exchange, said he is "surprised and frustrated" by its ongoing woes but hopeful that they will be resolved within the next month or two.
King stressed that while people cannot sign up for insurance online, the Cover Oregon website does allow them to browse information on available health plans.
A spokesman for Oregon Governor John Kitzhaber, a Democrat and medical doctor who supported the Affordable Care Act, did not immediately return messages seeking comment.
Greg Leo, chairman of Oregon's Republican Party and an avowed foe of the 2010 healthcare reform law, said its troubled rollout in Oregon underscores his view that patients would be better served by a system managed by the private sector.
"I don't take any joy in this," he said. "This creates a lot of harm for citizens in Oregon and nationally. It's a tragedy, and it further erodes people's confidence in government."
(Editing by Steve Gorman, Doina Chiacu and Sandra Maler)