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New online tool could help get Oregonians who are not on an employer-provided plan, Medicare or the Oregon Health Plan

SCREENSHOT - The Oregonhealthcare.gov website is shown here. It's open enrollment time for Oregonians who buy their own health insurance coverage. Will a new online tool for consumers help more people enroll?

Oregonians who are not on an employer-provided plan, Medicare or the Oregon Health Plan have until Dec. 15 to pick a private plan and enroll in it.

To help out, the state's enrollment website, Oregonhealthcare.gov, now lets consumers access "Oregon's window shop," which provides estimates of likely yearly cost for different plans, depending on whether you expect to be relatively healthy or max-out your out-of-pocket costs.

Clicking on "window shop" from the main state website leads consumers to Consumer's Checkbook, operated by a Washington, D.C.-based nonprofit, the Center for the Study of Services.

The window shop information tries to carve through complicated terminology to get to the bottom line of what health care could cost an Oregon consumer, providing an estimate of your costs for the year, depending on whether you expect have low, average or high usage of health care.

The new website "gives a more readable way for people to actually compare plans," said Numi Griffith, a health care policy analyst for the Oregon State Public Interest Group, or OSPIRG. "I think that's going to be a good tool."

She said the website may not be for everybody, given that it does not include fine print, such as penalties for going out of your insurer's approved network of doctors and other providers.

For some of those refined details of plans, and how your plan may have changed from last year, go to oregonhealthrates.org.

The state will pay Consumer's Checkbook $227,000 for the window-shopping service.

Another big change for consumers this year: Elizabeth Cronen, communications manager for the Oregon Health Insurance Marketplace, noted that the lowest level of plan, called a "bronze" plan, will include coverage of primary care visits for a co-pay, abandoning an earlier experiment that made the bronze plans appropriate for pairing with a health savings account — an option many people don't have.

The changes and new tools reflect how some states are seeking to overcome high premiums; the failings of the federal enrollment website Healthcare.gov; and counter-efforts by President Donald Trump to dismantle the Patient Protection and Affordable Care Act, commonly known as Obamacare, which took effect in 2014.

The law sparked a boost in individual health insurance enrollment, from about 185,605 in 2014 to 242,280 in 2016. That figure plummeted back down to 183,327 last year.

Cost have escalated steadily, helping explain the drop. But health care experts say changes made by the Trump administration have further driven costs up and enrollment down. Notably, those steps include eliminating the penalty for failing to get coverage and eliminating a Congressionally-approved program to limit the risk that health insurers will get hit with huge medical costs.

Slide over?

Many core features of the Affordable Care Act remain in place, including reduced premiums for people whose incomes qualify them for subsidies — $49,960 for an individual or $103,000 for a family of four.

Griffith said she is hopeful that the downward slide is over, noting that the biggest drop-off in enrollment has been among people who make only a little more than the income cutoff for subsidies.

She also noted that the premiums for next year's plans generally haven't gone up much, and in some instances have gone down.

"All indications are that the marketplace is in a pretty stable place," she said.

Despite the high costs of insurance, Griffith said it's a better investment than people might think.

"I had a climbing injury last month that I ended up going into the hospital for," Griffith said. "My out-of-pocket expenses for that injury have collectively ended up being around $2,200.

"The cash price for dealing with that would have been about $25,000 based on the bills that I looked through ... which is something that would definitely put you into bankruptcy."

What Obamacare did

Taking effect in 2014, the Affordable Care Act sought to boost overall health care coverage. It increased the number of people eligible for Medicaid, the low-income program, and also sought to boost enrollment in the individual health market, which is often how people who are self-employed or independent contractors get covered.

The law did so by prohibiting insurers from discriminating against people with pre-existing health conditions and requiring states use an online enrollment tool to let consumers sign up. It standardized bronze, silver and gold level plans to allow comparison-shopping online.

Meanwhile, the law required most people to have coverage or pay a penalty.


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