Oregon Site Visit Report

A report funded by the Robert Wood Johnson Foundation, as part of its Affordable Care Act (ACA) Implementation-Monitoring and Tracking Series, examines Oregon’s progress toward implementing health care reform—both the ACA and the state’s own health reforms.

As Oregon has been a pioneer of health care reform for nearly 25 years, the Urban Institute authors conclude that in many ways, the ACA simply provided the necessary resources and a clear timeline for Oregon to do many of the things state leaders had already been planning. For example, Oregon was one of the first states to enact legislation to establish a health insurance exchange under the ACA, but the concept of an exchange has been around in the state since 2006.

The authors state that while Oregon has moved rapidly on health reform implementation, it still faces challenges. One such challenge Oregon, as well as many other states face involves taking key pieces of reforms from concepts to details—details that must be approved by the state legislature. Further, although health reform in Oregon has been bipartisan thus far, it is not clear how the legislature will receive specifics, particularly headed into an election year. Finally, if Oregon’s (and most other states) poor fiscal condition declines further, it may take away from the state’s momentum and focus on health care reform. The authors conclude that in spite of these challenges, Oregon is well positioned to fully implement the ACA, as well as its own health care reforms by January 1, 2014.

This report is one of 10 state case study analyses that will be completed in 2012. For Oregon, a three-person team conducted a three-day site visit in September 2011 to interview officials from the Governor’s Office, Department of Human Services, Oregon Health Authority, Department of Insurance, and Oregon Health Insurance Exchange Corporation, as well as other health care stakeholders.