Portland, Oregon: Community Report

Oregon's collaborative spirit is reflected in bipartisan support for health care reform--the first state to pass legislation enacting a state-run health insurance exchange.

Shaped by Oregon’s collaborative culture and activist history on health care issues, the Portland metropolitan area appears well prepared for national health reform, according to a new Center for Studying Health System Change (HSC) study of the region’s commercial and Medicaid insurance markets (see Data Source). Longstanding bipartisan support for health reform helped Oregon be in the vanguard of states authorizing a state health insurance exchange. With highly regarded leadership at the exchange’s helm, there is broad-based consensus that Oregon is among the states best prepared to roll out open enrollment on Oct. 1, 2013, although substantial work and testing still needs to be accomplished to meet the deadline.

Oregon previously adopted many of the components of the Patient Protection and Affordable Care Act of 2010 (ACA)—including small-group and individual, or nongroup, health insurance regulations and an expanded Medicaid program for low-income people. While ACA insurance requirements are more stringent than Oregon’s, they will not be completely novel to a community accustomed to significant government involvement in health insurance markets. However, Portland-area health plan executives, benefits consultants, insurance brokers and others are concerned about the impact of health reform on risk selection and premiums in the nongroup and small-group markets.