Cover Oregon Seeking HHS Approval to Simplify Paper Application

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At nineteen pages long, and with close to 100 questions and four appendices, Cover Oregon’s paper application for health insurance and tax subsidies is no joke for people trying to get enrolled in coverage.

Cover Oregon officials say they recognize the application is not as user-friendly as it could be.

Acting Director Bruce Goldberg told legislators in mid-January the agency is seeking approval from the U.S. Department of Health and Human Services (HHS) to revise the form.

Since then, Cover Oregon staff have been unwilling to elaborate on the kind of revisions that are being considered.

However, members of Cover Oregon’s Community Advisory Committee offered a number of suggestions during the committee’s meeting in early January that give a hint of possible changes.

Suggestions ranged from simplifying some of the wording to adding explanations and reformatting the text.

Committee member Helen Ying, who is on the board of We Can Do Better, a Portland-based organization that advocates for healthcare reform, said the application should be as simple as possible.

“If we make the form daunting and difficult for people to fill out, they’ll avoid it,” Ying said.

Several other members of the committee also called for simplification.

Some also noted that the definition of a “household” for the purpose of calculating premium subsidies is trickier than it might seem.

It was suggested that the “household” part of the application should be significantly rewritten to include a variety of scenarios in which people live together but don’t file joint tax returns, such as domestic partners, unmarried partners, and children who have one parent in a couple.

Jesse Ellis O’Brien, a health care advocate at the consumer group OSPRIG, suggested moving all of the optional questions on the application to the end so that consumers don’t get bogged down on questions they don’t actually need to answer.

Every question the application asks is required by state or federal law. But consumers have the option of not answering some of the questions—such as those that ask about race and ethnicity.

One change that has already been made is related to how income is reported. The original application requested “gross” profits, rather than “net” profits. That proved especially tricky for self-employed people, since their gross profit doesn’t necessarily reflect business-related deductions. “It’s inherently difficult, because you don’t know what it’s going to be,” O’Brien said.

Cover Oregon’s evolving application is among a number of signs that the agency is committed to trying to make up for lost time, regain consumer confidence and increase enrollment as much as possible before the open enrollment period ends on March 31.

As of Jan. 24, more than 30,000 Oregonians had enrolled in a health plan using a paper application.