State-based Marketplace Project October 2024 Update

Senate Bill 972 (2023) requires the Oregon Health Authority (OHA) to transition the Marketplace from a state-based marketplace using the federal platform (SBM-FP) to a state-based marketplace (SBM) using its own technology in time for open enrollment for plan year 2027. Specifically, OHA is required to procure and administer an information technology platform or service and call center, separate from the federal platform and call center, to provide electronic access to the health insurance exchange in this state by November 1, 2026.  

The Oregon Health Insurance Marketplace helps people in Oregon access affordable, high-quality health insurance through enrollment in private health insurance and federal subsidies during annual open enrollment and special enrollment periods. A state-based marketplace will give the Marketplace more flexibility to make open enrollment fit the unique needs and budgets of people across Oregon while also allowing for community input into process and procedure changes.  

OHA is also dedicated to eliminating health inequities in Oregon by 2030. Below you will find some ways this change to the Marketplace will better serve communities of focus: 

• Allows access to real-time data and evidence to tailor outreach and be more intentional about efforts to enroll disproportionately uninsured people, including people of color and rural residents. 

• Collection of data, particularly on race and ethnicity, will facilitate our understanding of enrollment disparities. 

• Additional and more reliable data will allow Oregon to refine its outreach and communication strategies, both overall and in real time to reach targeted communities. 

• Immigrants and non-native English speakers may be more likely to enroll if additional translation and interpretation services are available to help them complete the application or to communicate effectively with navigators, agents and brokers, or the call center. 

Since the last update in July 2024, the SBM Project team has been diligently working to complete deliverables including:  

• Collaborating with the project’s independent quality management service (iQMS) to finalize a quality standards definition report, quality management plan, and QMS work plan;  
• iQMS vendor Bluecrane has been interviewing project team members to identify risks and issues. Bluecrane has also completed monthly and quarterly status reports since the project quality management standards and QMS work plans were completed in July.

Completing a request for proposals for SBM platform and consumer assistance center and undergoing the review and evaluation process that is scheduled to be completes by the end of November; and,Initiating work for the Centers for Medicare & Medicaid Services’ Exchange Blueprint Application as set in motion by Governor Tina Kotek’s Letter of Intent submitted on Sept. 11.  

The table below contains a comprehensive list of deliverables and milestones, along with their corresponding start dates, due dates, and current status.