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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 consumer assistance 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:
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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.
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Collection of data, particularly on race and ethnicity, will facilitate our understanding of enrollment disparities.
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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 October 2024, the SBM Project completed a variety of deliverables which included:
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Release of Request for Proposals #12121 for a platform and customer assistance center solution (closed for submissions on Jan. 8, 2025). For any questions regarding this solicitation, please contact Julie Curry, the Department of Administrative Services State Procurement Services Sole Point of Contact, at julie.a.curry@das.oregon.gov.
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Independent Quality Management Services (iQMS) Quality Standards Report, Quality Management Plan, and Baseline iQMS workplan.
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Monthly and quarterly reports provided by iQMS vendor.
The Marketplace continues to place an emphasis on the importance of partner engagement, with continued activities through the end of 2024, which included:
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Insurance agent, applications assister, and insurance carrier listening sessions in Oct. 2024. A report of results (orhim.info/40hryX5) is available on the SBM Project website.
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Project update given to the Health Insurance Marketplace Advisory Committee (HIMAC) in Oct. and Dec. 2024 with feedback gathered on Policy Option Package 424, progress on the request for proposals , and engagement activities.
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Monthly updates given at partner collaborative meetings and through newsletters sent to insurance agents and application assisters.
The table below contains a comprehensive list of deliverables and milestones, along with their corresponding start dates, due dates, and current status.
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Business case, charter, planning initialization
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Stage Gate 1 endorsement, Initiation complete
Approved conditionally, contingent on independent quality management services (IQMS) vendor acquisition
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Stage Gate 2 endorsement, Resource & solution analysis and planning complete
Resource and solution analysis and planning, includes cloud workbook, requirements collection, Quality Assurance vendor acquisition, start of RFP planning, 50% accuracy scope, schedule, and budget
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Solution vendor procurement
RFP planning and process through contract execution
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Stage Gate 3 endorsement, Implementation planning complete
Includes detailed budget and schedule, baseline project plan based on executed contract, approved LFO readiness assessment and execution funds
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Go/No-go for November 2026 go-live Assessment to determine system readiness for target date. Marks point of no return for transition completion by Nov. 2026
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Stage Gate 4, Execution complete and move to operations
Product/system acceptance, maintenance and operations in steady state begins
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