Providence Health & Services, one of the largest health care providers and insurers in Oregon, is leaving the Oregon health insurance market, affecting corporate, government and individual ACA plans: Providence to exit health insurance business in 2027, citing rising costs and tougher regulation – oregonlive.com
PacificSource, partially owned by Legacy Health, is exiting the ACA individual plan market in Oregon: PacificSource to slash Oregon workforce, drop ACA marketplace plans in three states – oregonlive.com
PacficSource was the only ACA market health insurer that provided access to insurance outside the state (or PNW) via a national care provider network. All other plans that were checked contained no coverage (except for emergency treatment only – all else had to be in Oregon), not even “out of network” coverage for out of state travel in the United States. I confirmed this with an insurance broker.
Insurers may be choosing to leave Oregon’s market at the end of 2026 – because in September 2026, Oregon will formally propose a state run Oregon Universal Health Plan that would cover everyone for medical, dental and vision. State income and capital gains taxes would double to pay for it – and all Medicare patients would be mandated to transfer to the state system at higher costs and loss of some benefits, and an inability to move to other states where if they signed up for supplemental plans they would be subject to pre-existing condition exclusions that are not present when signing up at age 65. As proposed so far, the UHP is a bad deal for the state’s 900,000 Medicare clients. (Oregon has a poor track record running health insurance – Cover Oregon completely failed[1]).
With a state run health insurance program, there will be no private insurers in Oregon. Some insurers may be choosing to leave ahead of the UHP – which is proposed to launch in 2028.
Fewer insurers means higher premiums – which in 2024, were for us (if no subsidy, which no longer exists) about $24,000 per year with a $9,600 per person deductible or a $19,200 per family deductible. In 2027, rates will go up even higher. If we were not on Medicare, we would have to leave the state.
The ACA failed, for reasons I explained in a 2016 paper. The ACA contained numerous design defects and was wholly unsustainable:
- Summary -> ACA Summary.docx
- 2025 – updated, re-organized: ACAIndivMktRisks.docx
- 2016 – original document: ACAIndMktRisks.docx – Google Docs
[1] In 2013, Oregon launched its own ACA state-run health insurance marketplace. Before being shut down, “Cover Oregon” failed to enroll any individuals in ACA plans. The State spent $450 million dollars to develop and market the failed system.
Oregon produced one of the country’s worst rollouts of the new national health insurance program. While the crippled website eventually worked, Oregon’s failed to enroll a single person online. The state had to resort to hiring 400 people to process paper applications.
They filed suit against Oracle – and settled by getting free Oracle software licenses for 6 years ($450M wasted, $60M settlement value), after which the state is largely locked into Oracle software systems and paying annual license fees to Oracle for years to come. Looks like Oracle won the lawsuit. See State settles lawsuit with Oracle over Cover Oregon website
