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). All other plans that were checked contained no coverage (except for emergency treatment only – all else had to be back in Oregon), not even “out of network” coverage for out of state travel in the United States. I confirmed this with an insurance broker.
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. (Oregon, which failed at running its own “health marketplace exchange”[1], is proposing ending Medicare in the state in 2028, moving everyone, including Medicare covered patients, to a state run insurance program. Medicare enrollees would lose most of their nationwide access, and lose benefits they may have through supplement policies like Plan G. Medicare enrollees would pay higher taxes – a literal doubling of the state’s already high flat rate income and capital gains tax – and lose some benefits.)
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 now largely locked into Oracle software systems and paying annual license fees to Oracle for years to come. Looks like Oracle basically won the lawsuit. See State settles lawsuit with Oracle over Cover Oregon website
