Oregon State Flexibility to Stabilize the Market Grant Award

Grant Application Summary

Oregon Grantee: State of Oregon Department of Consumer and Business Services

Award Date: August 20, 2018

Total Award: $282,754.02

Baseline Award: $274,344.83

Workload Award: $8,409.19

Section 2702 - In addition to ensuring health insurance issuers are offering approved products for purchase, the Oregon Department of Consumer and Business Services will contract with a firm specializing in providing actuarial and economic expertise in the healthcare industry to analyze the impacts that different rating areas, as well as guaranteed availability of coverage rules, have on the individual market. The firm will focus on the following: the geographic rating areas used by insurers in determining Oregon premiums; the viability of using and continuing with the established rating areas and the flexibility insurers have to set different rates per area; the potential impact an adjustment to geographic rating areas would have on plan affordability and availability; and the potential impacts that changes to rating areas could have, including reduction in plans, wider range of costs, and fewer marketplace options and related subsidies. The firm will also analyze potential gaps in coverage between geographic rating areas and insurance plan service areas and the potential impact a congruency requirement would have on plan affordability and availability. The analysis of rating area affordability may also uncover additional causes or symptoms of the issue, including hospital and provider changes, marketplace competition, and State and Federal subsidies.