Oregon's Health CO-OP 

Oregon Joins the Ranks of States Hoping to Host a CO-OP - Expanding health care coverage to more Americans is a cornerstone of the Patient Protection and Affordable Care Act of 2010. The legislation includes $3.8 billion in federal loans to capitalize prospective Consumer Operated and Oriented Plans (CO-OPs) for individuals and small businesses purchasing coverage through the Oregon Health Insurance Exchange. In October, Oregon joined at least two dozen other states as the home of a proposed CO-OP.

What is a CO-OP?

  • CO-OPs are consumer-oriented health plans with consumer-based boards.
  • Each CO-OP will have a majority of members on its governing board, all elected by majority vote of the CO-OP’s membership.
  • Unlike traditional “cooperatives,” according to federal rules, CO-OPs will not pay profits to individual members. Instead, any profits will be used to lower premiums, improve benefits, or develop programs to expand or improve the quality of health care delivered to members.
  • The federally proposed rules for CO-OPs allow a non-profit, non-issuer organization to sponsor and contract for services with, but not control or govern, a CO-OP. Oregon’s Health CO-OP's sponsor is CareOregon.
  • CO-OPs are independent entities, with governing boards and officers separate from their sponsors. If its board wishes, a CO-OP may enter into a contract with its sponsor to provide services.

 

How is Oregon’s Health CO-OP Organized?

  • Oregon’s Health CO-OP submitted its application to the federal government on October 15, 2011. If Oregon’s Health CO-OP’s application is approved, it could get a start-up loan in early 2012, and begin enrolling members by the end of 2013. Coverage would likely begin January 1, 2014, at the same time the Oregon’s Health Insurance Exchange becomes operational.
  • Oregon’s Health CO-OP’s start-up board includes three directors, who may elect up to 12 additional directors to the formational board. All serve without pay. The initial three directors are Cory Streisinger, former head of the Oregon Department of Consumer and Business Services and Oregon Insurance Commissioner; Brian Rohter, co-founder of New Seasons Market, a major Oregon retail grocery chain with strong community values; and Ed Blackburn, the executive director of Central City Concern, a non-profit agency which serves more than 13,000 adults and families in the Portland metro area experiencing homelessness, poverty or addiction.
  • As part of its application process, Oregon’s Health CO-OP received approximately $122,500 in cash and in-kind donations and supporting letters from unions, provider groups, health care advocacy organizations, community health centers, and lawmakers. Public officials who provided letters of support include Governor Kitzhaber, Senators Jeff Merkley and Ron Wyden, and Congressman Earl Blumenauer.
  • Oregon’s Health CO-OPintends to initially contract with CareOregon for assembling a provider network, as well as administrative, operational, and financial services.

 

What are Oregon’s Health CO-OP’s Goals?

  • Oregon’s Health CO-OP wants to offer Oregonians a new option for health coverage -- one that puts the members in control, and engages them in taking an active role in their own health and well-being. Focusing on preventive care, rather than waiting for major illnesses or acute episodes, can enable members to stay healthier, while controlling costs.
  • While the CO-OP will be open to all individuals and small businesses, Oregon’s Health CO-OP also hopes to serve Medicaid recipients who may lose their coverage. Approximately one-third of all Oregon Health Plan (Medicaid) recipients who “churn” off Medicaid as their incomes or circumstances change—are re-enrolled in Medicaid within 90 days. Oregon’s Health CO-OP initially intends to base its provider network on CareOregon’s. So former Medicaid recipients that chose to join Oregon’s Health CO-OP could continue seeing their established providers and ensure continuity of care.

For more information about Oregon's Health CO-OP, e-mail: info@ORHealthCO-OP.org or visit the Oregon's Health CO-OP website.