A lot of people beat up on the Oregon Health Plan. Some think the state's medical insurance plan for the poor is too stingy. Others think it's too generous. A tip from a reader revealed a more basic flaw: It's too busy.
Health plan members who have questions about what procedures are covered or who need to speak to a caseworker are referred to a toll-free number: 1-800-699-9075. The tipster claimed that the number, operational 9 am-5 pm weekdays) was always busy. She wasn't that far off.
During a recent four-day stretch, WW called the 800 number 48 times. We got through only twice (see below).
Part of the problem lies with state lawmakers, who initially threatened to wipe out the entire health-care program but in the end cobbled together enough cash to keep it going. But they're not about to fork over the estimated $500,000 needed to expand and upgrade the 16-line phone center, whose customer-service representatives each handle about 400 calls a week.
State officials share some of the blame. The phone line is operated by the Department of Human Services. When asked how often a caller could expect to get a busy signal, DHS officials told WW they don't track that info (which, they conceded, is readily available). Instead, they noted that the average wait to talk to someone has decreased from more than three minutes in February to under 40 seconds in September. That's great news--but only for callers who can get far enough to be put on hold.
The OHP is the proverbial safety net for Oregon's most vulnerable residents: people who are not just poor and not just sick, but poor and sick. The customer-service reps (who are very helpful once you get to talk to them) are their guides through a system that baffles even health-care experts. A busy signal is a roguishly horrible greeting. WW CALL RECORD Date (duration of test) Calls Made Busy Signal Sept. 30 (2 hours) 7 7 Oct. 1 (3 1/2 hours) 11 10 Oct. 2 (2 1/2 hours) 20 19 Oct. 3 (4 hours) 10 10