Though Oregon's health insurance exchange is not yet up and running, the number of uninsured is already dropping thanks to new fast-track enrollment for the Oregon Health Plan. The low-income, Medicaid-funded program has already signed up 56,000 new people, cutting the state's number of uninsured by 10 percent, according to Oregon Health Authority officials.
It's hardly a secret that the first two weeks of the Affordable Care Act's open-enrollment period have been rocky. Indeed, while officials scramble to address technical problems as quickly as possible, new concerns continue to come to light.
The system's defenders, however, are not without compelling responses. It is, for example, still early, and plenty of similar troubles have plagued similar systems in years past. It's also true that the system would be running far smoother if fewer Republican governors hadn't refused to create state marketplaces of their own. What's more, the problems have been technical, not structural -- the computer difficulties don't detract from the merits of the underlying law.
But as Jonathan Cohn noted this morning, to "fully appreciate what's happening, you need a split screen." While the federally-run marketplace has been overwhelmed, there are ample state-based success stories natonwide.
Take Oregon, for example.
Just to be clear, the progress is not the result of a better online exchange. On the contrary, Oregon's website doesn't work yet. Rather, state officials created a fast-track registration process, approved by the Obama administration, that's quickly expanding coverage through Medicaid expansion.
Sarah Kliff explained that Oregon Gov. John Kitzhaber (D) is "obsessed" with the issue, and his administration specifically targeted uninsured residents. The "wave of notices targeting the exact people who are supposed to qualify for Obamacare's benefits in the first place" has made a real difference.
The larger takeaway reinforces a couple of important truths. First, Medicaid expansion, rejected by far too many far-right governors, is a powerful tool in quickly reducing the number of uninsured Americans. For many "red" states to deliberately turn down these resources is a tragedy.
Second, as has been clear for a while, when state officials want "Obamacare" to work, it can quite well. Technical troubles notwithstanding, the success of the health care policy is largely a matter of political will.