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Oregon, a state that fully embraced the Affordable Care Act, is enduring one of the rockiest rollouts of President Barack Obama's signature health care law, with an inoperative online exchange that has yet to enroll a single subscriber, requiring thousands to apply on paper instead.
Unlike most other states, Oregon set an ambitious course to make its insurance exchange, dubbed Cover Oregon, an "all-in-one" website for every individual seeking health coverage, including those who are eligible for Medicaid.
But instead of serving as a national model, Oregon's experience has emerged as a cautionary tale, inviting comparisons to technical glitches that have plagued other state-run portals and the federal government's website for those states lacking exchanges of their own.
Oregon's online exchange has remained inaccessible to the public, requiring the state to sign up applicants the old-fashioned way, using paper forms. This has made comparison shopping more difficult for consumers and severely slowed the enrollment process.
"Oregonians have questions," said state Senate President Peter Courtney, a Democrat, in a written statement on Tuesday. "What went wrong with the rollout? How are they going to fix it? When are they going to get it right? Is the website contractor doing everything it can? Our people need to know."
Courtney urged state lawmakers to "ask the hard questions" of officials overseeing the state's health care exchange, and the Oregon Health Authority, at a pair of legislative hearings on the program scheduled for Wednesday.
With its online insurance marketplace out of commission and unavailable to the public indefinitely, the state has resorted to urging would-be subscribers to fill out applications that are between nine and 19 pages long by hand, said Michael Cox, a spokesman for Cover Oregon.
In the meantime, the program has hired about 400 temporary workers to help process those applications before Jan. 1, when the new plans are due to take effect, Cox said.
As part of that effort, staff members from his office are fanning out to hotel conference rooms and other venues across the state over the next week to help prospective enrollees complete the forms, he said.
Nearly 25,000 individuals and families have so far submitted hard-copy applications, Cox said, with nearly two-thirds of those applicants eligible for Medicaid, a federal-state health care plan for the needy.
But none of those applicants has actually been enrolled, with manual processing of the paperwork slowing the process dramatically.
Separately, about 70,000 residents have signed up for Medicaid by responding to letters sent by the state to more than 200,000 people deemed eligible for the program by virtue of their receiving food stamps, Cox said.
By comparison, Oregon's neighbor to the south, California - with a population 10 times larger - enrolled about 31,000 people in an Affordable Care Act plan last month, and added 29,000 in the first 12 days of November.
California had much farther to go, with an estimated 7.3 million adults and children lacking insurance in 2011, compared with 560,000 counted as uninsured that year in Oregon.
Jesse Ellis O'Brien, a health care advocate with the Oregon State Public Interest Research Group, which pushed for the exchange, said he is "surprised and frustrated" by its ongoing woes but hopeful that they will be resolved within the next month or two.
"Once the website is functional it will provide a lot of valuable tools for consumers to make informed comparisons between plans," he said.
A spokesman for Oregon Gov. John Kitzhaber, a Democrat and medical doctor who supported the Affordable Care Act, did not immediately return messages seeking comment.
Greg Leo, chairman of Oregon's Republican Party and an avowed foe of the 2010 health care reform law, said its troubled rollout in Oregon underscores his view that patients would be better served by a system managed by the private sector.
"I don't take any joy in this," he said. "This creates a lot of harm for citizens in Oregon and nationally. It's a tragedy, and it further erodes people's confidence in government."