STATE HOUSE, BOSTON, APRIL 10, 2014…. Many of the helpful features envisioned when the state set out to build the Rolls-Royce of health insurance exchanges may have to be set aside for now, according to the Patrick administration, which is tempering expectations in advance of the scheduled relaunch of its exchange site this fall.
Sarah Iselin, the special adviser Gov. Deval Patrick put in charge of fixing the exchange website, told the Health Connector Board on Thursday that she and her team would be ready in early May to present their plan to develop a fully functioning enrollment site before the start of the next open enrollment period in November.
The options include rebuilding the existing site, which continues to be bogged down by technical problems, or trying to leverage pieces of technology deployed in other states that have worked well.
“It has become abundantly clear that we are not going to have everything we want for the fall,” said Iselin, describing a future plan that will focus on minimizing the risk of failure a second time by developing a site that can efficiently accomplish the main objectives of allowing people to apply and shop for health insurance online.
Some of the consumer-friendly functions that may have to be put on hold until 2015 include the ability to pay premiums through the website after a plan has been selected, or the option of updating one’s policy to reflect life changes such as marriage or a birth.
Connector officials also offered enrollment updates to the board following the end of the open enrollment period for plans under the Affordable Care Act on March 31.
Iselin said she will present the plan to the board at a May 8 meeting, along with contingencies that under a worst case scenario would require the Connector to make actual public policy changes to accommodate the capacity of the website to process consumers.
Once the plan is fully developed, Iselin said she would go back to the Centers for Medicare and Medicaid Services to request a second three-month extension until Sept. 30 that would allow current subsidized health coverage subscribers in Commonwealth Care to keep their plans until they can be transitioned to ACA-compliant plans.
“We need to convince them that we are on a no-risk path for the next open enrollment period,” Iselin said.
Iselin, hired by Patrick to spearhead the turnaround effort on the Connector’s website, also touched briefly on the fact that she likely won’t be around to see all of her plans come to fruition. Iselin, who took an unpaid leave of absence from Blue Cross Blue Shield to take on this project for the governor, said she anticipates returning to her job in late May or early June.
“I’m working very closely with the governor’s office around really mapping out a transition plan that includes not only replacing me but having a single point of accountability for this project,” Iselin said. The state’s Chief Information Officer Bill Oates is expected to take on an expanded role, and Iselin said she hopes there will be a period of overlap between her and her successor.
Key to any long-term plan for developing a fully-functional website will be having a system in place that can automatically process applications and make eligibility determinations that assign applicants to correct coverage areas, including MassHealth, subsidized options or unsubsidized insurance. The failure of that component in the website built by the state’s former IT vendor CGI required Connector officials to develop manual ways of processing applications that is time-consuming and labor intensive.
Optum, the technology consultant brought on board to help with the fix, has begun testing the work they’ve completed to revamp the eligibility determination system and will continue the testing phase through late June when officials hope to begin transitioning people to their final health plans.
Though some applicants for health insurance through the Connector will be given until April 15 to complete the process if they encountered web trouble, the open enrollment period for most residents ended on March 31.
Connector officials reported that through April 8 the number of people enrolled in MassHealth, or Medicaid, had grown by 192,432 members to 1.6 million statewide under the expanded eligibility rules of the ACA. Conversely, enrollment in Commonwealth Care fell by 115,099 to 101,766. Another 159,111 individuals have been placed into temporary MassHealth coverage while they await determinations and placements in ACA-compliant health plans.
“The goal of all of us is to try to find every person in the Commonwealth and find them coverage and these numbers continue, notwithstanding the problems we’ve had, to show it’s very likely the numbers of insured have gone up,” board member Nancy Turnbull said.
While those enrolled in MassHealth are there to stay, there have been only another 769 individuals who have been able to successfully enroll in subsidized ACA plans, and another 34,040 people have subscribed through the Connector for unsubsidized individual or small group business plans compliant with ACA standards.
Secretary of Administration and Finance Glen Shor, who chairs the Connector board, said it was worth noting that about 20,000 subscribers for unsubsidized coverage were able to successfully navigate the website to find coverage.
Josh Archambault, director of health care policy at the Pioneer Institute, said the administration “appears to be suffering from delusions of success.”
“It is like celebrating the patching of most of the leaks on your boat, but still not having a working motor, any gas, or a functional steering wheel. No matter how you look at it, you still will not even think about leaving the dock,” Archambault said.
All 260,877 people in Commonwealth Care and transitional coverage will have to be transitioned before the end of September, assuming the state gets another extension.
Copyright 2014 State House News Service