Lawmakers grill official over health website issues
By Neal P. Goswami
VERMONT PRESS BUREAU | November 06,2013
MONTPELIER — Administration officials at the helm of Vermont Heath Connect were grilled by lawmakers Tuesday on the exchange site’s continuing failures as officials continued to iron out details for extending existing health plans.
Mark Larson, commissioner of Vermont Health Access, faced tough questions from the House Health Care Committee. Even typically administration-friendly lawmakers expressed frustration with the state’s troubled online insurance marketplace.
Rep. Chris Pearson, P-Burlington, said committee members had expressed concerns earlier this year about whether the exchange would be ready for the federally mandated launch of Oct. 1. The administration assured lawmakers at the time that things were on track, he said.
But now, Pearson said, reports have shown “it was kind of clear to some people behind the scenes that that was not the case.”
He added, “I think Vermonters would be well served to have advance warning if we’re not able to meet the promises we’ve made.”
Pearson questioned why lawmakers should trust that the administration is now on track to fix the persistent issues with the website. Poor functionality and a continuing failure of the system that processes payments for health insurance plans led to Gov. Peter Shumlin allowing an extension of current health care plans from Dec. 31 to March 31.
“The guts of what we’re doing is going to work and is going to be good, but the optics of a website that can’t handle a few thousand viewers after we’ve had an enormous expense is pretty bad,” Pearson said.
“So how am I supposed to have faith in the administration moving forward when we’re asking difficult questions and perhaps getting sugar-coated answers?” he asked.
Larson acknowledged the site’s shortcomings but pushed back against the suggestion that the administration downplayed those challenges with lawmakers and the public.
“The information that I provided at that time was consistent with the information that we had about our schedule,” Larson said. “We were always working on a very tight schedule from the very, very beginning. That was the biggest risk to not just our project, but to projects across the country.”
Officials also said Tuesday the state has considered dumping its main exchange developer, CGI Systems and Technologies. The response followed questions from Rep. Douglas Gage, R-Rutland, about CGI’s “dismal performance” on both the Vermont and federal sites.
“Are you at least considering terminating the contract with them and going with someone else instead of throwing good money after bad?” he asked.
Robin Lunge, the administration’s director of health care reform, said that action is “certainly an option,” but unlikely.
“At this point all options are on the table. We are considering the pros and cons of every legal remedy we have available to us,” Lunge said. “There is a significant con to that, which is the time frame for hiring a new vendor and getting them in place.”
Lunge said the state’s procurement process would take four to six months to complete before a new contractor could begin work.
“We don’t have four to six months, so there are significant reasons why we would want to continue … the work with CGI, keep their feet to the fire to deliver on what they promised,” she said.
Vermont opted to build its own health insurance exchange rather than join the federal site serving 36 other states. Each state is required to offer health insurance plans on a web-based marketplace under the federal Affordable Care Act, or Obamacare.
Vermont met its obligation to launch the state exchange site Oct. 1. But the site has been plagued with technical glitches from the onset, and enrollment remains slow.
Vermont is the only state to pass legislation mandating that all individuals and small businesses with 50 or fewer employers purchase insurance on the exchange. About 100,000 people in total are expected to seek exchange plans as a result. But according to Larson, only about 2,800 have done so.
The slow enrollment process is not a surprise, though, according to Larson. He said the administration expects enrollment numbers to skyrocket as deadlines approach, similar to the experience in Massachusetts when it launched its own health care reform initiative.
“I think if you look at the experience of the … Massachusetts exchange that started … several years ago, they saw the same process,” he said.
“The enrollment was sort of slow and steady growth until the end and then there was a very dramatic increase at the end because people took their time and then when they got to the deadline they made their selections.”
Because of the slow enrollment and technical issues, Shumlin opted to extend the deadline to March 31 and provide more options for people to access exchange plans, according to Larson.
Both individuals and employers will now be able to maintain current health care plans through March 31 even if they do not meet the new coverage requirements under ACA.
Shumlin also announced that small businesses can obtain insurance plans for employees directly with Blue Cross Blue Shield and MVP Health Care, the state’s two insurers.
Under ACA, insurance carriers can be considered “agents” of the exchange system and sell insurance plans directly to employers, bypassing the need for the exchange site. How payments will be processed and whether out-of-pocket deductibles will carry over into the new year or reset has yet to be determined.
Exactly how the administration will deal with the extension is expected to be explained this week. Administration officials met with the state’s two insurance carriers Monday and Tuesday.
“Those (details) will be forthcoming and we will provide training for navigators and brokers as soon as all of those details are available,” Larson said. “That will happen this week. What we’re aware of is that we can’t partially roll out the information.”
Rep. Mary Morrissey, R-Bennington, continued a tough line of questioning, peppering Larson with questions about how thoroughly the exchange site was tested before it launched.
Larson said the state demonstrated enough functionality to the federal government to receive a green light for launch. Internal testing also took place, he said, but not to the extent desired because of the fast-approaching launch date.
“Obviously in the schedule there was a limited amount of time for us to do a lot of testing that we would have preferred to have done,” he said.
Morrissey also sought a live demonstration of the exchange site, but Larson said it would require using real information, including a Social Security number.
Lawmakers were also concerned about a report delivered to DVHA officials by a consultant, Gartner Inc., that outlined concerns with the exchange site as early as mid-September. The report said Vermont Health Connect had significant risks of not meeting the Oct. 1 launch date.
“Consistently, we all knew that the timeline was tight and that the schedule was tight and that there was a significant amount of work that we had to do at the very end,” Larson said of the report.
“I believe that I always indicated that, while we were working on a schedule, there was a lot left to do and obviously in the end we didn’t complete enough of that work to be able … to have the functionality that was expected on Oct. 1 to be fully functional.”