Vt. Health Connect snag worries industry
By Peter Hirschfeld
Vermont Press Bureau | September 22,2013
MONTPELIER — Gov. Peter Shumlin last week dismissed as no big deal the disclosure by his administration that the new health insurance exchange won’t be ready to process premium payments until Nov. 1 — 30 days later than originally scheduled.
But one of the state’s most influential business groups said the postponement could complicate what it said has already become a harrowing transition for Vermont employers.
And the state’s largest insurance carrier, meanwhile, said it’s worried that the exchange’s vast technological apparatus might not be ready for prime time, and that deficiencies in the system and tight enrollment time frames could lead to lapses in coverage come the new year.
“The concern is that if information isn’t coming through cleanly, if people are not on the system by the time they need to be, then there may be an interruption of coverage for folks who went to the site and signed up and paid and did everything they needed to,” said Kevin Goddard, vice president of external affairs at Blue Cross Blue Shield of Vermont.
The health insurance exchange, called Vermont Health Connect, will serve as the online marketplace at which more than 100,000 Vermonters will soon purchase their insurance plans.
Shumlin signed into law a mandate last year that requires individuals and businesses with 50 or fewer employees to buy insurance from the exchange. While debate has long swirled over the financial impacts on prospective consumers, focus has now turned toward the capacity of the new system to process and transmit reams of digital enrollment data.
“The outreach part of this is going very, very well,” Goddard said. “Clearly there are incredible numbers of people with very complicated questions about how this transition will affect them … but we feel we’re well positioned for that portion of this task.”
He adds, “The other key piece, though, for the successful implementation of Vermont Heath Connect is not only informing people, but making sure you can enroll people. … And what we’ve been very concerned about is the IT (information technology) side of this project.”
At a press conference last week. Shumlin chided media outlets for their reporting on the delay in Vermont Health Connect’s ability to process electronic payments for the insurance products that will be sold there.
“I was amazed that we could make a headline out of that fact, to be honest with you,” Shumlin said. “The fact of the matter is, that’s a nothing-burger.”
Mark Larson, commissioner of Vermont Health Access, said last week consumers will still be able to visit the site, compare prices, select a plan and submit enrollment data.
“All we had said is you have to wait until Nov. 1 to pay electronically for insurance that you’re not going to have until Jan. 1,” Shumlin said. “I don’t think there’s very many Vermonters that are going to be eager to pay for insurance on Oct. 1 that won’t go into effect until Jan. 1. If they wish to, we might want to give them a 101 on accounting.”
But Betsy Bishop, executive director of the Vermont Chamber of Commerce, said the postponement will impact consumer behavior in ways that aren’t necessarily advantageous to a successful transition to the new insurance landscape.
If businesses know they site won’t be fully functional until Nov. 1, Bishop said, then many aren’t going to bother going there until then.
“Employers are not going to do this twice,” Bishop said. “They want to go into the system once, upload their data, figure out their payments and be done.”
The effect of the delay, according to Bishop, will be to shrink by a third the three-month window during which businesses have to complete the process. The exchange opens Oct. 1; plans sold there will go into effect in January.
“We have a very large task ahead of us to get over 100,000 people into a system in 90 days,” Bishop said. “And now we’ve taken 30 days out of that, so that’s a concern from the employers’ side.”
Susan Gretkowski of MVP Health Care, which, along with BlueCross, is one of two private carriers selling policies on the exchange, said her company is happy with the state’s decision to delay payment-processing capabilities. She said the delay is the result of a decision to expand the testing phase from two weeks to six weeks.
“We feel it’s better to take time on the front end to make sure everything is going to work well, rather than rush and get everything ready for Oct. 1,” Gretkowski said.
MVP is “really worried,” however, about the deadline for consumers to pay for policies that take effect Jan. 1, she said. The Department of Vermont Health Access has decided to give customers until Dec. 21 to submit payments for their premiums, just 10 days before the plans go live.
“The state is not going to give us any enrollment information until we receive payment in full, so there is a possibility that a huge chunk of people are going to be enrolling … at a very late date for a Jan. 1 effective date,” Gretkowski said.
“We’ve made it very clear to the state that if that happens, it’s very unlikely we’re going to have folks loaded into the system and have their ID cards in hand by Jan. 1,” she said.
Goddard said that even under the best of circumstances, it will be difficult for carriers to clear the logistical hurdles needed to accomplish a seamless transition. The fact that system testing won’t be done until Nov. 1, he said, will leave very little time to address any shortcomings exposed by the tests.
“It’s possible everything will go just fine, and the system needs no kind of correction, no re-programming,” he said. “Normally in an IT project of this magnitude, that’s not the case.”
Shumlin said people shouldn’t expect perfection, and that the transition won’t be without “surprises, challenges (and) bumps in the road.”
“As with any test of anything new, 99 percent of it works great, 1 percent doesn’t, and we’re working hard to fix that 1 percent,” Shumlin said. “You’ve got to expect there are going to be good days and bad days, happy days and sad days. But it’s going to work.”
Darcie Johnston, head of Vermonters for Health Care Freedom, an organization that lobbied against requiring employers to buy from the exchange, said the schedule changes and concerns from carriers are symptomatic of broader structural problems in the new marketplace.
“It has been promised over and over again that the system was on track to work, and that Vermonters could buy in an online marketplace on Oct. 1. And there’s no evidence that that is going to be the case,” Johnston said.
“And we are now greatly concerned that Vermonters who can afford to buy on the exchange are now going to be delayed, and risk the possibility that they’re going to have lapses in their health care coverage.”