Making it work
Gov. Peter Shumlin apologized last week for difficulties Vermonters are encountering on Vermont Health Connect, the new health care exchange, and he took steps to guarantee that consumers will not be left without insurance when the new year arrives.
Shumlin’s retreat from his previous attitude of boosterish optimism comes as foes of his health care initiatives are striking a more aggressive tone. Randy Brock, former candidate for governor and former state auditor, joined others in calling for a blue-ribbon commission to examine the failures of the exchange website and demanding that contractors be made to pay for their failures.
Vermont used the same Montreal-based company that the federal government did in setting up its website. And so far Vermont Health Connect has defied what is commonly described as “24/7” efforts to fix its glitches, errors and quirks. So far about 100,000 people have visited the state website, but only 10,500 accounts have been created, and only about 3,000 consumers have selected health coverage plans. So far nobody has been able to pay for their coverage.
On Wednesday last week, the website was subjected to a test of whether the payment function would work. It did not. So Shumlin gathered together a clutch of officials and insurance company executives to announce that he would push back the deadline for signing up from Jan. 1 to March 31.
This was a necessary and welcome action on Shumlin’s part, both to deflect mounting criticism and to ensure that people are not caught without insurance on Jan. 1. The worst situation of all would be for people to quit their present policies in order to obtain coverage on the exchange and then for the exchange to refuse to comply. It is important that the state, and the nation, maintain the credibility of the new system so that people will have confidence that it will do them some good.
A lot is at stake. Thousands of Vermonters are required by law to obtain their health care coverage on Vermont Health Connect. Businesses with 50 or fewer employers are required to provide coverage through the exchange or pay a penalty, and the individual market for people who do not receive coverage from employers will be through the exchange. If the exchange is not working, a lot of people could be left in the lurch.
The success of Vermont Health Connect, and of the federal program, is important, not to avoid embarrassment for Shumlin and President Obama. The Affordable Care Act represents the most significant social advance in decades. It promises to extend health care coverage to millions and to require that coverage be comprehensive and affordable. If the program were to fail, it would set back health care reform for a generation.
And clearly, that is what conservative opponents are hoping for. The market-oriented ideology that has prevailed in recent years does not allow for the involvement of the federal government in providing people’s health care. The failure of Obamacare — and Shumlincare — would mean a return to a system where it is every man or woman for him or herself: If you can’t afford insurance, that is your tough luck.
Pushing back the deadline for people to obtain coverage on the exchange ought to have the beneficial effect of allowing contractors and government officials a bit of breathing room so that they can correct website problems without rushing inadequate solutions forward. Apparently, the rush to put the website in place was part of the problem. Other problems are said to include an onerous bidding process that discourages highly qualified contractors from bidding on jobs and gives jobs to companies especially skilled at the bidding process.
These are the problems that the government ought to be investigating when the time comes to sort out the difficulties of the state and federal websites. A vindictive heads-must-roll attitude will not be not useful. Shumlin made clear he will hold the contractors accountable and will take advantage of clauses allowing the state to assess penalties for inadequate work.
The voters will also be able to hold Shumlin accountable. He has swung from cavalier dismissal of problems (it’s a “nothing burger”) to a willingness to recognize problems and take action. In the meantime, with 100,000 Vermonters logging on to the website, it is evident that people have an interest in making the system work.