Thursday, 08 May 2014

Do Romneycare’s Health Connector Failures Signal ObamaCare Woes?

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Massachusetts announced May 5 that it was abandoning its Health Connector website — the centerpiece of “Romneycare” that has been a model for ObamaCare nationally — after eight years of the landmark legislation in the Bay State. 

Politico.com's Kyle Cheney reported on May 5 that “Massachusetts has already spent $57 million on a system that never was able to enroll people with subsidies start to finish, and its failure has forced the state to enroll more than 160,000 residents in temporary Medicaid coverage — at an estimated $10 million-a-month cost.” In the wake of such massive inefficiencies, it's perhaps not surprising that Massachusetts healthcare plan policyholders have long paid among the highest premiums in the nation — premium costs exceeded only by Alaska and the District of Columbia in 2012, according to a Kaiser Family Foundation report.

Massachusetts appointed a new website administrator in February, Sarah Iselin, who has announced that the state is going toward a “dual track” of rebuilding its HealthConnectorMA.org website and making the state's policies compliant for purchase on the federal government's site. Iselin — chosen by Governor Deval Patrick to fix the website problem — had worked for the commissioner of insurance during the Romneycare rollout in 2006. She had also worked for the state's largest health insurance company, Blue Cross Blue Shield of Massachusetts.

Boston's WBZ Television reporter Jon Keller noted in a March 23, 2014 interview with Iselin that he had received numerous complaints about the state Health Connector website. Keller said he received one complaint from a woman who “sent in her application for coverage months ago, still does not know if it has been received, can not get a straight answer from the connector despite repeated phone calls. What's your message to her, and through her to thousands of others in the same plight?”

Iselin acknowledged that she inherited a backlog of unprocessed applications totaling 72,000, and told the local CBS affiliate:

First of all, we need to do better. That is what we are very much focused upon right now, because people should not be having this experience. It's not what residents of the commonwealth deserve. And it does not reflect our commitment to access to health care for folks in this state. So I'm hoping you will give me her information so I can have someone reach out to her and ensure that she can get through the system and get coverage.

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Iselin had been appointed in the wake of a MITRE Corporation report that recommended that the governor “establish one full-time senior government executive accountable for the success of ACA program planning and execution for the Commonwealth.” Governor Patrick appointed Iselin just two days later.

Six weeks later, Iselin had fired the chief contractor charged with managing the Massachusetts Health Connector website, the Canadian-based CGI, top executives of whom had been donors to top Massachusetts state politicians of both parties for years. CGI had also been a key contractor for ObamaCare's HealthCare.gov website, which also had famously experienced massive rollout problems.

The February 4, 2014 report from the MITRE Corporation noted that the Massachusetts “website was not fully operational on October 1, 2013, the federally mandated start of the initial health insurance marketplace open enrollment period in accordance with the ACA.” Part of the reason, the MITRE Corporation found, was that “no single entity within the Commonwealth owns IT governance and there are no clearly identified roles, responsibilities, decision-making authorities, and accountabilities.” In other words, Massachusetts healthcare had become an impenetrable bureaucracy with no accountability. The results, the MITRE Corporation concluded, were:

• Required core functions are not working correctly, including but not limited to, Account Creation/Login and MassHealth Provider Search.

• Because of a very poor user experience, certain users who submit unsubsidized applications abandon the Health Connector portal and pursue the purchase of insurance directly from issuers.

The dual track goal announced by Iselin means that Massachusetts healthcare plan customers may have the reset button pushed on their healthcare plans again. And the Boston Herald reported May 6, “People enrolled through the Massachusetts Health Connector could once again lose their health plans this year as insurance carriers struggle to comply with the state’s eleventh-hour 'dual track' solution to rescue the woeful Obamacare health exchange.”

If Massachusetts' healthcare plan problems don't sound familiar to other Americans, they should. ObamaCare has famously also had problems with cancelling policyholders' policies despite Obama's repeated public promise that “if you like the plan you have, you can keep it.” The fact that Massachusetts has been unable to fix its numerous problems eight years after the 2006 rollout of Romneycare may have implications for the future of ObamaCare.

Interestingly enough, CGI is still working for the federal government on ObamaCare, despite a rash of news stories back in January claiming that the Obama administration had cancelled CGI's contract. Perhaps the hundreds of thousands of dollars in political donations from top CGI officials to political leaders in Washington have made a difference. And the four former U.S. government officials CGI has employed as lobbyists probably did not hurt their chances of a contract extension either.

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