Health care exchange contingency plan outlined
MONTPELIER — Gov. Peter Shumlin laid out a contingency plan Thursday that will delay the mandate for health insurance coverage on the state’s health care exchange until March 31 after a key test of the online payment system failed Wednesday night.
Vermont Health Connect, the state’s version of the online health insurance marketplaces required under the Affordable Care Act, has been beset with technical glitches since it launched on Oct. 1.
The plan announced Thursday was a tacit admission of major failings in the system after weeks of expressing confidence that it would be fully functional around Nov. 1.
“The level of progress with Vermont Health Connect’s corrections has been slow enough so that I have determined that we need to add some additional options to ensure that Vermonters have no fear that they will lose coverage if they can’t find a way to navigate the system before the Jan. 1 deadline,” Shumlin told reporters at his weekly news conference.
Vermont passed legislation mandating that individuals and small businesses with 50 or fewer employees purchase health insurance on the exchange. But now, with a malfunctioning website and uncertainty when it will be fixed, the deadline will be extended.
The Department of Financial Regulation has issued a rule — permitted under Act 171 — to allow both individuals and employers to maintain current health care plans through March 31, even if they do not meet the new coverage requirements under ACA, said Shumlin, who was flanked by Republican Lt. Gov. Phil Scot, his senior health care team, Democratic legislative leaders and insurance company executives.
Small businesses, meanwhile, will be able to 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. Shumlin small businesses choosing this transitional option will make payments to the insurance carriers directly rather than through the exchange.
“Those two additional options should give Vermonters going into the holiday season a predictability and ease of mind that I believe they deserve given the technical problems we’ve been having,” Shumlin said. “To know that they can go to sleep tonight know that there is now way they will lose insurance on Jan. 1 if the website continues to struggle.”
Vermonters currently enrolled in Vermont Health Access Plan or Catamount Health will still transition to new plans under ACA on Jan. 1, according to Shumlin. Anyone under 138 percent of the poverty level will automatically roll in Medicaid plans. The state has already sent letters outlining that process, he said.
Vermonters above 138 percent of the poverty level receiving health care benefits through VHAP or Catamount will still be enrolled in Vermont Health Connect using paper applications and the exchange site if possible.
“We’re going to be working diligently with them to get them signed up by Jan. 1,” Shumlin said.
Underscoring the severity of the website’s problems, Shumlin said those plans could still be extended to March 31 if the exchange site problems persist.
“The backup plan is if for some reason we can’t get all the folks above 138 percent of poverty through the funnel we will extend their existing plans till March 31,” he said.
More than 100,000 Vermonters have visited the Vermont Health Connect site, with nearly 10,500 accounts created and almost 3,000 people selecting health care plans.
But the payment function has yet to work, and a new major test of the system Wednesday night resulted in a fresh failure, prompting Thursday’s announcement.
“We thought that last night’s test would be able to bring us functionality of those systems. It didn’t. So, our vendors continue to work 24-7 to get those systems working,” Shumlin said.
Shumlin said he “fully expects” the site will be operational, but he said he will no longer try to predict when it will be ready.
“If I’ve learned one lesson as governor, with my enthusiasm to make change and to get tough things done, it is this — never give a date again,” Shumlin said.
Shumlin also said for the first time Thursday that his administration will seek reimbursements guaranteed in the contract with CGI Systems and Technologies for missing key goals.
“I’ve explained to the vendors that we are having our legal team begin the process of ensuring that all options afforded to us in the contracts are exercised so that we are compensated for the difficulties that we have been having,” the governor said.
“We will pursue those as we continue to work cooperatively with our vendors to try and make changes and improvements to the site as quickly as we can,” he said.
Shumlin apologized for the site’s failures and struck a softer tone Thursday, a stark contrast to extreme confidence he had been expressing for weeks, even as the concerns of political opponents grew louder.
“As governor my job is at times to push and at times I’ve got to be the one who takes the responsibility for where we are and charts a predictable course that doesn’t disrupt business and doesn’t disrupt individual Vermonters who desperately need health insurance,” he said. “I apologize for the challenges that we’ve been having. I take full responsibilities for them. I will continue to fix them.”
Darcie Johnston, head of Vermonters for Health Freedom and perhaps the strongest opponent of Vermont Health Connect, said she was “thrilled” that Shumlin acted “to protect all Vermonters from losing their health insurance in January.”
Johnston and Republican leaders in the Legislature had previously called for such an action.
She said her group will now turn its attention to eliminating the mandate altogether and convincing lawmakers to investigate the exchange mishaps.
“Clearly this issue is going to be on docket for the Legislature and we are strongly encouraging that the Legislature create a blue ribbon, independent commission to investigate, and hire an independent investigator to review what happened with Vermont Health Connect. Heads should roll,” Johnston said. “There were clearly problems that should not have gone on this long. Whether or not it goes beyond incompetence, whether or not individuals within Vermont Health Connect knowingly deceived the federal government and Vermonters is something that I think an independent commission needs to determine,” she said
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