• Horses midstream
    February 19,2014

    Another potential crisis is looming for Vermontís new health care exchange as the deadline for obtaining coverage approaches. If people eligible for coverage on the exchange donít sign up by March 15, they may be left without insurance altogether.

    In one sense, the rollout of Vermontís health care exchange ó Vermont Health Connect ó has been a success. In Vermont the highest percentage of eligible residents has successfully selected a plan on the state website. But as in other states, the launch of the website in October was a technological fiasco, and state officials and contractors have been struggling to fix the system so that people will not be left without coverage.

    Now, as reported in the Sunday Times Argus, state officials fear that thousands will rush to obtain coverage as the March 15 deadline approaches. And if they donít succeed in negotiating the website and securing a health plan, they could be left with no coverage at all until January.

    This dilemma has come to light as Vermont officials react to a lengthy article in Newsweek examining the creation of Vermont Health Connect and the failures of the lead contractor, CGI Technologies and Solutions. Newsweek portrays Vermontís struggles as a worrisome portent for the success of Obamacare as a whole and a dire warning about the prospects for Vermontís own plan to institute a single-payer system in 2017.

    The entire process has suffered from a pattern of optimistic cheerleading by Gov. Peter Shumlin and his team, followed by the admission of problems and pledges to set things straight. The Newsweek article suggests that Vermont officials were duped by CGI, which held a demonstration in July to show officials that the link between the state and federal systems was working. There is some dispute among participants about whether CGIís demonstration was or wasnít a charade to mollify worried Vermonters.

    At each stage of the project Shumlin and Mark Larson, the commissioner of health care access, have sounded cheery notes about progress even when they knew about numerous problems. Certainly, political leaders always like to inspire confidence in their projects, but when misplaced confidence becomes the rule, credibility suffers.

    We are midstream now, and there will be no immediate changing of horses. But people in a number of categories may be left without health insurance unless they sign up by March 15. These include people who are currently uninsured; they will not lose insurance, but they will be frozen out from obtaining insurance available to them until Jan. 1. Employees of small businesses whose coverage has been dropped by their employers have until March 15 to find coverage on their own.

    People presently in the Catamount and Vermont Health Access plans will lose their coverage at the end of March, but they will still be able to sign up on Vermont Health Connect after the deadline.

    If a sizable segment of the population suddenly finds itself frozen out of coverage, that would be a sorry outcome. But efforts are underway to lure as many people as possible into the exchange, both for the financial health of the exchange and for the well-being of individuals. It remains to be seen whether the website, which is much improved since its dysfunctional launch, will be able to handle a rush of people trying to sign up.

    What is apparent at this point is that thousands of people are now dependent on Vermont Health Connect, which, according to a report from Fletcher Allen in Burlington, the stateís largest hospital, appears to be working well. There is no easy way to go back, which is the case with the federal program as well. Those who have supported the new reforms are tied to a flawed product, and so they have an interest in making it work. They also have an interest in extending coverage to as many people as possible, which has been part of the point since the beginning.

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