Today’s Connector Board meeting focused on open enrollment progress, IT issues and coverage workarounds. The Connector leadership expressed a strong commitment to extending coverage to everyone eligible, without gaps and delays. At the same time, they acknowledged continuing problems with the IT, both the website and the eligibility processing systems. They are determined to find solutions and seek accountability for the deficiencies.
The meeting attracted more press than the Connector has seen in a long while, with a lengthy media scrum after the meeting. Coverage included the Springfield Republican, and Springfield’s channel 22, and the Boston Globe and Herald. Materials from the meeting are posted here. Our full report is coming right up:
New coverage options under the Affordable Care Act (ACA) became a reality for millions of people across the country as of January 1, 2014. Because the ACA goes beyond Massachusetts’ previous reforms, more residents will be eligible for help paying for health insurance under the ACA. According to Connector staff, despite significant website and eligibility system problems, 28,000 new people have access to subsidized coverage through MassHealth and the Health Connector. Many others were previously enrolled in coverage and must transition to new programs.
As of January 1st, 109,781 people were enrolled into Commonwealth Care and 39,224 people were enrolled in Commonwealth Choice. About 130,000 people with incomes below 133% of the federal poverty level (FPL) in Commonwealth Care – both those who were enrolled in a plan and those who were eligible but never enrolled – were automatically transitioned to MassHealth due to the ACA’s Medicaid expansion.
About 4,000 people seeking unsubsidized coverage were able to enroll in ACA coverage as of January 1st, which is a fraction of the current Commonwealth Choice population. The bulk of Commonwealth Choice members have a renewal date of April 1st and will need to reapply, choose a plan and pay a premium by March 24th.
Due to significant IT challenges, however, the eligibility system for new subsidized coverage options is not functional. Therefore, the Connector – in collaboration with MassHealth – implemented several coverage workarounds to ensure no one loses subsidized coverage and those who applied for subsidized coverage for January 1st can get it. Jean Yang, the Health Connector’s Executive Director, stated, “Our commitment is not to leave a single person out…Our goal is to sign people up for health insurance and we will make sure that happens with or without IT solutions.”
About 124,000 Commonwealth Care, Medical Security Plan (MSP) and Insurance Partnership (IP) members not eligible for MassHealth have access to extended coverage through March 31st, and need to reapply for ACA coverage by March 24th. Another 26,000 residents are enrolled temporary coverage. Provided through MassHealth. Temporary coverage is being provided to people for whom the Connector was unable to make an eligibility determination for, as long as they submitted a completed application for subsidized insurance and are not already enrolled in other subsidized health insurance programs. The state will receive a 50% federal match for this coverage.
In the longer term, the Connector is working to solve the persistent website and IT Issues. They brought in a rapid response assessment team to review the existing IT system and help determine next steps for technical fixes. The technical review will be made public once it is complete, next week.
Several board members suggested that while clearly the IT vendor CGI is at fault for the non-operational website and underlying IT system, the reviewers should also look at what went wrong with how the Connector and others involved in managed the contract and CGI’s work, in order to make improvements moving forward. Jean Yang responded that while the review is focused on technical fixes, part of the review will look at these process issues. Governor Patrick has also directed the Connector to consider the agency’s legal rights around CGI’s failure to perform and the cost of remediation.