By Carla Anderson
April 4, 2014
To accommodate the many people who have struggled with the Massachusetts Health Connector, the state extended the sign-up deadline. Massachusetts residents now have until April 15 to shop online for unsubsidized health insurance. They must pay their first premium by April 23 for coverage effective May 1 or by May 22 for coverage starting June 1.
While the health insurance marketplaces created by 2010 Affordable Care Act (ACA) are modeled on the Massachusetts exchange, the Health Connector has performed very poorly since the current enrollment period opened on Oct. 1. Technical upgrades that were needed to make Health Connector ACA-compliant were not implemented smoothly or on time. Consumers have had difficulty creating accounts and experienced broken links, error messages, and “frozen” screens. Even worse, software on the Health Connector is not able to determine which type of subsidies consumers are eligible for. That issue forced Health Connector to process many applications manually.
Health Connector hired a consultant, MITRE Corporation, to assess its website problems. MITRE determined that CGI — the lead IT vendor — lacked necessary expertise, managed the project poorly, lost data, and failed to adequately test the revamped website prior to its launch. MITRE also said the roles and decision-making authority of the three state entities involved in the project (Massachusetts Health Connector, MassHealth, and the University of Massachusetts Medical School) were unclear.
Despite the issues with CGI, Gov. Deval Patrick said it would be too disruptive to cut all ties with CGI during open enrollment. Now that open enrollment is over, Health Connector officials are moving to terminate the CGI contract. So far, the state has paid CSI $15 million of a $68 million contract that was to run through September. In January, Massachusetts brought on Optum, a subsidiary of United HealthGroup, to work through some of the immediate problems with the Connector. The Optum contract is valued at nearly $10 million. Gov. Patrick appointed Sarah Iselin, chief strategy officer at Blue Cross Blue Shield of Massachusetts, to lead the fixes to the Health Connector.
To fall in line with the ACA’s eligibility standards, Massachusetts had to rely on its balky system to manage not only new applicants, but also populations that were already enrolled in state-sponsored programs. The two main programs affected were Commonwealth Care (for uninsured low and moderate-income individuals) and Commonwealth Choice (for uninsured adults who make too much to qualify for Commonwealth Care). Those previously enrolled in Commonwealth Care moved to either MassHealth (a combined program for Medicaid and the Children’s State Health Insurance Program, or CHIP) or became eligible to shop for a subsidized plan on Health Connector. Those enrolled in Commonwealth Choice were to select a new plan by March 31; however, the federal government has extended the deadline to June 30.
As of March 28, about 24,000 people had enrolled in private health plans. About 125,000 people who recently applied for subsidized coverage have been temporarily enrolled in MassHealth plans while systems experts work to repair the Health Connector. An additional 115,000 people remain on state-sponsored programs that pre-date the Affordable Care Act.
Ten health insurers are offering 114 options on the Health Connector for 2014:
Massachusetts Health Connector
State Exchange Profile: Massachusetts
The Henry J. Kaiser Family Foundation overview of Massachusetts’ progress toward creating a state health insurance exchange.
Health Care for All – Massachusetts Consumer Assistance Program
Assists people insured by private health plans, Medicaid, or other plans in resolving problems pertaining to their health coverage; assists uninsured residents with access to care.(800) 272-4232
Office of Patient Protection, Department of Public Health
800-436-7757 (toll-free nationwide)
Serves residents and other consumers who receive health coverage from a Massachusetts carrier, insurer, or HMO.
Let your Massachusetts governor and legislators know how you feel about the state’s proposed health insurance exchange.Massachusetts Governor Deval Patrick