Massachusetts

2019 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

I've ranted several times before about the importance of current Obamacare private policy enrollees making sure to actually visit the exchange website, shop aroundlog into your account and manually re-enroll for 2015, even if nothing has changed at your end (ie, no changes in income, dependents, residence etc).

There are many reasons NOT to auto-renew, most of which are financial in nature. The short version is, you could easily end up paying more than you thought next year by not switching (in addition to premium changes, your tax credit might drop even if your income hasn't changed due to how it's calculated), and you could pay substantially less next year if you do switch to another policy (premiums are actually dropping in many markets).

During the first open enrollment period, the official data releases from the various exchanges ranged all over the place.

HHS, of course, only issued monthly reports, without giving any official data in between (that is, until the numbers started looking good, at which point they issued milestone press releases of "3 million", "5 million" and so on, although even then they didn't give exact numbers or dates).

Some of the state exchanges stuck with monthly numbers as well (Colorado), while others gave out data roughly weekly (Nevada, via Twitter), bi-weekly, or whenever they happened to feel like it (most of the other states). As things ramped up towards March/April, some states started issuing regular weekly updates (including Oregon, which is ironic given all of their technical problems).

A few minutes ago, a guy named Ed Lyons tweeted the following:

The new @HealthConnector exchange launches tomorrow, 8 am. As I have said for a couple of months, I think it will be fine this time. #mapoli

— Ed Lyons (@mysteriousrook) November 14, 2014

This is huge. Why?

Because Ed Lyons is the same guy who wrote The Health Connector Autopsy Report, which documented everything that went wrong with the MA ACA exchange project, from before the beginning until after the end. I mean, everything.

All 31,000 words of it.

It's difficult to get across just how in-depth, comprehensive or well-researched/documented that report is. It's also important to understand that a) to the best of my knowledge, like myself, Mr. Lyons didn't do it for money or for fun; it was something of an obsession for him. It should also be noted that Mr. Lyons is a Republican.

Lots of people have spent today saying stuff like this:

COLORADO: Exchange COO joins exodus, new system late

Colorado’s 2.0 “Kentucky-style” system that is supposed to simplify the way people get health insurance won’t be ready until days before the Nov. 15 open enrollment starts.

And as Colorado’s health exchange enters its busy season, a third “chief” has announced she’s leaving Connect for Health Colorado. Chief Executive Patty Fontneau departed in August. Chief Financial Officer Cammie Blais left two weeks ago. And Chief Operating Officer Lindy Hinman announced her resignation and plans to leave next month after open enrollment begins.

VIRGINIA: Funds to help Va. health care coverage signups

Virginia is getting $9.3 million in federal funding to help residents sign up for health insurance.

Gov. Terry McAuliffe said the money will help hire more than 100 people to help with enrollment that runs from Nov. 15 through Feb. 15.

WASHINGTON: Health Exchange leaders are trying to solve the problems from the first sign-up period

CLARKSTON, WA – Leaders with Washington’s Health Care Exchange are preparing for the second open enrollment period, but at the same time they are still working on resolving billing and computer problems for 1,300 accounts from the first sign-up period.

IOWA: Three health insurers get OK to increase rates

This is very confusingly worded, because it makes it sound like all 3 companies have been operating on the HC.gov exchange when it turns out that only 2 of them have. Wellmark did not participate in the ACA exchange; the 19,000 customers referred to here have off-exchange policies which are still ACA-compliant:

Commissioner Nick Gerhart said today that he has approved premium increases from Wellmark Blue Cross and Blue Shield, CoOportunity Health and Coventry Health.

A nifty summary of technical data points/specs behind the completely overhauled/revamped state ACA exchange website in Massachusetts after the first one failed spectacularly last year includes the following key points:

306,000 — the latest number of Massachusetts residents enrolled in temporary coverage. Will all these people need to get coverage through the state? No one knows, because there’s been no way to process their eligibility this year. But the total number of people trying to use the site during the three months of open enrollment could be around…

450,000 — which is 306,000 + the 100,000 or so people who are still in subsidized Commonwealth Care plans and another 33,000 or so residents who buy insurance through the Connector.

With Open Enrollment 2.0 coming up fast, here's some quick hits from the various state-run ACA exchanges:

Massachusetts: State vows easier time on rebuilt Mass. Health Connector site

When people shop online for health insurance through the Massachusetts Health Connector next month, they will have a radically different experience than the trouble they encountered last year, state officials promised Thursday.

Last year’s website, redesigned to meet the terms of the Affordable Care Act, never worked properly, leaving people unable to buy subsidized health insurance. This year, officials say, the newly rebuilt website will enable users to cruise smoothly from log-in to plan choice.

Vermont: Thousands directed to shut-down health exchange website to pay bills

Thousands of Vermont Health Connect customers who signed up to pay health care premiums online recently received email notices directing them to pay through a website that is offline.

A couple of weeks ago there was a rather absurd-sounding report from a right-wing outlet called "The Pioneer Institute" which claimed that the Massachusetts Health Connector (their ACA exchange site) was going to cost over $1.1 billion over a 2-year period. I didn't really address it at the time, mainly because regardless of the disastrous experience of the MA exchange, that number just didn't seem grounded in reality. Sure enough, it turns out that estimate was about four times too high:

BOSTON - With the next open enrollment period set for Nov. 15, Gov. Deval Patrick on Monday said the state's troubled health care exchange website is fixed, at a cost of an additional $26 million to the state, bringing the federal and state total to $254 million in information technology costs.

...Consumers who log onto the Health Care Connector website will have a "full end-to-end shopping experience" for health plans on Nov. 15, Patrick said.

OK, all of this is moot if the new software platform proves to be as much of a mess as last year's was, but assuming the new setup works properly, this sounds like a fairly smart way of cleaning up the mess:

Open enrollment begins November 15, but individuals’ deadlines to enroll may vary.

A total of 285,000 people who currently have temporary coverage will need to re-enroll, but a proposal is in the state’s hands to do that enrollment in three waves, with three different deadlines– Jan. 15th for wave one, Jan. 31st for wave two, and Feb. 15th for wave three.

For those of you currently enrolled in a non-subsidized Affordable Care Act Plan, your deadline to re-enroll is by the end of this year, December 31st. Missing that deadline will cause you to have a gap in your coverage.

My in box is once again flooded with ACA-related stories which are interesting but which I just don't have time to do full write-ups on...

Fate of Children’s Insurance Program Is Called Into Question at Senate Hearing

WASHINGTON — A Senate hearing on Tuesday set the stage for a coming debate over whether the federal government should continue financing a popular health insurance program for lower-income children who are now eligible for new coverage options under the Affordable Care Act.

The Children’s Health Insurance Program, known as CHIP, has helped cut in half the uninsured rate for children, to about 7 percent in 2013 from 14 percent in 1997, when it was enacted. It provides coverage for about eight million children in families that earn too much to qualify for Medicaid, the government health care program for the poor, but cannot afford private coverage.

Zenefits’ Leader Is Rattling an Industry, So Why Is He Stressed Out?

Contributor ArcticStones forwarded this to me. I'm not in a position to either confirm or debunk many points in this article, but a quick search of this site for "Massachusetts Limbo" will bring up a number of references made in it. The author is a quite open Republican activist. However, if his claims are correct--and the bulk of them certainly seem to be--then those in charge of the first version of Massachusetts' ACA exchange should be held accountable for some rather appallingly bad decisions before, during and after the 2014 open enrollment period.

I generally support the Affordable Care Act, and states like Kentucky, Connecticut and (for the most part) Washington State, New York, Rhode Island and Colorado have proven that when the technology, budget, personnel and other project aspects are handled properly, it can be extremely successful. However, that also means not turning a blind eye or blaming the wrong source when things go wrong...and in the case of states like Oregon and Massachusetts, things did indeed go very, very wrong.

I've been too busy with my day job (I do have one, you know...) to post much lately, but plenty of ACA-related news has piled up, so I'm clearing off my desk with some quick bits:

KENTUCKY: Women leading Kentucky health: Kynect’s Banahan excited to reach even more people

First in a series of profiles about KY women in charge of the state exchange:

Energy exudes from Carrie Banahan when she talks about her work with others to bring affordable health care to more than half a million Kentuckians.

“I worked all my life to see this happen, that we can provide affordable health insurance to people, and it has actually happened,” she said. “I am thrilled that we are actually helping people in Kentucky. It is the highlight of my career.”

Banahan is executive director of the Kentucky Health Benefits Exchange, which the state has branded as Kynect, partly to avoid identification with the pejorative nickname Obamacare. She shares the credit for its success.

This is a classic case of one's attitude determining whether this is good or bad news. The headline and lede make a huge deal about 400,000 people having to re-enroll in the Massachusetts ACA exchange this winter...except that I've been pushing hard for everyone to be required to re-enroll once per year anyway regardless of whether their personal incomes/circumstances have changed over the past year or not...which means that to me, it's not only not a big deal that everyone in MA will be required to re-enroll, but it's actually a good thing:

Nearly 400,000 people in Massachusetts will need to reapply for health insurance before the end of the year, and many of them probably do not even know it.

They are people who do not have employer-sponsored health insurance and who instead sought insurance through the state. After the Massachusetts insurance website failed last year, most of them were enrolled in temporary coverage that ends Dec. 31, which is why they must select a new plan.

Some good news (relatively speaking) on the Massachusetts front: As you'll recall, the state which inspired the ACA (ironically due to the program being spearheaded by then-Governor Mitt Romney), and which has been operating under their state-level version of the law smoothly for some years now, had an incredibly embarrassing misfire with their ACA-specific exchange website. After hobbling through the first enrollment period (and leaving over 200,000 residents in healthcare limbo as a result), it was determined that the existing site was such a mess that they had two choices: Either replace the existing software with an entirely new system, or drop the whole thing and move over to the Federal exchange as Oregon is doing.

Instead, Massachusetts decided to hedge their bets and pursue both: They've been working with a new vendor to rebuild their own exchange from scratch, while simultaneously arranging for a quick move to HC.gov just in case Plan A doesn't work out.

The good news is that so far, anyway, the new platform seems to be working out in early testing, though it's way too early to be sure of anything:

Well I'll be damned:

When Massachusetts passed its landmark health coverage law under Gov. Mitt Romney in 2006, no one claimed the state would get to zero, as in 0 percent of residents who are uninsured. But numbers out today suggest Massachusetts is very close.

Between December 2013 and March of this year, when the federal government was urging people to enroll, the number of Massachusetts residents signed up for health coverage increased by more than 215,000. If that number holds, the percentage of Massachusetts residents who do not have coverage has dropped to less than 1 percent.

According to the Kaiser Family Foundation, Massachusetts only had around 242,000 uninsured residents out of 6.65 million total as of last September (about 3.6%), just before the ACA exchanges launched. So on the one hand, Massachusetts already had the lowest uninsured rate in the country due, of course, to RomneyCare, the precursor of Obamacare (no matter how much Mitt wants to deny it now, Lord knows why...)

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