Vermont

VT Digger, September 16:

The Vermont Health Connect website went down Monday night and will remain offline for several weeks to allow for improvements to the user experience and data security, state officials said Tuesday.

Customers who need to report changes in income or make changes to their coverage or personal information will need to contact the customer service call center.

Vermont Governor Shumlin, November 7th:

Gov. Peter Shumlin is “hopeful” that Vermont’s health care exchange website will be online in time for the open enrollment period that begins Nov. 15. But he didn’t sound certain Friday that his team will make the deadline.

“I’ve been discouraged so many times by this website that I’ll believe it when I see it,” Shumlin said on Vermont Edition Friday. “What I’ve been told by my folks who are working really hard on this is that we’ll be ready for open enrollment on Nov. 15.”

VERMONT: Federal Law Raises Questions About Who Can Bid For IT Projects That Support The Exchange

A provision of the Affordable Care Act precluding health insurers or companies in the “same controlled group of corporations” as a health insurer from holding exchange contracts raises questions about Optum working on Vermont Health Connect.

Concerns regarding Optum were raised at the federal level by Sens. Orrin Hatch, R-Utah, and Chuck Grassley, R-Iowa, the ranking members of the Finance and Judiciary committees respectively.

IDAHO: Your Health Idaho to launch sign-up system

Basically just an overview of the new Idaho ACA exchange; ID is the only state moving from HC.gov to their own website for the 2nd year, giving them a unique perspective. Most interesting to me is that they're spinning the "autonomy/states-rights" angle, which was the whole reason for pushing states to set up their own exchanges in the first place:

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.

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...

ILLINOIS: Clock Ticking For Illinois To Form State-Run Obamacare Exchange

Unless Illinois acts quickly, it will leave hundreds of millions of federal dollars on the table that would go toward building its own health insurance marketplace, potentially upping the cost of coverage for nearly 170,000 Illinois residents. State lawmakers, unable to break a years-long standoff, have not passed a law authorizing a state-based exchange, the marketplaces created under the Affordable Care Act that allow consumers to compare and buy health coverage, often with the help of federal tax credits. As a result, Illinois was one of 36 states that relied on the federal government to host its marketplace on HealthCare.gov, the website that survived a disastrous launch late last year to enroll about 217,000 Illinoisans, 77 percent of whom received federal help.

On the one hand, Vermont's ACA exchange still has serious technical flaws heading into the 2nd open enrollment period this November. On the other hand, under the circumstances, this is probably the smartest move to make right now:

The Vermont Health Connect website went down Monday night and will remain offline for several weeks to allow for improvements to the user experience and data security, state officials said Tuesday.

Customers who need to report changes in income or make changes to their coverage or personal information will need to contact the customer service call center.

...None of the major functions that are still being developed will be launched when the website comes back online, said Lawrence Miller Chief of Health Care Reform.

 

The timeline for remaining elements, such as online changes to coverage or personal information or allowing small businesses to use the site has not changed.

Those functions are expected to launch sometime next year.

Between my son being sick for the past 4 days (he's better now, thanks!), losing my internet connection for 2 days (it's back up now, thanks!) and just generally being swamped with work, I don't have time to give these stories the attention they deserve, but they're all worth checking out:

McAuliffe unveils 10-step plan to expand health coverage for Virginians

Beyond that [the 25,000 people being added to Medicaid], the strategy seeks to chip away at the ranks of the uninsured, by enrolling them in programs they already qualify but haven't signed up for. The state will launch a website to help Virginians enroll in health care coverage through existing programs such as Medicaid and will step up efforts to sign up more Virginians for the federal health insurance exchange, HealthCare.gov.

Bill Straub: Kentucky GOP’s rendition of ‘I’m Against It’ may hit sour note on health care

This is a fairly short article. The thing that's noteworthy about my "weighting" is that I had to combine both the individual QHPs as well as VT's SHOP enrollments due to the unique situation in that state (it's a long story). QHPs + SHOP = around 66,600 paid enrollees as of the end of July. Since BCBSVT has 65K of those (over 97%), that gives a weighted average increase of around 7.8%.

Again, the other important things to note are that 1) this is still well below the "double-digit spikes!!" that nay-sayers have been screaming about for the past year, and 2) it's also around 20% lower on average than what the insurers had originally requested (weighted average).

MONTPELIER — People who buy their health insurance through the Vermont Health Connect website are going to be seeing their rates go up.

On Tuesday, the Green Mountain Care Board authorized Blue Cross and Blue Shield of Vermont to increase its rates an average of 7.7 percent while MVP subscribers will see their rates increase 10.9 percent.

Blue Cross, the state’s largest health care insurer with about 65,000 customers enrolled through Vermont Health Connect, had requested an increase of 9.8 percent while MVP asked for 15.3 percent.

Three more quick hits...the third one really deserves its own entry, but frankly, I'm too exhausted today and want to get it off the books, so...

Vermont: STATE SIGNS $9.5 MILLION CONTRACT EXPANDING ROLE OF OPTUM IN HEALTH CARE EXCHANGE

Vermont signed a revised contract with the tech firm Optum that expands its role in Vermont Health Connect’s operations.

Optum already had a contract worth $5.6 million for consulting work, and the latest deal, signed Aug. 15, is worth an additional $9.5 million for a total of $15.1 million.

 

...At latest count, Optum has helped the state halve its backlog of coverage changes and information errors from a high of more than 14,000 to roughly 7,000. Also, close to 4,000 people are having billing issues with Vermont Health Connect. There is some overlap between the two groups, Miller said.

Minnesota exchange gets new marketers

The news that MNsure is switching to a new ad team isn't that noteworthy, but check out the reasoning (in bold):

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 hits:

HEALTHCARE.GOV: Lack of Back End Software for Federal Exchange

One of the big news stories in 2013 and early 2014 was the botched launch of the federal Exchange (and several key state Exchanges), which led to many Americans having to wait to be enrolled in an ACA-sanctioned health plan.  Although some technical snafus have been addressed, many still remain.  For example, a top White House official told Congress recently that the automated system to send payments to insurance companies is still under development, and didn't offer a completion date. The lack of an electronic verification process is only one part of the "backend" of the software that is still problematic five years after the Act was passed.

NEVADA: After health care debacle, Gov. Brian Sandoval reluctantly extends Nevada’s ties with Xerox

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:

ARKANSAS:

Mark Pryor shows Democrats how they should campaign on the Affordable Care Act in a red state. You don't have to mention Obamacare (which technically doesn't even exist), you don't have to even mention the Affordable Care Act. You do have to personalize what the law actually means for real people with real medical issues which were fixed or improved by the law:

Read more on this ad & angle from Greg Sargent of the Washington Post.

VERMONT:

Finally, a solid update out of Vermont; thanks to Morgan True of VT Digger for pointing me towards the most recent Vermont Health Connect report as of just a week or so ago:

There's a lot going on in the table above. For one thing, this demonstrates, again, how stupid it was to hyperventilate about "How many have PAID???" back in February or March, when a good 40% or more of the people who would eventually enroll wouldn't even have their policies kick in for weeks or even months yet. Note that of those whose policies started between January 1 - May 1st, over 95% have paid their first premiums by now:

Once toothless, Cover Oregon board tackles an uncertain future

...After taking political heat for the exchange's technological failure, the appointees of Gov. John Kitzhaber are taking on a more significant role, transforming the agency for the future. At a time when critics of the agency say it should go away, it's the bureaucratic equivalent of an existential moment for an agency considered crucial to federal health reforms.

... The state's planned 2015 partnership with the federal exchange is called a "supported state-based" exchange. But it's supposed to be a temporary fix before setting up a full-fledged state-based exchange. It allows Oregon to keep insurer fees of about 2.5 percent of premiums for itself until the state resurrects its own website.

Vermont Health Connect shakes up practices, adds personnel

OK, the Medicaid number is a bit squirrelly since it isn't broken out by expansion/woodworkers/churn; the official number as of 4/19 was 27,268, so I'm estimating it at an even 30K.

Otherwise, the QHP total is for paid enrollees, up from 27,221, and the SHOP number is up from 33,614.

Vermont Health Connect has helped 144,500 Vermonters get health coverage. More than half, 80,400, were enrolled in Medicaid, many as a result of the program’s expansion under the Affordable Care Act.

However, the website was launched with significant problems, and eight months later it is still incomplete. State officials said this week that they will continue to rely on the two participating insurance carriers to enroll small businesses throughout the upcoming open enrollment period that begins Nov. 15. There are currently 34,800 people in that group.

There are also 29,300 people in the individual market who purchased commercial insurance. More than half, 62 percent, qualified for subsidies that lower the cost of those plans, though advocates say they are often still difficult to afford.

As I noted yesterday, there are three states which had unusually large discrepancies between the official HHS and state exchange QHP enrollments:

  • New York came in over 65,000 lower than the number I had for a simple reason: The New York exchange lumps enrollees in their Child Health Plus program in with QHPs, even though technically this isn't a QHP program. There were over 40,000 of these as of the end of February; this number has climbed to 65,028 as of 4/19.
    Since Child Health Plus is privately funded (and therefore isn't on the Medicaid/CHIP side), but also isn't officially a QHP either according to HHS, I've moved it over to the "Off Exchange QHP" column.

Latest Vermont Health Connect stats

• 52,156: Vermonters who used the Vermont Health Connect website, call center or navigators to shop for 2013 health insurance and now have coverage.

• 24,888: Vermonters who purchased commercial coverage through Vermont Health Connect.

• 27,268: Vermonters who shopped on Vermont Health Connect but qualified and are now enrolled in Medicaid. Eligibility expanded under the federal Affordable Care Act.

• 33,549: Vermonters previously covered by the Vermont Health Access Program and Catamount Health who the state enrolled automatically in Medicaid based on income information on record.

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