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Problems continue to plague Mass. health marketplace

With three weeks left in the year, not one of the thousands of Massachusetts residents who need to enroll in new health insurance plans by Jan. 1 has been able to do so through the state insurance marketplace that was revamped to comply with the national Affordable Care Act.

About 126,000 people enrolled in health plans subsidized by the state have until March to choose a new plan and can keep their current coverage until then. But thousands of others are depending on a new plan to start on the first of the year, and some worry that their coverage will not be ready in time. Their anxiety has only been heightened by stubborn technical problems, such as a snag this week that blocked many people from signing in to the website.

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Gina Kamentsky of Somerville has been trying to enroll through the Massachusetts Health Connector for weeks. Her insurance plan, bought through her partner’s former employer, expires this month. Because of expensive medications and a doctor’s appointment she cannot miss, the 54-year-old artist from Somerville said she needs coverage in January. Plus, the landmark 2006 state health insurance law, the model for the national law, requires her and most others to have coverage.

Kamentsky was first stymied by the widespread technological problems. At the end of October, she filed a paper application. She has been stuck since then in a shuffle of documents and on long calls with customer support staff, but she feels no closer to being enrolled.

“There’s no feedback,” she said. “There’s no way to tell if anything has been processed. Time is ticking away.”

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More than 32,000 people have been able to complete an application. Only about 1,700 have selected a health plan.

A small number have been able to submit payment information online, bringing them near full enrollment, but the state will not process those payments until Dec. 23.

‘There’s no feedback. There’s no way to tell if anything has been processed. Time is ticking away.’

Gina Kamentsky, Somerville 
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The Connector Authority will mail invoices starting next week, said executive director Jean Yang. That leaves little time for customers to return a check or credit card information and for the Connector Authority to deliver payments to insurers, with all information needed to create accounts and finalize enrollment.

“Obviously time is tight,” Yang said. “At the same time, we are working extremely closely with the carriers, so that they know what’s coming.”

The $69 million website was built by CGI, which helped develop the much-maligned federal health insurance site, HealthCare.gov. The Health Connector website, by communicating with federal databases and the state Medicaid program, was meant to give users a place where they could find out which insurance subsidies they qualify for. But that function of the website has not worked.

Many people who applied for a subsidy are in a holding pattern, waiting for the Connector Authority to verify their eligibility so they can shop for a plan. Yang said Health Connector staff and contractors are working to find the fixes necessary to make online verification possible and, in the meantime, to identify applicants who need coverage starting Jan. 1.

Many people already receiving state insurance subsidies — through Commonwealth Care, the Medical Security Program for people who are unemployed, and the Insurance Partnership for small business employees — must re-enroll in a new plan, but the state extended the deadline for that group from Dec. 23 until March 24, giving them three more months on their current plans.

As many as 15,000 people who have completed applications do not fall into that category, and an unknown number of them could be uninsured on Jan. 1 if they are not enrolled through the Health Connector.

Yang said CGI has increased the number of people working on the website, and the Connector Authority plans to boost the number of customer service representatives to as many as 190 by the end of December, up from about 65 last month.

“We are not happy with the situation; there’s no question about it,” Yang said. “We look at the vendors critically. We look at ourselves critically. We ask ourselves every day how fast can we make things better.”

Nationally, insurers have expressed frustration that the enrollment records sent by the federal website have been inaccurate. Yang said the state is preparing a back-up plan to deliver data in a spreadsheet or a similar format if the state’s website fails on that front, too.

Typically, insurers need seven to 10 days to set up an account and get insurance cards and an enrollment packet to new customers, said Eric Linzer, spokesman for the Massachusetts Association of Health Plans. But the carriers sometimes receive information about new enrollments up to the last day of the month. The state has not approached carriers about any possibility of missing its deadline for January enrollees, Linzer said.

“The plans are going to be working very hard to make sure that members have what they need for coverage that’s effective Jan. 1,” he said.

But the state may already be short on time, said Bill Fields, a business consultant who works with companies on insurance compliance. Insurers may process the occasional case on the last day of the month, but he figures that the bulk of enrollments must to be sent to carriers by about the end of next week to be processed in time.

“This is a mess,” Fields said. “The sad thing is that the people who are going to get hurt are the people that they’re trying to help.”

Carrie Murray of Abington completed the application process for her family of five on Tuesday. Murray has been buying unsubsidized coverage through the Health Connector since June, when her husband started his own architectural firm. That plan expires this month. After months of grappling with the Health Connector website, Murray finished applying over the phone. Now, she is waiting on an invoice and is still anxious.

“I don’t know if I’m going to get the paperwork in time,” she said. “And, then once I pay the check, will that go through in time.”

Connector administrators need to communicate more directly with the public to explain what challenges they are facing and what they are doing to fix them, said Brian Rosman, research director for Health Care for All, the Boston-based consumer group. But, he said, he is confident that the agency will find ways to keep people like Kamentsky and Murray from falling through the cracks.

“They’ve told us they will, and there’s no reason to think that they won’t,” he said. “They have to.”

Chelsea Conaboy can be reached at chelsea.conaboy
@globe.com
. Follow her on Twitter @cconaboy.
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