Though it was the first state to create an easy-to-use online health insurance marketplace and served as a model for the Affordable Care Act, Massachusetts now ranks last in its progress toward enrolling people under the federal law.
The failure of the state’s revamped website, run by the Massachusetts Health Connector, has required the state to process most applications on paper or offline, a slow process that has frustrated customers.
By the end of December, three months into the enrollment period, only 5,428 Connector shoppers had succeeded in choosing their preferred health plan, according to a report released this week by the US Department of Health and Human Services. That is far short of where the state needs to be to meet a goal of enrolling 250,000 in private health plans by the end of March.
To get there, the Connector should have had 117,500 sign-ups in the first half of the enrollment period, according to a federal memo. Actual sign-ups totaled just 5 percent of that goal. While some states had far less ambitious goals, none has fallen so far short of its target, an analysis by The New York Times found.
Enrollment goals were outlined in a September memo from Marilyn Tavenner, head of the Centers for Medicare & Medicaid Services. It noted that the Massachusetts target was set by the state.
But Connector spokesman Jason Lefferts said the Connector’s enrollment goal is a bit more conservative. In a report to the board last year, Connector staff projected enrollment at just over 200,000 by June 2014.
Plus, Lefferts said, many more people are being covered through the Connector, despite the small number of people who have chosen a health plan. Tens of thousands who were already enrolled in state insurance programs under the state’s landmark 2006 health insurance law have had their coverage extended through the end of March, to give the state time to work out problems with the website. Another 28,000 who applied for new state assistance have been given temporary coverage while the Connector determines their eligibility for state programs.
“Massachusetts was positioned to expand health care access and affordability by implementing the Affordable Care Act,” Lefferts said. “Halfway through the federal open enrollment period that is exactly what has happened.”
The state marketplace is meant to provide options to part-time workers, the self-
employed, or people who otherwise do not have affordable employer-sponsored coverage. The deadline for applying is March 24.
There is little indication that the website will be working then. Yet, at least 152,000 people on temporary or extended state coverage must use the Connector system to enroll in a new plan.
“People who up until this point have assumed that nothing’s wrong need to have some candid conversations,” said Joshua Archambault, director of health care policy at the Pioneer Institute, a Boston think tank.
Several states have far surpassed their sign-up goals in the first three months of enrollment or made a big dent. Connecticut signed up more than twice its goal of 15,510 people. Michigan hit its goal, with more than 75,500 sign-ups. Maryland had 18,272 people sign up for plans, about a quarter of its targeted number.
An independent technology firm is now reviewing the Connector website and will make recommendations about the best path forward. That review is expected to be completed Friday, but it is unclear when a final report will be issued.