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The Boston Globe

Health & wellness

Some who sought health coverage remain uninsured

The state cashed Carol Clark's premium check on Jan. 13, but she has no confirmation that she has been enrolled in coverage. ”I’m 62 years old. I cannot risk having my retirement and everything taken away from me if I’m in a car accident or I have a heart attack.”

Suzanne Kreiter/Globe Staff

The state cashed Carol Clark's premium check on Jan. 13, but she has no confirmation that she has been enrolled in coverage. ”I’m 62 years old. I cannot risk having my retirement and everything taken away from me if I’m in a car accident or I have a heart attack.”

Hannah Orestis has no health coverage, despite her best efforts. The 27-year-old nurse from Marlborough selected a plan that was supposed to start in January through the Massachusetts Health Connector Authority, which runs the state’s insurance marketplace. She mailed a check Dec. 24, but it was never cashed.

Orestis has spent hours on the phone with state customer service representatives trying to find out what happened and how to fix it. She said she has been told repeatedly to expect a call from a supervisor that never comes. She has asked for help from the governor’s office, with little effect.

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The botched relaunch of the Connector’s website last fall, done to comply with the federal Affordable Care Act, left state leaders scrambling to get people the insurance they need, including moving tens of thousands of people who may qualify for subsidies into temporary plans. But an untold number of people who, like Orestis, applied for Connector plans without financial assistance have not gotten coverage, because their payments were lost or somehow never linked to their accounts.

For Orestis, whose previous health plan expired in December, being uninsured means paying the $600 monthly cost of medication to manage her Crohn’s disease, more than she can afford.

“It’s really sad,” she said. “I’m worried about my health.”

‘I’m 62 years old. I cannot risk having my retirement and everything taken away from me if I’m in a car accident or I have a heart attack.’

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Nearly 7,000 people have succeeded in signing up for unsubsidized health plans through the new Connector. But Connector officials acknowledged Thursday that others have completed applications and paid for their preferred health plan but still have not been granted coverage.

Jim Liebowitz of Natick, 50, hand delivered his $968 January premium payment to a Connector office. It was cashed Dec. 31, he said. A month later, he and his wife had received no information. After many calls to the Connector, he decided Thursday to purchase insurance directly from Blue Cross Blue Shield of Massachusetts. He planned to ask for a refund from the Connector.

Hannah Orestis selected a plan that was supposed to start in January through the Massachusetts Health Connector, the state’s insurance marketplace. “It’s really sad. . . . I’m worried about my health,” she said.

Jim Davis/Globe Staff

Hannah Orestis selected a plan that was supposed to start in January through the Massachusetts Health Connector, the state’s insurance marketplace. “It’s really sad. . . . I’m worried about my health,” she said.

“I’m very disappointed, very disgruntled,” Liebowitz said. “There is just no accountability.”

Connector executive director Jean Yang said Thursday that the manual systems created to bypass the malfunctioning website are complicated. The agency has been working to identify stalled enrollments, so that a crisis management team can address them.

The team was working on between 40 and 50 cases Thursday, Yang said, though she could not say how many were related to premium payments that were not properly processed. She said the Connector is planning to improve customer service with better training.

The fixes have not “happened as fast as we would have liked,” Yang said. “We won’t stop until it’s all taken care of.”

The Connector website was developed by CGI, the same firm that created the federal healthcare.gov website that got off to a rocky start.

But, while the federal site is largely fixed, major components of the state site still do not work, including those that process payments, determine whether people are eligible for subsidies, and transfer information automatically to health insurers.

Yang said the state has received a draft report from an independent contractor recommending a solution, but she said federal officials have not made the report available for public release.

“We will have a fix,” Governor Deval Patrick told State House News Service Thursday. “We are not going to let people slip through the cracks.”

Liebowitz and others, who have spent hours trying to get answers from the Connector and failing, feel they already have.

Carol Clark of Brookline said the Connector cashed her check, payment for a plan to start in February, on Jan. 13. But many calls to the Connector have yielded no information about whether she will have coverage Saturday, when the insurance she has been buying through a former employer will end. One customer service representative told her the cashed check was confirmation enough, she said.

“I can’t go into the emergency room waving a canceled check,” Clark said. “I’m 62 years old. I cannot risk having my retirement and everything taken away from me if I’m in a car accident or I have a heart attack.”

After paying a January premium but not receiving coverage, Heather Foley, 37, of Brewster was told by Connector representatives that she had to pay a February premium, too, or her plan would be canceled. Her detailed log of calls made in an attempt to verify her coverage spans four typed pages.

That the Connector has asked her to make payment on a service she has not received is frustrating, said Foley, a chiropractor who has been putting off surgery to repair cartilage in her hip. In her business, she said, “that would be fraud.”

The Legislature’s Joint Committee on Health Care Financing has scheduled a Feb. 12 hearing on the Connector woes.

“This is going to be an opportunity for the Connector and the administration to be able to kind of come in and tell exactly what has happened, where they are now, and where they see us being able to be,” said its cochairman, Senator James Welch, a West Springfield Democrat.

State contractors, including CGI, will not be invited to give testimony or answer questions, Welch said. Nor will members of the public.

Chelsea Conaboy can be reached at chelsea.conaboy@globe.com.

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