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50,000 filings for health coverage in limbo

State may need months to process paper applications

“The market cannot wait and people need help,” said Health Connector head Jean Yang.

About 50,000 health insurance applications, many filed by low-
income Massachusetts residents, have yet to be processed by the state’s troubled insurance marketplace, officials disclosed Thursday, and it may take months to get all these people enrolled in subsidized plans.

For several months, residents have been encouraged to file old-fashioned paper applications because the state’s insurance website has been hobbled by error messages and has crashed frequently since it was revamped in October to comply with the more complex requirements of the federal health care law.

Frustration with the broken Massachusetts Health Connector website and the paperwork backlog was evident Thursday, when Jean Yang, the agency’s executive director, wept as she told the Connector board how demoralized her staff is.


“These people came here to lead and innovate, and instead they’re doing manual workarounds,” Yang said. “And they are embarrassed to tell friends and family that they work for the Health Connector,” once considered a national model.

She made clear that she was not looking for sympathy.

“We have to work harder,” she said. “That means I need to tell the staff members they’re not doing a good enough job, and I’m telling them that, even though they have been doing this tirelessly for months and they’re exhausted.”

Sarah Iselin, a health insurance executive whom Governor Deval Patrick last week put in charge of fixing the website, said the state is bringing in 300 people from Optum, a private contractor, to process the applications. The state is also working to develop a faster data-
entry system, though that task alone could take three weeks, she said.

Currently, it takes two hours to enter each application into a computer database. Each application may represent a family or an individual.

“We’ve got to catch up,” Iselin said at the Connector board meeting. “That’s priority number one.”


The website was working smoothly until it was overhauled by the tech firm CGI in a botched attempt to comply with the federal Affordable Care Act. Since then, the state has resorted to off-line workarounds and has put many people into temporary health plans. But an unknown number of other people may be uninsured because their applications have sat untouched.

Yang’s unusual display of emotion at a meeting normally focused on dry policy discussions came a day after she, Iselin, and other state health insurance officials were grilled by angry legislators who complained bitterly that many of their constituents have been unable to find coverage.

Yang said those concerns have been driving her and her staff to lose sleep. “The market cannot wait, and people need help,” she said. “That’s what keeps me up at night.”

Dolores L. Mitchell, a Connector board member, thanked Yang.

“A shaky voice every now and then sends a powerful message about how much you care,” Mitchell told her. “You’re going to get it right. I know you are.”

Despite the many problems, officials said they had received some encouraging news: On Wednesday night, federal officials granted a three-month extension for 124,000 people with subsidized health insurance who were set to lose their coverage on March 31 because it did not comply with the federal law.

The state had requested a six-month extension, but Iselin said the three months will give the state extra time to enroll those people in plans of their choosing.


Iselin said another 32,000 people with insurance that is not subsidized and whose coverage expires March 31 are being mailed paper forms that will allow them to “sign, pay, and enroll” in plans that comply with the federal law, without having to use the faulty website.

The state has also opened a command center in Quincy where state Medicaid officials and Connector staff are working with CGI and Optum, which was hired to make fixes. Iselin said staff are there around the clock, although she could not say when the website will be operating properly.

Optum is being paid $9.8 million for the first month of services, but is expected to work through the end of the year.

“There’s clearly been a failure of the actual coding of this beast,” said Jonathan Gruber, a Connector board member and MIT economist.

Board members floated the idea of hiring a “dream team” of computer programmers to help Optum, with the promise that they would be showered with praise for their work.

Connector staff said they would explore the idea, which is based on last year’s “tech surge,” when the Obama administration enlisted engineers from Google and other firms to help Optum repair the troubled website.

In the meantime, the Connector is operating a call center with 270 staff members fielding questions about insurance coverage from anxious residents, up from 65 several weeks ago.

“We know we’re not where we need to be,” Iselin said. “We’re disappointed to be in this position. And we are determined and committed to fixing it.”


Michael Levenson can be reached at michael.levenson@
.com. Follow him on Twitter @mlevenson.