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.
The total cost of the Connector upgrade is $254 million, most of it funded by the federal government. The state will pay $42 million of that, $26.1 million more than it would have cost state taxpayers had the site worked in the first place.
“We’re about to deliver better, faster access to health security,” Maydad Cohen, the special adviser to Governor Deval Patrick who is overseeing the repair project, told the Connector’s board Thursday.
Still, Cohen cautioned that there will be glitches, as with any website rollout.
People who do not get health insurance through their employers use the Connector to shop for coverage and get federal and state subsidies. As many as a quarter-million people are expected to enroll this way, with the portals opening Nov. 15.
The part of the system that may prove problematic involves getting enrollees’ information and payments into the hands of insurers. Known as the “back end,” this always-thorny process is especially difficult for Massachusetts because the information technology company Dell handles billing, which means there must be precise communication among the Connector, Dell, and 11 insurance companies offering numerous plans.
“I’m hopeful that we’re heading in the right direction, but there’s more work that needs to be done,” said Lora Pellegrini, president of the Massachusetts Association of Health Plans.
Jon Kingsdale, who was the Connector’s director in its early years and now consults with other states on their exchanges, said the “back end” issues have posed the biggest problems for the federal exchange and other state exchanges. “It’s exponentially more complicated” than the rest of the website, he said.
The Connector technicians conducted more than 2,000 tests of the system, using fictional cases of people seeking health insurance. Only 105 defects occurred. Of those, 13 were “critical” errors — either giving the wrong result or preventing the user from moving forward. An additional 47 were high-priority problems.
“This is really very, very good results,” said John Santelli, chief information officer for Optum, the company hired to manage the website repair, adapting off-the-shelf software from its subsidiary, hCentive. He said Optum would endeavor to fix all the defects.
“There’s a point in the project where you want to be fixing more defects than you’re discovering,” Cohen said, “and we are there. And that’s where you want to be.”
Cohen expects the site to be able to handle 46,000 users at the same time on the first day of enrollment.
The Connector has hired 680 customer service representatives, more than double the number last year. They are undergoing a six-week training program.
Cohen told the Connector board Thursday morning that the state has completed contract negotiations with Optum, settling on a $102 million fee for its work in 2014 and 2015. Under the contract, the state will pay less if Optum does not meet certain standards, and it is also holding back 25 percent of the payment until the project is completed.
The total cost figure for the Connector overhaul — $254 million — covers just the technology costs and does not include administrative expenses and the cost of temporary coverage programs set up for people who, because of the software failure, could not determine whether they were eligible for assistance. Most of those people were placed in a temporary Medicaid program paid for by the state and federal government.
A dispute about the ultimate cost to taxpayers of the website’s failure heated up again Thursday. The Pioneer Institute, a public policy research firm, last month pegged the cost at $1 billion, a figure Patrick dismissed at the time as spurious. On Thursday, the institute reasserted its findings in an open letter to the governor, predicting that taxpayers will be hit in coming years with huge costs related to the failure.
But Glen Shor, chairman of the Connector board and state secretary of administration and finance, continued to assert that the cost of the temporary coverage program falls within the state’s budget, which anticipated increased Medicaid membership. The costs for the temporary program “are no more than it would have been” if the website had worked, he said.
A total of 306,000 people have enrolled in the program since January, although it is unknown how many are actually eligible for Medicaid. The state has spent $321 million on their care, at least half of which will be reimbursed by the federal government.