State rolls out campaign to reintroduce the Connector
Rebuilt site will debut Saturday
A crucial test for the Patrick administration starts Saturday, when the newly rebuilt website for the Massachusetts Health Connector opens its virtual doors to tens of thousands of people seeking health insurance.
How well the software performs will determine whether Massachusetts residents have easy access to coverage, whether taxpayers get their money’s worth from $254 million in technology costs, and whether departing Governor Deval Patrick achieves redemption from one of the starkest embarrassments of his tenure.
The state is supporting the effort with a $13.2 million plan, funded by a federal grant, to contact the 400,000 people who need to enroll within just three months -- and probably don’t know it.
The Connector has already begun making robocalls and sending out mailings about the change. On Saturday the agency will launch an advertising campaign (“Need health coverage? Now’s the time”) and start sending out canvassers, with the goal of eventually knocking on 200,000 doors.
“It’s really no longer a challenge of the IT,” said Maydad Cohen, the special adviser to the governor overseeing the website rebuild. “I really believe the IT system will hold. … We have a task in reaching a large group of people who need to take action.”
A little over a year ago, President Obama came to Faneuil Hall to extol the state’s success at enrolling people in health insurance, through a program that served as the model for the federal health care overhaul. Behind the scenes, however, the state had launched a website so dysfunctional that it could hardly enroll anyone.
Now, a brand new website — to serve people who do not get health insurance through an employer — comes online at 8 a.m. Saturday, amid promises of much smoother sailing. But two questions loom: Will the website work well and will enough people use it?
The Connector has already placed 72,800 robocalls (out of 1 million planned) and sent 265,000 pieces of mail, said spokesman Jason Lefferts. Ads will run on TV and radio, on buses and in stores, in print and online. Also in the works are a series of community events where people can enroll. More than 300 call center agents have been hired and trained to help people through the process, as well as dozens of “navigators” who can enroll people in person.
At the Boston Public Health Commission, one of the agencies working to inform and enroll people, calls are already coming in to the Mayor’s Helpline (617-534-5050), said Beth Baker, director of health access and wellness services. She expects to eventually receive 150 calls a day.
“Do I get hives when I think about the website not working? Yes,” Baker said. Last year, “we took a lot of angry phone calls.” But Baker’s team helped 2,500 people submit health insurance applications, nearly all on paper. This year they’ve had a chance to test-drive the new website, which she finds “reassuring.”
“We are really excited to be launching this campaign that will reach into communities across the commonwealth,” said Amy Whitcomb Slemmer, executive director of Health Care for All, the advocacy group that has a $1.9 million contract with the state to do the door-to-door canvassing. Health Care for All and its partner agencies have 122 canvassers trained and ready to go. Last year, the group went to 57,000 homes, Whitcomb Slemmer said. “This year we’re just ramping it up,” she said. “We found it to be wildly successful.”
Whitcomb Slemmer may be alone in using the word “success” to refer to last year’s experience, but she makes this point: The website’s failure did not cut into the state’s highest-in-the-nation health insurance rate of 97 percent. To make sure people would not lose coverage, the state took the extraordinary step of placing everyone who sought assistance -- ultimately more than 300,000 people -- in a temporary, all-expenses-paid Medicaid program, while allowing 90,000 to continue on a state-subsidized insurance program for an extra year.
Two Republican congressmen recently raised questions about whether the temporary Medicaid program is legal, while critics in Massachusetts predict that, once all the bills are tallied, the program will prove costly to taxpayers. The Pioneer Institute, a public-policy think tank, estimates that the temporary Medicaid program will cost $540 million in calendar 2014; the state has said its Medicaid spending has so far stayed within budget despite covering this new population. Insurers say that they have lost out on premiums.
But the big issue now is that people in the temporary program need to sign up for coverage that fits their financial circumstances. Some whose incomes are not low enough for Medicaid may end up paying premiums, deductibles, and co-pays that they didn’t see before.
Although several other states and the federal government had trouble with their health insurance websites last year, Massachusetts is in a unique situation. The state already had an insurance exchange — the Connector, created in 2006. People could log on to the Connector to browse insurance options, but anyone seeking a subsidy had to fill out a paper application and mail it in.
Starting last year, the federal Affordable Care Act required the state to launch a more sophisticated system that would allow people to shop for insurance, determine subsidies, and buy insurance online. But the system, developed by the technology company CGI, never worked properly and had to be scrapped, forcing paper work-arounds.
This year, Massachusetts is deploying off-the-shelf software from the Virginia tech company hCentive Inc. adapted to the state’s requirements, including the unique state subsidies that supplement the federal ones.
Reflecting on the difference between this year and last, Jean Yang, the Connector’s executive director, said: “I feel more confident, but also more informed. We have a much more disciplined, much more structured, dependable process. … which gives us the confidence that things are indeed shaping up to go live successfully.”
The hardest part, she said, will be recruiting enrollees, especially “people who are very low-income, people juggling between multiple jobs. They don’t have a lot of opportunities to sit down and think about their health care options.”
Joshua Archambault, director of health care policy at the Pioneer Institute, predicted that any problems in the system will show up weeks after open enrollment starts. He called for transparency if that happens. “They lost a lot of credibility for false promises in the past,” Archambault said. “I hope they’ve learned from that.”
The Connector plans daily press briefings and will post an online “dashboard” tracking website activity on a daily and weekly basis.
“There is some trust that needs to be earned back,” said Jonathan Gruber, the MIT economist who was an architect of the federal and state health care overhauls, and now sits on the Connector board. “We have a state that believes in successful government. I think people are going to give us the benefit of the doubt.”