On Thursday morning, I reported to the Health Connector Board that the state will deliver a website on Nov. 15 that will allow anyone seeking affordable, quality health insurance to access it through a single front door on the Connector website.
How do we know it will work? How much is this project costing taxpayers? Is it really worth it? Those are all fair, important questions, and ones that we in various state agencies have addressed through dozens of public briefings and regular reporting to our state and federal partners. Here are the facts:
Why it will work: The project’s turnaround began when Governor Patrick put a single person accountable directly to him in charge. At first it was Sarah Iselin from Blue Cross Blue Shield of Massachusetts, and now it’s me. At the same time, we replaced our underperforming vendor with Optum, the IT vendor that fixed the federal Exchange after its own bumpy roll-out. And, rather than rebuild our site from scratch, we made the strategic decision to leverage a proven, off-the-shelf solution that is live and working in states like Kentucky and Colorado.
We set the bar high. We frontloaded core functionality into early software releases, met key Centers for Medicare and Medicaid Services milestones and are rigorously testing the system to ensure it performs like it’s supposed to and can handle heavy traffic. The Health Connector and MassHealth are driving rapid progress working with insurers, providers and consumer advocates so that the website works and we maintain the unique, successful features of Massachusetts health reform.
Though we have more to do, the hard work is paying off. CMS supported our August assessment that the new system will be ready for open enrollment, allowing Massachusetts to remain a state-based marketplace. Since then, we have finished IT system development and executed over 3,000 test cases. We’ve also developed comprehensive operations and contingency plans, including adding 430 staff to process applications. This planning shows we know that no matter how well built or tested, no IT system rollout is ever perfect. Regardless of any potential glitches, we will have ways to meet Massachusetts’ residents need for health insurance. That’s what Patrick means when he says health care is more than just a website.
What it costs: Our original IT budget stood at $174.5 million, with $159 million contributed by the federal government and $16 million by the state. We have requested and received an additional $80 million from CMS to complete the project. The IT budget now stands at $254 million, and the state share is $42 million, $26 million more than originally envisioned.
To date, we have placed more than 400,000 people into subsidized and unsubsidized coverage within budget because we always planned to provide more coverage to more people under the ACA. Despite technology challenges, we have not requested a supplemental appropriation to bring our program or administrative budgets into balance. Per member costs in legacy and temporary insurance programs have been cost-effective.
Why it’s worth it: Here in Massachusetts, we believe that health is a public good, and that everyone who needs insurance should be able to get it. Thanks to that fundamental belief, more than 97 percent of our residents have insurance. Massachusetts has increased the number of people insured since the ACA began here, and we are about to deliver better, faster access to health security.
I readily admit this hasn’t always been easy, and we made our fair share of mistakes. That sometimes happens when you take on a challenge this big. We have learned from our mistakes, enlisted outside expertise, and made significant improvements both to this project and the state’s IT management generally.
As we stand on the cusp of the next big milestone in Massachusetts health care reform, here’s what matters most: More people have health insurance in Massachusetts today than ever, and we will have a website that makes it easier for them to access coverage from day one of open enrollment.
Maydad Cohen is special assistant to the governor for project delivery.