By Matt Murphy
STATE HOUSE NEWS SERVICE
STATE HOUSE -- The Patrick administration remains undecided over whether to try to salvage its poorly functioning Obamacare website or build a new enrollment portal from scratch, a choice that carries broad implications for how soon subscribers will ultimately be placed in their final health insurance plans.
In the meantime, a team put in place by Gov. Deval Patrick to manage the enrollment process and web fix has been chipping away at the backlog of applications and enrolling thousands of residents in temporary Medicaid plans that will protect their insurance through at least June 30 under an extension granted by the Obama administration.
Sarah Iselin, the governor's special assistant in charge of the Health Connector website fix, told the Health Connector board at a meeting on Thursday that by next week an additional 21,000 residents will have been enrolled over the past two weeks in transitional coverage. Despite processing 35,000 applications over the past two weeks, the backlog remains at 54,000 to be processed with 17,000, or roughly 1,000 new applications a day, being filed since efforts ramped up.
"We are on track to get up to the state levels that we have promised," Iselin said. "We also know we have a lot more to do, both in the near-term goals and on the long-term path.
Of the 35,000 processed applications, 7,000 applicants already had coverage but will need to be in the system for their eventual transition to an Affordable Care Act-compliant health plan. Another 3,000 applications had missing data, while 4,000 were duplicates.
Iselin said the vendor Optum had deployed a new data entry tool on Monday that has significantly reduced the time it takes to manually enter a paper application from two hours to 39 minutes, and a team of 250 employees were in place at centers in North Carolina, Florida and Texas for data entry.
"You're going to a lot of southern right-to-work places. I really don't appreciate that, so maybe you can think about it. I know it's an emergency, but it sucks," said Celia Wcislo, a board member and vice president of 1199 SEIU United Healthcare Workers East.
While the governor's crisis team works to enroll residents in temporary coverage, improve consumer experiences on the website and diagnose what it might take to have a fully functional website up and running before the June 30 deadline, Iselin said a number of options remain on the table.
"We are frankly hedging our bets," she told the board. The options include continuing to try to fix the platform built by vendor CGI, with a particular focus on getting the eligibility determination system functioning, to borrow components from other states or the federal exchange to fit in the existing system, or to "start over."
Depending on which path is most feasible, Iselin said it remains to be determined whether the state will need to seek another extension beyond June 30 from the Centers for Medicare and Medicaid Services to protect existing coverage until subscribers can be enrolled in ACA-compliant plans.
"These all have trade-offs," Iselin said.
While the Connector so far has been able to enroll roughly 140,000 people in their final Obamacare plans so far, the bulk of that population is accounted for by the 130,000 Commonwealth Care subscribers who were automatically shifted to MassHealth under the ACA expansion of Medicaid. Another 11,000 people have been enrolled in qualified health plans, the majority of whom purchased unsubsidized plans for which the website does work.
Connector officials said packets have also been mailed to the 32,455 members currently enrolled in unsubsidized Commonwealth Choice plans who will lose coverage by March 31 if they don't re-enroll and are not covered by the extension. Those individuals are being given the option to either select a plan chosen by the Connector that most closely resembles the coverage they already have, or to go online and shop.
Administration and Finance Secretary Glen Shor said that at the next board meeting in two weeks he expected to give an update on the budgetary implications of enrolling thousands of people in temporary MassHealth plans as well as the expected vendor costs required to fix the website.
Health Connector Executive Director Jean Yang said she expects to have an update on negotiations with managed care plans to provide continued coverage under the terms of the CMS extension through June 30, and Iselin said more decisions about the long-term strategy could be made by then.
Optum experts are also working to improve the customer service experience for those who dial the call-centers with questions about their applications.