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State path set for health exchange site, focus shifts to outreach


By Matt Murphy


STATE HOUSE — The Obama administration has given Massachusetts the green light to continue developing its state-based health insurance exchange for a November rollout, signing off on the new website and allowing the state to abandon preparations for possibly joining the federal marketplace.

State health officials, including the governor’s special project manager Maydad Cohen, travelled to Washington on Thursday for a meeting with leaders at the Centers for Medicare and Medicaid Services where they demonstrated the latest capabilities of the new site using off-the-shelf software developed and customized by hCentive.

“The decision we’ve made and the decision CMS supports is to move forward exclusively with hCentive,” Cohen said on a conference call Friday morning, expressing optimism that the new site would deliver a “smooth consumer experience” for residents when it goes live on Nov. 15.

Having passed this latest test, Cohen said the Massachusetts Health Connector Authority would stop its simultaneous preparation to join the federal health insurance marketplace, which was intended to be a fallback plan in case CMS or state officials doubted the potential for the new state site to be operational by the start of the next open enrollment period in 99 days.

The benefits of retaining state control of the exchange, according to Cohen, is that the state can continue to incorporate the “state wrap” program into its insurance offerings, providing additional subsidies beyond those available through the Affordable Care Act for low-income individuals to purchase health coverage.

The latest version of the web exchange also works as a program determination tool for people who might be eligible for either an ACA plan or MassHealth and is able to communicate directly with vendor Dell for subscriber billing and enrollment. Customers will still receive bills in the mail, but state officials said they hope to make online payment available as an option in 2015.

Some of the new functionality of the website will be demonstrated during the Health Connector Authority board meeting next Thursday.

“As much as I’d like to I can’t breathe a big sigh of relief now. No one on our team can,” Cohen said.

In addition to making sure the hCentive powered website is ready for use in November, health officials are also preparing for a massive outreach campaign to at least 450,000 Massachusetts residents who may be eligible for subsidized insurance and will need to apply through the website. That population includes the roughly 100,000 people still enrolled in Commonwealth Care and the more than 250,000 who were placed in temporary MassHealth coverage after the botched rollout last year of the Connector exchange website made it difficult to place people in appropriate health plans.

Cohen said the campaign will include outreach through social, ethnic and traditional media, door knocking, health fairs and robocalls.

State officials still do not have a final cost estimate for the development of the new website, and won’t know for sure how much they plan to request from the federal government until after a new contract with IT vendor Optum is finalized. Cohen said he expects negotiations to be wrapped up “soon.”

In light of the commitment to a state-based exchange and the experience of last fall when residents struggled to navigate through the glitch-filled website and enrollment system, Republican gubernatorial candidate Charlie Baker on Friday called on the Connector to be transparent about project milestones.

“I care deeply about protecting Massachusetts’ health care system and in order to prevent history from repeating itself, the Connector Board must prove every aspect of the new site is ready to go before launching,” Baker said in a statement. “To restore confidence in Massachusetts health care, the public deserves a clear understanding that the new site will work, how and when it will work, and how the board plans to address the issues that have plagued the Connector thus far.”

Massachusetts Association of Health Plans President Lora Pellegrini said the final decision from CMS provided the “clarity” needed to make sure health plans are ready to process new enrollees in the fall.

“We are pleased with today’s decision as we have believed that a state-based solution offers the best approach for Massachusetts residents given the unique offerings to supplement coverage, such as the state wrap, that are available only in our state and would not be possible through the Federally Facilitated Marketplace,” Pellegrini said.

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