Once the Obamacare model, Massachusetts now the law’s disaster

Robert Eno | Contributor

BOSTON — Obamacare is an absolute mess in Massachusetts.

Nearly eight years ago, surrounded by legislative leaders and Senator Ted Kennedy, then-Massachusetts Gov. Mitt Romney signed historic health legislation into law.

Starting in 2007 — over a period of three years — Massachusetts spent $3,449,520 developing a first-in-the-nation online health exchange, which allowed the state’s citizens to purchase health coverage. And when President Obama campaigned for the passage of his own federal health law, he leaned on the Massachusetts experiment as a model for the nation.

But the changes mandated by Obama’s Affordable Care Act, or Obamacare, have actually gutted the effectiveness of Massachusetts’ once-working model.

Thanks to Obamacare, in 2012, Massachusetts began a transition to a new federally compliant health exchange, budgeted to cost $69 million. But to date, not one person has purchased health care through that federally funded exchange.

In addition, Jean Yang, the executive director of the Health Connector Authority, told her board that 50,000 paper applications remain unprocessed — leading the Commonwealth’s leading progressive blog to quip that, “lives are at risk.”

Bay Staters elected Scott Brown to the Senate in 2010, who promised he would be the 41st vote against Obamacare. But through parliamentary procedures, Congress passed the Affordable Care Act anyway and President Obama signed it into law.

Fast forward to today — Massachusetts now ranks near last in the nation for implementation of its health exchange, according to the Associated Press. So how did that happen?

After passage of the Affordable Care Act, Massachusetts opted to run its own exchange. With a $69 million grant from the Centers for Medicare & Medicaid Services, the Massachusetts Health Connector Authority started collecting bids for the work. CGI Federal won that bid, and work began in 2012 on the creation of a new Obamacare compliant health exchange for Massachusetts.

The Boston Herald has reported that the project was seemingly doomed from the start. Expectations were set sky high, but infighting among stakeholders began almost immediately. An email obtained by the Herald showed that the state wanted, “[the] absolute Rolls Royce of any health exchange.” But that’s far from what they got.

Over the next year, progress on the exchange was slow. The Massachusetts legislature didn’t even vote until June of 2013 to authorize the Connector Authority to change from their original functioning exchange over to the new system. Shortly after that vote, as The Boston Globe reported, officials started warning the Health Connector that the website would not work.

On October 1, 2013, the Health Connector launched the new version of its health exchange to much fanfare. But the website did not work. The conservative blog Red Mass Group (which this writer owns and operates), collected Facebook posts from December outlining how bad the system was.

On the day of Game 6 of the World Series, Obama came to Boston to promise a fix of the flailing federal exchange. His ally, Massachusetts Governor Deval Patrick introduced him and said that Obamacare was not about a website, but about values. Patrick would fall back on that refrain over and over again in the following months.

On stage with Obama and Patrick were members of a community organizing group that received $2,500,000 — including thousands of dollars to go door-to-door — from the Obama Administration to sell Obamacare to the people of Massachusetts.

As the fall turned into winter, the exchange still was not working.

The Health Connector Authority realized that since not a single person had signed up using the web site, a workaround was needed. They decided to extend coverage for all subsidized members of the exchange indefinitely until they could be enrolled in new coverage.

Unsubsidized members were finally given a reprieve at the last minute to get their coverage in order. Even with the changes, reports indicate that some families have paid for health coverage, had their checks cashed and still don’t have a policy over 45 days after paying.

The process seemed so broken that Republican gubernatorial candidate Charlie Baker, himself a former health care executive, called on the state to ask for a waiver from Obamacare every week until it was granted — and to return to the old system.

As the website woes continued through January, the former executive director of the grassroots group that received the $2.5 million in Obamacare grants lost his patience with the pace of the fix. John E. McDonough wrote on his Boston.com blog, “I was waiting to hear the Governor share with the Commonwealth his plans to get the Health Insurance Connector website working at an acceptable rate. It’s nearly four months now since it’s been officially and completely dysfunctional. And now we know that the Administration was warned of this impending calamity as early as last July.”

McDonough continued, “This is unacceptable. I can’t name a single Massachusetts official who is leveling with the public on this national embarrassment. From what I hear, second and third hand, four months into this disaster, the Patrick Administration has no plan.”

In response to that criticism from an ally, Patrick told the press that his solution would involve using clipboards if they had to: “The folks who are worried about the website, yeah, it’s concerning, but the website is not the main event and I’ve said that over and over again. People are not going to fall through any crack. They’re going to be covered if what it takes to work around failings of our private vendor is to have people sit on folk’s front stoops with a clipboard and make sure they’re signed up.”

Patrick then engaged NSA contractor MITRE Corp to complete a review of the website. Their findings spurred Patrick into appointing a Blue Cross Blue Shield of Massachusetts executive to oversee the fix. In addition a new contractor was hired, at $326,000 a day, to manage CGI Federal in their fix of the system.

After the new plans were announced, one of the governor’s strongest allies — Blue Mass Group blogger Charley Blandy — was still not impressed, quipping in a February 11 blog post, “No, Governor, this is not an ‘inconvenience.’ The failure of the state’s health care Connector website and application process is actually endangering lives.”

As part of the new triage strategy, the Health Connector is now giving weekly updates.

On February 13 executive director Jean Yang said, “These people came here to lead and innovate, and instead they’re doing manual workarounds, and they are embarrassed to tell friends and family that they work for the Health Connector.”

The Connector Authority also disclosed that it did not have confidence the site would be fixed by March 31, 2014, the deadline for people to get covered.  So they have offered workarounds for both subsidized and unsubsidized plans.

On the unsubsidized side, Connector Authority spokesman Jason Lefferts told the Daily Caller, “We have worked with carriers to define the most similar plan to current coverage. The members will get a notice with the details. If they like it, all they do is pay the bill and they are all set. If they don’t, they are able to shop for a new plan. This new mechanism will allow these people to keep coverage without having to go through the website. All members will get notices within the next week.”

Yet four and a half months after the launch date of the new exchange, there remains no end date in site for the fixes.

Yang summed up the current situation at the last board meeting: “We have to work harder,” she said, according to the Boston Globe. “That means I need to tell the staff members they’re not doing a good enough job and I’m telling them that, even though they have been doing this tirelessly for months, and they’re exhausted.”

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