Today's Boston Globe Podium section includes an update from Maydad Cohen, the Governor's health reform czar (horrible official title: "special assistant to the governor for project delivery." Please.). The bold forecast, "Why the Mass. Health Connector website will work" It's based on the report he provided to the Health Connector Board this morning.
The bottom line: "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."
We fully agree. We've seen live working demos of the site as well, and we're optimistic, too. The Connector, MassHealth and the administration are to be congratulated for fixing the problems. They saw the failures, and got to work to make it good. And it appears to be paying off. It should also be noted that the Connector Board meeting today also was told about extensive contingency plans in place if not all works at the start. This is praisewothy as well.
(BTW, "website" is shorthand for much more than the actual web site - the guts is the eligibility and enrollment system that takes input from a user on the site, connects to various databases to confirm information, calculates eligibility for various programs using a very complex algorithm, informs the user of which program he or she is eligible for, and then process next steps, like choosing a health plan.)
Cohen writes that the turnaround came when a single point of authority was created, and the decision was made to adapt existing software used in other states, rather the create something from scratch. Here's where we are:
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. ...
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.
Open enrollment starts on November 15, in 5 weeks. At HCFA, we're doing all we can to make sure it works, from serving as a sounding board and reviewing forms and materials for the Health Connector, to getting the word out to people who need to use the system, in every way we can. The ACA has already been good for Massachusetts, and we see it getting much better, soon.
- Brian Rosman