Health exchange problems qualify as ‘something-burger,’ governor says

Gov. Peter Shumlin says Vermont’s new health insurance market and the troubles many Vermonters have run into when trying to access it are “something-burgers.”

What was a “nothing-burger,” he said, is the delay of the Web-based market’s payment function from Oct. 1 to Nov. 1.

“Let’s talk about nothing-burgers and something-burgers,” Shumlin said at a Thursday news conference in the Statehouse. “The website is a something-burger. The challenges that we’re having with the website obviously are something-burgers.”

The front-end pages of the online portal, called Vermont Health Connect, have sped up since its sluggish start Tuesday. By Thursday at 4 p.m., more than 25,000 Vermonters had visited the site, and more than 1,800 had registered an account, state officials said.

But some key support personnel for the market said they have been unable to log in.

Mary Eversole, director of the Vermont Insurance Agents Association, says the back-end part of the website that brokers use for enrolling Vermonters in health care plans is not working for many of her members.

“I think I have a mutiny on my hands. My brokers keep getting locked out of the system, and they can’t enroll people,” she said. “They are using paper applications. We have groups that need to be enrolled within 75 days, and that goes quickly. So, we are concerned.”

Mark Larson, commissioner of Vermont Health Access, who is overseeing the implementation of the market, told the legislative Health Oversight Committee on Thursday that his team has identified the problems and is working to solve them. In addition to the more-than 100 brokers assisting Vermonters, there are more than 200 so-called navigators who are providing in-person free assistance.

“Many navigators and brokers have had a difficult time logging into their account,” Larson said. “It’s a matter of connecting with each one of them to make sure they know how to get themselves into the system.”

The slow speed of the site has caused problems for many navigators, brokers and Vermonters trying to partially enroll in a health insurance plan. Larson said his team changed a setting in the software that sped up the loading of some Web pages.

“In terms of the load time, we know that the website is running slower than we expected it to,” Larson said. “As of yesterday afternoon, there was a marked improvement in speed on the front pages.”

On day one, Larson announced that the state had “successfully launched the website.” But Sen. Kevin Mullin, R-Rutland, on Thursday begged to differ.

“I don’t think that this can be viewed as a success if someone can view all of the products but can’t pay for them.” Mullin said.

On Jan. 1, 2014, the state is mandating that the roughly 100,000 Vermonters buying insurance independently or through businesses with 50 or fewer full-time employees to do so through the exchange. Right now, Vermonters are unable to make purchases on the Vermont Health Connect website.

Aside from the absent payment mechanism, the state system is not fully connected to the computer systems of Blue Cross Blue Shield of Vermont and MVP Health Care. Those are the two insurers offering a total of 18 plans — nine each — on the state market.

Larson did, however, emphasize to legislators that the state is connected to the federal data hub. When a Vermonter enters his or her personal details into Vermont Health Connect, they go to a U.S. government data hub that then transmits them to various federal databases. Larson said the hub is used to authenticate details such as citizenship and income level.

“I want to be very clear that Vermont Health Connect is connected to the federal data hub, and that connection is functional, and it is demonstrated by the fact that Vermonters are submitting applications that require authorization in real-time,” he said.

One of the main hurdles Vermont and many other states have bumped into is the set of tight timelines for building and implementing massive IT infrastructure that the federal government set forth in the Affordable Care Act. Both Larson and Shumlin stressed that point.

“The Affordable Care Act was passed by Congress and signed into law by the president. They chose the implementation dates. The governors didn’t,” Shumlin said. “I think it’s relevant that the date of Oct. 1 was chosen by the folks in Washington, and the governors were asked to implement it.

“We are doing that,” he continued. “But if you look at the timeline we were all asked to work under … we are obviously all struggling to have perfect websites by Oct. 1.”

Follow Andrew on Twitter @andrewcstein

Andrew SteinAndrew Stein

Comments

  1. Linda Quackenbush :

    Wow…Vermont is in serious trouble. We’re outsourcing our greatest resources(education, healthcare & energy) to elite corporate monopolies. Monopolies “always” destroy FREE CHOICES aka MARKETS…Beware of an Authoritarian government.

    The Pioneer Institute of Massachusetts is an excellent source of information on Common Core and the damaging effects it will have on our children. Also, Dr. Sandra Stotsky the former Commissioner of the Massachusetts Department of Education works with the Pioneer Institute. States that took the money to implement CC are no longer in control of their curriculum at a local level. The Federal government is the sole school board.

    Vermont’s Governor Peter Shumlin gave up local control of local school boards by implementing Common Core. In doing so he has relinquished our children’s biometric data to the Federal government to use by the biggest benefactor of CC…Bill Gates(MSN & GE)
    Simply Shameful…

  2. Linda Quackenbush :

    Green Mountain Care, Common Core Education Reform and Vermont Energy and Climate Action Network(VECAN) are synonymous with the word “nationalized”.

    Governor Shumlin has not only outsourced but sold our local control of the electoral process to the Federal government. I consider myself a very informed person and I don’t ever remember voting for GMC & CC. As for energy, Smart Meter technology was implemented “6” years ago in Vermont without any consideration to public health risks and/or input! The World Health Organization(WHO) doesn’t recognize Smart Meter Technology.

    All I can say is Vermont is headed down a precarious road of democratic destruction. Our country was founded on freedom of individual rights to “choose” healthcare, education or to have a smart meter installed. Peter Shumlin has nationalized healthcare, education and energy without any public due process. He sold the heart and soul of this great state to the monopoly of the Federal government and its corporate cronies …

    • Walter Carpenter :

      “Peter Shumlin has nationalized healthcare, education and energy without any public due process.”

      If anything has so-called “nationalized” health care it is the ACA, not Shumlin. And, for the record, we already have three single-payer “nationalized” health care programs — Medicare, Medicaid, the VA system. If you are concerned about “nationalization,” then these are the real threats since they already exist across all fifty states. In general, without getting into specifics of each program, these programs restrict your choices to whether or not you want to visit a medical provider.

      • Linda Quackenbush :

        Walter,
        Exactly my point! Medicare & Medicaid are “government” run and virtually insolvent. Believe me I have done my homework with “many” doctors here in VT concerning Green Mountain Care. Almost “all” of them agree that the “government” has absolutely “no” right in dictating the price of care of their patients. As a matter of fact many doctors are paying exuberant premiums in medical malpractice insurance and have advocated to the state of Vermont for Tort reform legislation.The state of Vermont has not only refused but has done the complete opposite. They hired a state lobbyist Deb Richtor MD who championed for Single Payer healthcare. As a result many Vermont rdoctors have stopped taking “new” patients or worse have left the state of Vermont since the invocation of GMC.

        What you don’t realize is the government has access and control of your most personal health records with nationalized healthcare. The same is true with the nationalized education curriculum known as Common Core. Our childrens biometric data is being stored and “sold” to the Gates Foundation MSN. So be forewarned the government will eventually have access to ALL of your personal records including financial… Have a great day!

        • Lee Russ :

          Linda,

          Your statement is extremely misleading.

          The only way you can conclude that “Medicare & Medicaid are “government” run and virtually insolvent” is to compare the current assets/revenue to estimated future costs and assume that the revenue/resources will not grow in the future.

          If you did the same thing with private health insurance, you would compare current premiums to the likely payments required of insurers in the future. All insurers would appear to be approaching insolvency.

          That’s why private insurance premiums have been skyrocketing, and why Medicare/Medicaid has needed additional revenue. But the relevant factor is rising costs, not the public nature of Medicare and Medicaid.

          And your experience with “many” Vermont doctors is contrary to my experience with them.

          • Linda Quackenbush :

            America has the best healthcare system in the world! That’s “why” We PAY more in insurance! As a matter of fact patients from socialized medicine countries come here for better care.

            Why not let the 30 million people that don’t have health insurance battle out the costs with the government! That way the “insured” won’t need governmental involvement. The government gets in the way of the FREE MARKET system! Government makes absolutely NO money and/or profit for America…Our government is spending “our” money precariously and granting healthcare waivers to big corporations and exempting themselves from ACA. How is this FAIR?

          • Lee Russ :

            That didn’t respond to anything I said. The point is that private insurers would also appear to be “insolvent” if you compared their current premium revenue to the benefits they’d have to pay five or ten years for now.

            That’s the comparison people make when they say Medicare is “insolvent.”

            The implication in your reply to Walter that Medicare is insolvent because it’s government run is simply unwarranted. And that fact won’t change no matter how enthusiastic you are in your belief in the free market.

      • Linda Quackenbush :

        Here’s a copy of the elitist healthcare plan…No ACA for these pompous politicians…
        http://www.opm.gov/retirement-services/publications-forms/pamphlets/ri75-13.pdf

  3. Chris Lewis :

    And we are supposed to trust these same folks to safegaurd our personal medical information?

  4. Jed Guertin :

    I’m sure that there is a fair bit of government incompetence involved in the access problems we’re currently seeing. But these types of issues aren’t unique with new software. Nor are they unique to government.

    Microsoft’s VISTA OS comes to mind

    • Paul Dame :

      Difference is there’s no tax penalty if you don’t buy Microsoft Vista and keep the current OS that you have, and that you like.

      • Lee Russ :

        That analogy probably sounds good on the surface, but it really makes no sense. Jed’s point was that there is nothing unusual in newly designed software demonstrating initial kinks. It had nothing to do with the fact that some people are required to purchase health insurance through the exchanges.

        • Lee Russ :

          You’re just having a conversation with yourself. Jed’s point had nothing to do with who has to use the exchange, and your comment above has nothing to do with what I said.

  5. John Greenberg :

    Linda Quackenbush writes: “America has the best healthcare system in the world! ”

    Actually, no it doesn’t. The USA DOES have the most expensive system in the world, but all of the medical statistics, including life expectancy, infant mortality, etc. put the US way below quite a number of countries with universal, and even (gasp) socialized medical systems. There are numerous studies by a variety of organizations to back this up.

  6. Ron Pulcer :

    Why do the state and national media refer to these exchanges as “websites”? They are all actually web-based “applications”, with hooks into various other state and federal agencies. The term “website” still connotes a more static site to me (Web 1.0).

    As for the response time or speed of the web app, I wonder if the software vendor hired for VT exchange implemented any sort of “load balancing” for this application? In a load balanced app, people would go to “healthconnect.vermont.gov”, but they would immediately get switched to one of X number of servers that have same software installed / configured to run app. Think of it as like a “queue” at your bank or at airline check-in desk. But instead of waiting in a queue for awhile, if there are sufficient number of servers, you would redirected immediately to one of the available servers in the load balance list. My company has used several methods of load balancing, homegrown software implementation, HAProxy open-source software, and Cisco hardware switching.

    If you think about when Amazon.com got started, most people were on dial-up, or didn’t have Internet access yet, so they could grow their business over time and their web app’s capacity and scaling. But for these health exchanges, it is conceivable that there is a lot of pent up demand to get health insurance coverage, given the number of uninsured people. Plus many people are curious about the new exchanges, including the press and the opponents of Obama-care checking out these exchanges.

    I wonder if anyone from VT Health Connect has checked any of their weblogs to analyze traffic. I am curious if in Vermont and around the country if any of the state exchanges had experienced any DOS attacks (Denial of Service). I haven’t heard any reports, but given the number of people who want to see the exchanges fail, it makes me wonder if any denial-of-service web bots were unleashed specifically to make the initial performance of these web apps look bad. I am not suggesting that this actually happened, but it is something that could be looked into. The things to look for would be heavy spikes in traffic in weblogs emanating from similar IP address range, or unusual query params on requests, things like that.

    I looked around the VT Health Connect web pages the day before it officially opened (last Monday) and viewed the details for some of the insurance plans, and checked out the subsidy calculator. I did not experience any slowness. But the traffic was probably pretty low on Monday.

Comments

*

Comment policy Privacy policy
Thanks for reporting an error with the story, "Health exchange problems qualify as ‘something-burger,’ g..."