State refutes Newsweek article, asks for corrections

The Department of Vermont Health Access has requested a laundry list of corrections from Newsweek for what they say are a slew of inaccuracies in a recent story about the troubled rollout of Vermont Health Connect.

In her piece for Newsweek’s online magazine titled “Doubling down on Obamacare,” reporter Lynnley Browning says the Shumlin administration concealed problems with the state’s health care exchange website to leverage federal dollars for its planned universal health care system.

While the administration may have downplayed Vermont Health Connect’s shortcomings, it appears Browning might have also overstated her case.

Mark Larson, commissioner of the Department of Vermont Health Access

Mark Larson, commissioner of the Department of Vermont Health Access

Mark Larson, commissioner of DVHA, says that throughout the article, Browning talks about Vermont’s contract with CGI Federal, a Virginia-based subsidiary of the Montreal-based tech giant.

But Vermont’s contract is with CGI not its subsidiary, Larson said.

That’s either sloppy, said Larson, or Browning was attempting to hitch Vermont’s situation to CGI Federal, which the Obama administration recently jettisoned.

He also disputes a central charge in the article that a July demonstration of the exchange was essentially faked.

Browning writes:

In the demonstration, “a lot was left to the imagination,” says a person familiar with the event who declined to be named, citing the ongoing work between CGI Federal, which has an $83 million contract for the job, and Vermont officials. Some state staffers that July 26 thought it showed “live” registrations and enrollments by hypothetical consumers, when in fact static, premade screens were displayed. “People weren’t technologically sophisticated enough to understand what was actually going on,” this person explains.

A spokeswoman for DVHA responded in an email that “This demonstration showed exactly what it was designed to: that Vermont Health Connect (VHC) was connected to the federal data hub, that it could send and receive information, and that VHC could determine accurately the eligibility of a hypothetical customer.”

In an email to VTDigger, Newsweek editor Jim Impoco said: “We stand 100% behind this important story.”

He did not address the specific corrections requested by DVHA.

The one bright spot Browning’s article finds in Vermont’s rollout of the Affordable Care Act is also incorrect.

Browning writes that, “Website glitches aside, Vermont boasts one eye-catching figure: It has seen the greatest percentage of eligible uninsured residents — 15,015 out of 43,000 people — successfully enroll and select a health plan.”

The figure comes from data collected by the Kaiser Family Foundation, and it’s just the number of eligible Vermonters who selected a plan between Oct. 1 and Dec. 28.

It would be impossible to know how many of the 15,015 were previously uninsured. The group includes sole proprietors, who must purchase individual insurance through the exchange, those formerly on Catamount or VHAP and individuals with private insurance.

Impoco said the magazine will fix the error and issue a correction.

Larson said the state won’t have concrete numbers for how many of the 43,000 uninsured Vermonters have accessed health care through the exchange until the state conducts its next household insurance survey.

The story also refers to Vermont Republicans’ passing a resolution in the Legislature calling for enrollment through the exchange to be voluntary, and for residents to have the option to buy health insurance in other states.

That resolution was passed by the Vermont State Republican Committee.

Below is a full list of the corrections DVHA requested of Newsweek (excerpts from the Newsweek article are in italics, DHVA’s response is in normal type):

Newsweek: In the demonstration, “a lot was left to the imagination,” says a person familiar with the event who declined to be named, citing the ongoing work between CGI Federal, which has an $83 million contract for the job, and Vermont officials. Some state staffers that July 26 thought it showed “live” registrations and enrollments by hypothetical consumers, when in fact static, premade screens were displayed. “People weren’t technologically sophisticated enough to understand what was actually going on,” this person explains.

DVHA: This demonstration showed exactly what it was designed to: that Vermont Health Connect (VHC) was connected to the federal data hub, that it could send and receive information, and that VHC could determine accurately the eligibility of a hypothetical customer.

Newsweek: And while some Vermont staffers remained skeptical that the website was all CGI Federal had promised, others were fooled into believing things were going well.

DVHA: This is purely speculative and backed up by no evidence. The question of whether or not VHC staff felt they were fooled during the demonstration was never asked.

Newsweek: Yet Vermont is spending more federal money, $167.9 million, than any other state in the nation on uninsured residents, according to Newsweek calculations based on data from the Centers for Medicaid and Medicare Services (CMS) and the U.S. Census Bureau. Larger states that are spending less but have higher numbers of uninsured include Connecticut, Massachusetts, Minnesota and Rhode Island, plus the District of Columbia. Massachusetts, for example, has 272,000 uninsured among its 6.5 million residents – yet it is spending $134.4 million in federal money building its marketplace. Connecticut is spending nearly as much as Vermont, some $164 million, but it has 284,000 uninsured people. Washington, D.C., with 50,000 uninsured, is spending $133.4 million.

DVHA: Each state was awarded funding differently, so a comparison is not accurate. The state of Vermont has paid CGI $19 million to date, and is withholding payment to CGI for functionality that is not completed. Vermont’s federal grant award is also not spent exclusively on CGI. For example, grant awards are used for work related to training, personnel, outreach and education, and in-person assisters.

Newsweek: But that’s where Vermont’s numbers start to get fuzzy. “Select” doesn’t mean “cross the finish line” – actually buying a policy. More strikingly, the figures cover both online and paper enrollments that are later manually entered into the system by CGI Federal. Translation: there is no way to tell how many Vermonters have used the website to successfully sign up.

DVHA: There is nothing “fuzzy” about the numbers. Over 25,000 Vermonters have picked plans using Vermont Health Connect that took effect in January. And over 23,000 have had their coverage effectuated. The statement below references 11,943 who have crossed the finish line. It is more accurate to say that those individuals have enrolled in a private, qualified health plan. The remaining Vermonters who make up the referenced 23,000 have enrolled in Medicaid, also a health plan.

We expect the remaining to select their plans and pay their premiums over the next few weeks, since many are currently covered and have until March 31 to select plans under extension options.

CGI does not manually enter any applications into the system. Even paper applications are entered into the same online system, by VHC staff.

Newsweek: CMS data show that as of December 28, 2013, nearly 37,000 Vermonters had applied for coverage both online and via paper and been approved as eligible – the first of many hurdles to getting insurance. The difference between that 37,000 in the early stage and the 11,943 who have actually crossed the finish line suggests that thousands of Vermonters are still bedeviled by website failures.

DVHA: Contrasting the number of people who had their eligibility determined by starting an application with the number of people who checked out, made a payment and had their coverage effectuated is very misleading. Because of extension options provided by the Governor, many of the Vermonters that had an initial eligibility determination chose to extended their 2013 coverage until the end of March. Therefore, many are waiting to complete their plan selection until mid-March. If Vermonters work for a small business, their employer either extended 2013 coverage through March or immediately enrolled in Vermont Health Connect coverage through an insurance carrier.

Newsweek: Because the website still isn’t handling small-business enrollments, the state has no idea how many of the 55,000 employees of small firms – such as craft breweries, organic farms, start-ups and the like – expected to benefit from the exchange have actually signed up.

DVHA: About 46,000 Vermonters who receive their insurance through a small businesses had plans that rolled over on Jan. 1. Of that, about 18,000 have directly enrolled in a 2014 VHC plan through BCBS or MVP. Another 17,800 had their current plans extended for up to three months. About 5,400 are sole proprietors who, under the new ACA rules, are required to buy insurance as individuals. They can today sign up through VHC, but their 2013 coverage was extended for up to three months as a default to ensure they didn’t see a lapse in coverage. And about 4,600 work for an employer that decided to no longer offer coverage in 2014. Those Vermonters can sign up through VHC today, if they have not done so already.

Newsweek: On February 1, Vermont Republicans passed a resolution in the state legislature calling for enrollment through the exchange to be voluntary, and for residents to have the option to buy health insurance in other states.

DVHA: This is simply not true. No such resolution passed the Vermont legislature.

Newsweek: In mid-November 2012, troubled by reports that Oregon was having problems building its marketplace through Oracle, its main technology contractor, Shumlin made a dramatic decision. He jettisoned Oracle and went shopping for a new partner.

DVHA: The decision to end discussions with Oracle was made because Oracle would not agree to the state’s legal terms. In retrospect, given the difficulties of rolling out exchanges in Vermont and around the country, it was absolutely the right call to insist on legal protections for the state of Vermont.

Morgan True

Comments

  1. Jim Christiansen :

    Perhaps Mr. Larson can write an article detailing all the things that have been successfully completed and delivered on time by DVHA to the Vermont taxpayer.

  2. John McClaughry :

    I’m curious as to why Larson can’t bring himself to say “Over 23,000 Vermonters purchased insurance coverage”. Instead he invents the passive “over 23,000 have had their coverage effectuated. ” I suspect this is more than just poor writing.

    • Karl Riemer :

      I’m not sure. Commissioner Larson is a master of mealy-mouthed verbose indefinition.
      “I think there are pieces of the story which are just not factually true and other places where the reporter raises inflammatory speculation, but without any basis in reality. It makes for an interesting story, but I’m not sure it’s an accurate story.”
      It’s possible that talking circles around what he wants to say instead of simply saying it is disingenuity or lack of confidence, but it’s also possible he’s incapable of plain speech. His consistent oblique obscurantism suggests that obfuscations like “have had their coverage effectuated” may in fact be nothing more nefarious than habitually poor writing. It nicely illustrates Newsweek’s article. While Mr. McClaughry suggests that his contortions clumsily conceal embarrassing information, Newsweek seems to prefer the more plausible explanation that they clumsily conceal an embarrassing lack of information, that he was bamboozled and is perhaps still baffled.

  3. Now that Commissioner Larson has taken the time, energy and money to respond to the Newsweek article, maybe he can tell us why the state elected to attempt to build a Vermont health care exchange in the first place.

    I raise this point because:

    The construction of the VT exchange is costing tens of millions of hard earned tax payer dollars plus millions more in promotion and administrative expenses.

    The federal exchange option was available for Vermont use at essentially no cost. Also, remember that President Obama just told us the federal exchange is working fine.

    A hugely expensive VT exchange was built to list the policies of only two health care insurers.

    The real Shumlin plan is to ditch ObamaCare and go to a single payer system, ASAP.

    So, Commissioner Larson, if it was so important for you to respond to Newsweek, isn’t it time to tell Vermonters why the VT exchange was opted for in the first place?

    Commissioner Larson, you have the floor.

  4. Wendy wilton :

    The Newsweek article is correct. Vermont Republicans (the state GOP committee) did pass a resolution to support a voluntary exchange and this was covered in several media outlets. I was the author of this successful resolution which was based on amendment offered by House Republicans before the passage of Act 48. The amendment did not pass the legislature. If it had been approved by the majority Vermonters would have been able to choose off exchange insurance and avoid the problems Mr. Larson cannot seem to solve.

    Mr Larson and DVHA do not read VT Digger apparently.

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