Vermont Health Connect is closing in on its goal of enrolling 89,000 Vermonters in federally qualified health plans, but state officials were hesitant to claim victory Tuesday.
“I do think we are looking at numbers in the right range to say that we’ve achieved that goal,” said Mark Larson, commissioner of the Department of Vermont Health Access. “But we want to look at those numbers and make sure that we’re looking at each specific population within them, not just the overall number.”
There are 36,846 Vermonters who have enrolled in health coverage, 33,549 who were automatically transitioned to Medicaid and 30,000 to 40,000 in the small-group market who were enrolled directly by the insurance carriers participating in the exchange. The administration’s original goal of 101,000 enrollees was adjusted to about 89,000 in October. That goal does not include the number of people automatically moved to Medicaid, but does include about 22,000 who qualified for Medicaid when they applied for coverage through Vermont Health Connect.
Larson said he wanted more time to scrutinize the enrollment numbers coming from the insurers but even using the low end of his estimate, Vermont has inched past its enrollment goal.
Persistent problems with the system have clouded the achievement, however.
“We heard some impressive numbers today … it’s been a huge effort to get this many Vermonters through Vermont Health Connect,” said Rep. Mike Fisher, D-Lincoln, chair of the House Health Care Committee.
But he added, “We have to recognize there are a whole set of Vermonters who continue to have challenges as they work their way through the exchange and we can’t ignore that population.”
Consumers are still unable to make changes or fix errors in their application, personal information or coverage information through the website.
Larson acknowledged there are some Vermonters who signed up for coverage starting in January that are still mired in the process.
Those people must work with Vermont Health Connect’s customer service representatives to fix problems offline, a process that can be irksome and time-consuming.
Larson said the so-called “change of circumstance” function would be online before the next open enrollment period, which begins Nov. 15.
Small businesses to continue direct enrollment
Businesses in the small-group market still can’t use the website to enroll in health insurance plans.
Vermont received federal approval for insurers to continue to directly enroll small businesses through the next open enrollment period, Larson said.
Businesses with 50 or fewer employees must enroll in qualified health plans offered through Vermont Health Connect, but when they enroll directly with insurers their employees have fewer coverage options due to the administrative burden it creates for insurers.
Larson said the federal government was “mindful” of the employee choice issue in their decision to allow direct enrollment to continue, and work has begun with the insurers to expand options.
Some low-income Vermonters still not signing up
There are roughly 4,000 Vermonters covered by the two state-assisted health plans, VHAP and Catamount, who have yet to begin the application process for coverage through Vermont Health Connect.
For that group, open enrollment extends through May 31. For everyone else, open enrollment ends March 31 and the deadline for coverage starting in April was March 15. Those who sign up during the rest of March will have coverage that begins May 1.
The state has sent direct mail and worked in the community to try to induce the remaining people who are insured through VHAP and Catamount to enroll.
That outreach will continue, Larson said, but the state can’t sign up for them.
Some portion of that 4,000 might have found coverage through a new job or a spouse, but for some the greater out-of-pocket cost of coverage through Vermont Health Connect as compared to VHAP and Catamount has created a reluctance to enroll at all.
State officials have encouraged them to apply because it’s possible they could qualify for Medicaid and not have to pay any premiums.
Those who don’t sign up will be subject to a penalty of $95 or 1 percent of their income, whichever is higher.
In many cases, those who don’t sign up are looking at a larger penalty than they might realize.
Vermont sticking with CGI
Larson told lawmakers Vermont has no intention of dumping CGI, the contractor that is responsible for the Vermont Health Connect website. The federal government dropped the IT conglomerate earlier in the year and Massachusetts announced it would also break ties with CGI this week.
“We have a responsibility to assess what is the best path forward to get the remaining work done, and to protect the functionality that Vermonters are using today,” he said.
Dumping CGI at this stage would create more risk for Vermont, Larson said, and would not give the state a fresh start.
Larson said in no uncertain terms that the website would be complete by the end of the year, allowing the project to be paid in full with federal money.
Federal grants made to states for building their own exchanges must be spent by January 2015.
Asked why Gov. Peter Shumlin has said he will lobby the feds for flexibility in that deadline, Larson said, “If there’s any other additional work to be done in terms of upgrades to the site or modifications … the ability to use those federal funds to be able to continue to improve Vermont Health Connect, we’d like to take advantage of that opportunity.”
He suggested that continued access to that money could relieve pressure on a tight state budget.
Correction: An earlier version of this story incorrectly stated the number of Vermonters the state had planned to enroll through Vermont Health Connect.
