[T]op lawmakers and the governor say there is little news in the state auditor’s recent analysis of Vermont Health Connect, but leaders have drawn different conclusions about how to proceed in light of the findings.
The report highlighted “a number of things we already knew,” but put them all together in way that offers insight into why the system isn’t working properly, House Speaker Shap Smith, D-Morristown, said Friday on WDEV’s The Mark Johnson Show.
Democratic Gov. Peter Shumlin, speaking on the same program, called the report a “helpful document” but said it reflects “what we’ve been saying all along” that “since the exchange went up it’s been a huge disappointment.”
Smith said he has “real concerns,” based on the report, about whether Vermont Health Connect will meet the May 31 deadline to automate the back-end process for entering changes customers need to make to their coverage or personal information.
“The reality is that many Vermonters have already lost confidence in the exchange, and if we don’t meet another deadline it’s going to be almost impossible to get any confidence back,” Smith said.
If VHC can’t show that the change process is automated on the back end, and that it is reducing the time Vermonters are waiting for changes to be made, then the state needs a “structure” in place to move in a new direction, Smith said.
Shumlin sees it differently. The governor said Optum, the tech-firm now responsible for developing exchange functions, has been “extraordinarily productive, so far,” and he is optimistic the firm will meet the May deadline.
Delivering the automated change process is critical, he said, and so is automating the re-enrollment process. Consumers who needed to change information in their electronic applications had to submit paper forms. Workers made the changes in the VHC system by hand, which greatly increased costs, he said. The state should wait until October to make a decision about the exchange’s future based on what’s in place at that time, Shumlin added.
“We know the Affordable Care Act is working for us,” Shumlin said, noting that it has helped to cut the state’s uninsured rate in half. “Now we’ve got to make sure the technology is working for us. If it’s not working by November we’re out.”
Shumlin has said if VHC isn’t up to snuff his administration will make a recommendation to the legislative Joint Fiscal Committee in November about how to transition to some version of the federal exchange.
Both agree that, as the state auditor’s report makes clear, Vermont can’t transition to the federal exchange before the open enrollment period for 2017 coverage, which begins in November 2016. The feds require 12 months notice from a state before it can make that change, according to the report.
Lt. Gov. Phil Scott, a Republican, said he worries that if the state waits until after May 31 to start making concrete plans for how to make such a transition it won’t be prepared to do so when the time comes.
Instead of “running out the clock” by trying to fix the current exchange, it would be better to struggle through another open enrollment period in the fall of 2015 with the “cobbled together” manual processes it relies on now, and save the federal grants for a transition in 2016, Scott said.
“Any federal money that we have right now is being poured into this hole, and if in the end we’re not going to use it, why keep spending money?” Scott said. The state has $200 million in federal grants for implementing an exchange. It had spent $126 million at the end of 2014. That figure doesn’t include any of the work Optum has performed to this point.
Shumlin argues that transitioning to the federal exchange should be a last resort, because it could jeopardize the state’s ability to offer its own subsidies to customers and VHC would still have to be operated as the front end of the state’s Medicaid system.
The May 31 deadline is likely to pass after the Legislature has adjourned, but Smith said that lawmakers could possibly take action through the legislative Joint Fiscal Committee or Emergency Board over the summer if necessary.
Senate President Pro Tempore, John Campbell, D-Windsor, said his thinking is “more in line with the speaker” than the governor on this topic, and the two are planning to meet next week to discuss their options.
The public won’t see any difference in the VHC website on May 31. The process for requesting a change will be the same. However, state workers and contractors will be able to enter those changes using the new automated process, which will dramatically reduce the time it takes for that change to take effect, Lawrence Miller, chief of Health Care Reform for the Shumlin administration, said Thursday.
