Once written off as a “nothing burger” by Gov. Peter Shumlin, problems with the payment portion of Vermont Health Connect have forced another delay in the state’s implementation of the Affordable Care Act (ACA).
The Shumlin administration is extending 2013 health insurance plans into 2014 for up to 1,400 small businesses because the state’s online health insurance exchange still can’t process payments for the new plans.
Officials said they have made progress developing the payment system for individuals and families. A batch of overnight upgrades to the Vermont Health Connect website should allow those participants to start paying for their plans in time for them to take effect in January.
There’s a caveat, however — they’ll have to do so by mailing in a check, rather than simply entering their credit card information online. That’s because the Department of Vermont Health Access can’t ensure that security protections are up to snuff, DVHA Commissioner Mark Larson said Monday.
The administration continues to decline to provide a date by which both payment systems will be fully up and running. Testing is ongoing, according to Larson.
Larson said the fact that the system is on the verge of being able to send out invoices to individuals represents major progress.
“I think that is clearly a milestone and a significant step forward,” Larson told reporters during a conference call Monday morning. “We are excited to be able to announce today the ability for individuals and families to be able to be invoiced.”
Shumlin described the development as “a big moment for us,” when asked about it at an unrelated news conference in Barre.
“From Commissioner Larson’s perspective and mine, this is a huge accomplishment because it means the systems are working, that you can actually go in, complete the process and get the bill out,” Shumlin said.
The Vermont Health Connect website will be taken offline for the upgrade, beginning 5 p.m. Monday. By Tuesday afternoon, DVHA officials say Vermont Health Connect will produce accurate invoices, and process payments for individuals and families.
The hitch is that people can’t actually pay online yet. DVHA will start sending out bills later this week to the roughly 7,000 families and individuals who have selected plans. People entering the individual market need to select a plan by Dec. 23 and pay for it by Jan. 7.
This is the second time DVHA has turned to paper options — the department distributed paper applications in October, allowing people to pick up plans without dealing with the glitch-ridden website.
Robin Lunge, Shumlin’s director of health care reform, said significant improvements will take place “behind the scenes” Monday night, but she acknowledged that they won’t streamline the process for the consumer.
“It’s important to realize there is a lot of data that will be passed between us and the carriers in order to get people enrolled, so that’s also part of the launch,” she said. “So, while from the consumer experience, they are getting a paper bill and a paper check, there’s a lot more going on behind the scenes that’s not obvious to the consumer.”
The extension for businesses with 50 or fewer employees, which will last through March 31, only applies to the employers who signed up through Vermont Health Connect. It doesn’t impact employers who decided to bypass the exchange by signing up directly through an insurance carrier, nor does it affect businesses that had already opted to extend their coverage until March 31.
Small businesses that have already elected to extend their current coverage through March 31 are not affected by Monday’s decision, an administration news release said.
Shumlin unveiled those additional options Oct. 31 in response to website glitches that had stymied employers’ attempts to enroll in the exchange. Larson said DVHA doesn’t yet know how many businesses chose those routes.
The commissioner emphasized that the extension for small businesses is keeping with the administration’s top priority: making sure Vermonters don’t experience an interruption in their health coverage.
“We will ensure that all small groups have a pathway to coverage that does not create a gap in their coverage, and that is significant progress,” Larson said.
But the stopgap could create complications for businesses planning to switch insurance carriers in 2014. Unless they stay with the same carrier, deductibles and out-of-pocket costs will reset when businesses transition from the extended plan to the new plan.
“That’s why the long-term solution remains the same, “ Larson said. “We want to be able to have employers process their applications through Vermont Health Connect so they can offer employees a choice of plans and carriers without having this issue created by the extension.”
Larson is directing businesses to contact their insurance carriers with questions about how the extension will affect coverage.
Darcie Johnston, director of Vermonters for Health Care Freedom, said the extension creates more uncertainty for small businesses. Johnston, who opposes the mandate that small businesses and individuals enroll in the exchange, maintains that a year-long delay of that requirement makes more sense than a solution that has businesses switching plans mid-year.
“Businesses need certainty. Vermonters need certainty, and this is anything but a certain process. It’s been a constant drip, drip, drip water torture,” Johnston said.
Johnston described Monday’s announcement as “purely political,” and she criticized Larson for putting a rosy spin on a system that continues to malfunction.
The Department of Vermont Health Access issued a news release with the headline, “Premium Processing and Payment Functions to be Deployed for Individuals and Families.” In a release of her own, Johnston wrote, “The commissioner wants to show forward progress — reality be damned.”
