[I]n the wake of State Auditor Doug Hoffer’s sobering analysis of Vermont Health Connect’s performance and chances for success, lawmakers are looking to strengthen contingencies should the exchange miss key deadlines.
Gov. Peter Shumlin laid out a contingency plan in March if contractors for Vermont Health Connect can’t automate crucial functions at the end of May and the end of October. If the exchange still relies on costly and ineffective manual processes for changing customer information and renewing people’s coverage, his administration will provide lawmakers with a plan to transition to some version of the federal exchange in November.
Last week top lawmakers said the timeline for improvements is too lax.
House Speaker Shap Smith and Senate President Pro Tem John Campbell have both said the state should pull the plug if the exchange isn’t working by June 1 and move to a regional or federal exchange program.
“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.
At a Tuesday news conference, Shumlin grew exasperated with questions about what his administration’s specific plan is if the automated process for making changes isn’t in place come June, saying he’s confident the new technology will be in place.
He told reporters “not (to) create conflicts that we don’t need to have.”
Pressed repeatedly by reporters the governor made an insensitive joke about suicide. “I’m going to find a high building. I’m at the end of my rope, I don’t think the Fifth Floor is high enough,” referring to his office in the Pavilion Building. Shumlin later apologized, and said the remark was “inappropriate,” “insensitive,” and was made in frustration.
In March, after Shumlin announced his plan, Lawrence Miller, Shumlin’s top health care adviser, proposed language codifying the contingencies in legislation. Those suggestions were incorporated into H.487, which set a December deadline for the legislative Joint Fiscal Committee to make its own recommendation on whether to pull the plug on VHC.
Rep. Bill Lippert, D-Hinesburg, said that in light of Hoffer’s report, his committee may need to “tighten up” the contingency language in H.487, which could easily be amended prior to its passage. Rep. Chris Pearson, P-Burlington, the vice chair, said he’d like to “explore” language that’s “more aggressive than a decision at the end of the year.”
Members of the House Health Care Committee heard from Hoffer and Miller on Tuesday.
Hoffer summarized his report, highlighting improvements to project management, but added that the challenges and stumbling blocks that stand in the way of meeting the end of May deadline are substantial.
While he wouldn’t “handicap” the odds that VHC and its contractors will deliver, he said — as he does in the audit report — that it would be “prudent” to begin a cost-benefit analysis of the different options for transitioning to the federal exchange well before the governor makes his recommendation in November.
Hoffer also recommended lawmakers do their own analysis of the options going forward and not rely on the administration for that information.
Miller said he agrees that there needs to be a detailed analysis of the state’s options should the expected technology not be in place by the end of May. However, the state can’t just “throw up its hands” in June and abandon VHC, he said.
Vermont chose to design its exchange in a way that supports its Medicaid program, and therefore it must be completed regardless of whether the state transitions to the federal exchange for people buying commercial insurance, Miller said.
There’s also no practical way to transition to the federal exchange before the upcoming open enrollment period in the fall, and if the state doesn’t want a repeat of the frustrations that were replete throughout open enrollment this year, then it must press forward with improvements, he added.
Miller said that if the end of May technology release hasn’t significantly reduced the time it takes for customers’ changes to be made by the time the Supreme Court hands down a decision in the King v. Burwell case that could prohibit states using the federal exchange from offering subsidies, he will “assign a full team to developing the alternative plan” that will be prepared to go to work after the ruling.
Lippert said his committee will continue to explore if further legislation is needed to provide proper oversight of activities that will likely take place after adjournment. He asked Miller to return Wednesday morning for additional testimony.
