Republican leaders want the Green Mountain Care Board to determine whether the state should fix Vermont Health Connect or move the state’s health care exchange to the federal system.
After nearly three years and anticipated expenditures of $300 million, the state health exchange website a remains hobbled by technical problems.
Lt. Gov. Phil Scott, a Republican candidate for governor, at a press conference Friday called for an independent assessment by the board because “Vermonters have lost faith and trust in the [Shumlin] administration when it comes to Vermont Health Connect.”
Scott and his colleagues in the Statehouse, Rep. Don Turner, the House minority leader, and Sen. Joe Benning, the Senate minority leader, say they don’t believe the Shumlin administration can be counted on to oversee a re-evaluation of the dysfunctional system.
“The Green Mountain Care Board is intended to be an independent regulatory arm for health care in the state, and should be willing to take on this challenge,” Scott said.
The lieutenant governor said there has been an uptick in Vermonters who are complaining that they are having trouble applying for health insurance through the exchange website or find that plans have been cancelled and billing hasn’t been properly reconciled with insurers. Simple insurance policy changes based on personal information, such as the birth of a child or a divorce, have been difficult to make through the website.
Checks for premium payments have been returned, Scott said, and patients who show up at the pharmacy or at the doctor’s office too often find out they don’t have insurance.
Scott said he “feels like a broken record” talking about the exchange, “but that’s because Vermont Health Connect is broken.”
“We need to consider other options because what we’re doing isn’t working,” Scott said. “We need an assessment with someone who is independent, that’s why we’re asking the Green Mountain Care Board to oversee this so that they give us the information and do it in a transparent way.
“I’m not sure we’re seeing all the information [from the Shumlin administration],” Scott continued. “They [Gartner, Inc., a consulting firm] made suggestions along the way but it was ignored.”
The board is charged with regulating insurance rates and hospital spending. There is nothing in statute currently that would give the five-member panel the authority to hire an independent consultant to review the state health care exchange.
Al Gobeille, the chair of the Green Mountain Care Board, says the board has to be instructed by the Legislature to move forward with the Republicans’ wishes. “The next move on the chess board is legislation,” Gobeille said.
While Turner is drafting a bill to that would authorize the board to assess the exchange and that he will seek bipartisan support for, it’s unlikely the Democratic majority in the Statehouse will embrace the notion.
House Speaker Shap Smith says moving the responsibility for independent assessments to the Green Mountain Care Board “doesn’t seem like a natural fit.” The board doesn’t have the technical expertise, and oversight of Vermont Health Connect, he said, “is not part of their mission.”
The state should stick with Gartner, Inc., the consulting company hired by the Shumlin administration, Smith said, because the firm has provided lawmakers and the state with an “honest” assessment of Vermont Health Connect.
“It seems to me, Gartner is doing what the Republicans are asking,” Smith said. “They are giving us an independent analysis of where we really are.”
This week, Frank Petrus, a senior managing partner at Gartner, said the state should stop spending money to build new Vermont Health Connect technology, try to leverage investments it has already made, and commission a three to four month study of the technical issues with the website. Petrus’ testimony was part of a weekly Wednesday hearing on Vermont Health Connect held by the House Health Care Committee.
Gartner warned the Shumlin administration of technical and management issues with Vermont Health Connect early on, and Petrus said while some of the advice was heeded by the Shumlin administration, some of it was ignored.
Scott and his colleagues used that news as an opportunity to bash the Shumlin administration for failing to fully repair the dysfunctional website, which was launched in October 2013 and has never worked properly.
Turner said it appears the Shumlin administration is willing to consider an assessment, and “we are suggesting taking it out of the administration’s control and hire a consultant through a different body so we can be transparent and monitor it as it moves forward.”
“When you find yourself in a hole, you need to stop digging,” Scott said. “It seems the administration has gotten the word it’s time to stop digging.”
Benning recited a litany of promises from the Shumlin administration over the past three years that have gone unfulfilled. Benning’s timeline is a rundown of deadlines blown, cost overruns and the thousands of people who have ended up in a backlog, waiting for policy changes.
“Vermonters have suffered a long history of broken promises and missed deadlines on this frustrating path to affordable and dependable health care,” Benning said. “The [Shumlin] administration has been either incapable of recognizing or purposely choosing not to be truthful about the lack of progress of its efforts. It’s time to get a realistic assessment that puts Vermonters first, not politics.”
Scott Coriell, spokesman for the Shumlin administration says the website was shut down for a period of time for fixes, and the backlog hit 5,700. The number is now going down again, although it will “always” hover at around 3,000, he says, because hundreds of people make changes to their plans every day.
“I think we have to remember the state is now in the insurance business,” Coriell said. “If people are thinking that before Vermont Health Connect insurance went well for people they’re mistaken. So, yes, people have issues with Vermont Health Connect. People have had issues with the insurance business as long as it’s existed.”
A delegation from the Statehouse, including Scott and several lawmakers last spring talked with Connecticut about joining that state’s exchange. Scott says he’d like the Shumlin administration to consider all the options, including the Connecticut, Hawaii, Oregon and federal exchanges.
The Shumlin administration says it would be too expensive for the state to move to another exchange. It would cost $24 million to transition the technology to the federal exchange, Coriell says, and $5 million a year to operate. Insurance premiums would also be higher on the federal exchange, he says.
“We’ve studied VHC for three years,” Coriell said. “What we’re trying to do is make it work for people. If the Republicans and the lieutenant governor have an idea for what to do, they should just come out and say it. The last thing we should do is move to the federal exchange.
“If that’s what they want propose, go ahead and propose it, but don’t try to put the decision on someone else,” Coriell said.
The Shumlin administration estimates it has spent $198.7 million in state and federal money setting up Vermont Health Connect and will expend an additional $103.6 million on operations in 2015 and 2016.
Turner said some of the money slated for the state exchange this year could be used to transition Vermont Health Connect to the federal exchange system.
Shawn Shouldice, campaign manager for Bruce Lisman, Scott’s rival in the 2016 Republican gubernatorial primary, said it was “refreshing to see the the lieutenant governor step up and take a position.”
If elected, Lisman would shut the Vermont Health Exchange “day one,” Shouldice said.
“The last thing we need is more studies by the governor or the Legislature,” she said. “Further, the Green Mountain Care Board has no oversight authority over Vermont Health Connect pursuant to Act 48. Oversight responsibility for VHC lies with the Legislature.”
Editor’s note: This story was updated at 7:12 a.m. Feb. 20.
CORRECTION: House Speaker Shap Smith was not involved in the investigation of Connecticut’s health exchange as originally reported. He has talked with experts about the Oregon exchange.
