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Vox: How Mass. ‘Screwed Up Obamacare’ (The Website)

(RightBrainPhotography/flickr)

(RightBrainPhotography/flickr)

Just to be clear, in defense of Massachusetts: The state did not screw up Obamacare itself, and its record on health insurance coverage for our residents remains the best in the nation. Massachusetts screwed up — in fact, you could use harsher language than that — the health-insurance marketplace website that was part of Obamacare, as WBUR’s Martha Bebinger has been covering for months.

But that’s just a headline quibble. Sarah Kliff’s Vox feature today — How Massachusetts Screwed Up Obamacare — provides some answers to the many of us who still feel baffled by the state’s ability to go from top of the class nationally on health insurance to the Obamacare dunce corner. The most memorable quote, from former Connector chief Jon Kingsdale: “”In some ways it’s harder to rehab your house when you’re still living it.”  And the basic explanation:

The state spent years trying to build what they hoped would be the country’s most advanced marketplace. What got in their way, state officials and outside experts say, were poor management, a too-ambitious agenda, and a failed relationship with its main technology vendor, CGI — the same company that managed the failed launch of healthcare.gov.

Massachusetts’ prior experience running an exchange may have turned into a distinct disadvantage, some say: it led the state to underestimate how different — and challenging — building an Obamacare exchange would be.

Health Insurance Limbo: The Latest On Mass. ‘Connector’ Sign-Up

Screenshot of Mass. Health Connector website

Screenshot of Mass. Health Connector website

More than 44,000 Massachusetts residents (as of Dec. 24) who have applied for coverage through the Massachusetts Health Connector are in limbo. The vast majority have applied for subsidized insurance and are waiting to find out:

• If they qualify for free or subsidized coverage
• If they are eligible for a subsidized plan, what are their options?
• If they don’t qualify for government help, do they have to start all over again?

Many people submitted applications months ago. The Connector, the Massachusetts health insurance exchange, has had a lot of problems with its website — to the point that the state is reviewing its legal options against the contractor. Here, we address some of the most common questions from Massachusetts residents who’ve applied for insurance assistance. Connector spokesman Jason Lefferts helped us with the answers:

1) I submitted an application for subsidized coverage. When will I find out if I qualify?

The state expects to send most of the more than 44,000 outstanding applicants a letter by January 1st. The letter will say either:

a) You are approved for a subsidy or
b) the Connector hasn’t processed your application yet and is putting you, temporarily, into a MassHealth (Medicaid) plan.

The Connector is giving priority to applicants who may qualify for an insurance subsidy and aren’t already enrolled in Commonwealth Care. Health plans for everyone who is already in Commonwealth Care have been extended through March.

2) If I qualify for subsidized coverage, how do I choose a health plan? Continue reading

What Rockin’ Fun A Health Insurance Exchange Can Be

The Rolling Stones in 2006 (Charliecorgan via Wikimedia Commons)

The Rolling Stones in 2006 (Charliecorgan via Wikimedia Commons)

I was listening against my will to my tween daughter’s top-40 station in the car, thinking that it should be illegal to play Carly Rae Jepsen’s “Call Me Maybe” more than ten times an hour, when suddenly a fresh health-care breeze came across the airwaves. It was a catchy little song that went like this (click on the play button to the right to hear it):

Have a budget to protect?
Then it’s time that you connect
To the Health Connector.
It’s the place to shop and save,
So health care shoppers rave
About the Health Connector.
It’s where
You compare
All health plans side by side.
For the best deal
On how you feel,
Let the Connector be your guide.

Then an announcer said, “Go to MAhealthconnector.org. to shop for health insurance at the state’s Health Connector. It’s the perfect place to compare all leading plans side by side – making it easier to save, and choose the health insurance plan that fits you and your family the best. Open enrollment is July 1st through August 15th. So now’s the time to shop for the health plan that’s right for you…and your wallet.”

My first thought: In the states that are refusing to create health insurance exchanges under Obamacare, if only those grinch-like governors knew what fun an exchange can be! Okay, maybe it’s too much to expect anyone, ever, to get excited about shopping for health insurance, but really, it was a lively little jingle and such an improvement over “Call Me Maybe…”

I expressed my appreciation last week to Connector spokesman Richard Powers, and discovered that I didn’t know half the agency’s wild hijinks. He messaged: Continue reading

Mass. Health Connector In NYT: Promise And Perils Of Insurance Exchanges

connector

Abby Goodnough, the outgoing Boston bureau chief of The New York Times, is now shifting to the health care beat, and if this surprisingly readable profile of The Massachusetts Health Connector is any indication, that is a very good thing.

The Connector, of course, is the agency that helps Massachusetts residents shop for and obtain health insurance — the sort of insurance marketplace or “exchange” that is slated to crop up in states nationwide, as many more people get health insurance under Obamacare. If Obamacare continues to exist after the Supreme Court’s expected ruling this month, that is.

So, as in so many things related to health reform, the nation’s eyes (or their media surrogates) turn to Massachusetts to see how this stuff works. The state of play:

The law requires every state to establish an exchange, but many are balking, complaining about everything from the expense to the perceived federal intrusion. Some, like Louisiana and Maine, are refusing. Others are deferring crucial decisions until the court rules and the November election plays out. So far, only about 15 states and the District of Columbia have established exchanges, with California and Maryland among the furthest in their planning.

The experience of Mr. Kim in Massachusetts, which with Utah is one of only two states with an exchange up and running, illustrates how exchanges are ideally supposed to work. After just an hour of research on the exchange’s Web site, he says, he found a better deal. He enrolled in a plan through Harvard Pilgrim for which he pays $1,086 a month for his family.

Sounds good so far. Now for the challenges: Continue reading

Connector: Commonwealth Care Insurance To Get Five Percent Cheaper


This just in from the Connector, the agency that helps Massachusetts residents shop for and obtain health insurance:

For the second year in a row, the Massachusetts Health Connector’s Commonwealth Care program will provide private health insurance to eligible residents at a lower cost than the previous year. At tomorrow’s monthly meeting, the board of directors of the Health Connector will vote on bids from private insurance carriers that provide an average five percent reduction in per-person cost. Combined with similar savings achieved this year, tomorrow’s action will save the state approximately $91 million with no benefit reductions or member co-pay increases.
[…]
Commonwealth Care is the Health Connector’s health insurance program for uninsured adults who meet income and other eligibility requirements. There are currently 173,000 Commonwealth Care members and enrollment may exceed 200,000 during the next year. In the six years since health care reform became law, the per member per month rate the state pays to insurance carriers has increased by an average of less than two percent, while member satisfaction remains consistently high. In the most recent survey conducted during FY 2012, members rated their Commonwealth Care experience favorably, with 77 percent of all members being satisfied or extremely satisfied with the program. Continue reading

New York Times Correction On Mass. Premium Prices

New York Times building

The New York Times building (fotopedia.com)

Today’s New York Times runs this correction:

An article on March 28 about the requirement that most Massachusetts residents have health insurance gave an incomplete account of the options that Wayde Lodor, an independent consultant from Leominster, had for buying health coverage. While Mr. Lodor, after researching several plans, estimated he would have to spend at least $1,200 a month to insure himself and his daughter, he could in fact have bought coverage through the state’s insurance exchange for significantly less.

Let’s take a look back and see what the story said. it described Wayde Lodor as one of the roughly 120,000 Massachusetts residents who still lack health insurance, and said he faces a penalty this year for making enough money to afford insurance but not buying it.

“I’m in good shape, I don’t eat meat, I don’t drink excessively, I’ve never smoked,” said Mr. Lodor, 53, who estimates he would have to spend at least $1,200 a month to cover himself and his college-age daughter. “The last thing I’m going to do is not pay my rent because I have to pay for some state-mandated health coverage that I don’t think I need.”

According to Connector spokesman Richard Powers, “Policies through the Connector for himself and his daughter start at $652. The story says his daughter is “college-age.” If she is enrolled in a Massachusetts college, I would assume she is getting coverage through the school since college students in this state have been required to have insurance since the 1980s. If that is true, the gentleman would only have to purchase coverage for himself. Commonwealth Choice plans for individuals his age start at $350.” Continue reading

Couple Wins Appeal Of Fine For Shoddy Health Insurance

Thump thump thump. That’s the sound of the Boston Herald patting itself on the back on Thanksgiving, over this undeniably excellent news: Lauren and Nick Destito will not, in the end, have to pay a fine for having shoddy health insurance. Read the full Herald story here, including:

Weeks after the Herald chronicled the couple’s financial nightmare, there’s a very happy ending, thanks to her vigilant state representative, U.S. senator and the Herald, Destito said.

Herald columnist Margery Eagan reported on Oct. 18 that the Plainville couple, both 50, already bankrupt and behind on their mortgage, faced a $3,000 fine because their insurance didn’t meet the minimum standards established under Massachusetts health reform.

The case went immediately national, wielded by Newt Gingrich against Mitt Romney in a Republican presidential debate. It looked like it had the sympathy factor to become a widely cited example of how requiring virtually everyone to have health insurance could hurt people already knocked down by the recession.

This CommonHealth post added some context from the Connector, the agency that helps Massachusetts residents shop for and obtain health insurance — including the point that more than 60 percent of the residents who appeal their penalties, as the Destitos did, win their cases.

Connector spokesman Richard Powers in the Herald story: ““Health reform is about insuring people, not penalizing them.” From the Connector: Continue reading

Couple’s Penalty For Shoddy Health Coverage Resonates Nationally

Prediction: The name Destito is going to be bandied about in national politics. I can even imagine an attack ad against ObamaCare: “Do you want to become a Destito?”

Boston Herald columnist Margery Eagan listened in on the Destitos’ appeal hearing with the state Connector, the agency that helps Massachusetts residents shop for and obtain health insurance, and describes it in the Herald here. She writes that the Plainville couple, both 50 and already bankrupt, face a $3,000 fine because the shoddy health insurance they bought after their business folded “apparently does not pass muster with the state’s mandatory universal health insurance law.”

Do I hear the conservative talk show hosts clearing their throats? Already, Newt Gingrich wielded the Herald report against Mitt Romney in the Oct. 18 Republican presidential debate. The Destitos’ case touches on the third rail of health reform politics: the “individual mandate” that requires virtually everyone to have health insurance or pay a penalty, for reasons of both equity and economics. it’s the hottest-button issue in national health reform, and faces major legal challenges. Posted yesterday, the Herald column has already garnered over 140 comments, including this from MuffinMom: “They had health inurance and the state says it wasn’t enough and is fining them???? Beyond the pale!”

‘An avenue for individuals to come tell their stories to a human being’

But before the Destito case goes national, here’s some important context from the Connector: State law does require that health insurance fulfill some minimal coverage levels to count under the mandate, but residents who face fines have ample rights to appeal the fines and explain their economic straits, and their appeals win more often than not.

Connector chief Glen Shor

Glen Shor, chief of the Connector, emphasizes that the appeals process is, very deliberately, a “point of flexibility” in the system, meant to ensure that penalties imposed under the individual mandate “in any given instance are not solely a function of rules on paper doing their thing. Rather, the appeals process creates an avenue for individuals to come tell their stories to a human being, encompassing all the relevant details of their individual lives.” Continue reading

If You Get Your Own Health Insurance, MA Open Enrollment Ends Today

If you’re among the 121,000 Massachusetts residents who buy their own health insurance, take heed. Today is the final day of the open enrollment period mandated by a state law passed last year — meaning that if you want to shop around and compare options while you can, you should head right over to the “Connector” now. (Actually, you have until midnight if you do it online, but if you’re going to need the customer service line, it’s only open until 5 p.m. at 1-877-623-6765).

The Connector is the agency that helps Massachusetts residents shop for and obtain our (mandatory) insurance, but this deadline is not just for people who buy their health insurance through the Connector. It’s for anyone who gets health insurance on their own rather than from an employer or a public program like MassHealth. If that’s you, you should know that if you don’t switch plans now, you’re stuck with your current plan until the next open enrollment period next July. That is, even if your health insurance contract expires, your only option is to continue the same plan with the same health insurer for the time being.

Seems oddly inflexible, but the Connector explains:

The open enrollment period was created by 2010 cost containment legislation, Chapter 288, after insurance carriers complained that too many people were signing up for coverage when they required expensive medical services, then dropping it.

If you’re about to go shop, check out a new feature on the Connector’s health information portal: The ability to plug in a doctor or hospital’s name and find plans that include them. The site also includes the ability to compare different plans side-by-side simply — a feature that states around the country will be adopting as part of federal health reform.

Readers, please let us know how your insurance-shopping goes — and please help spread word of the deadline to people who need to know. Connector chief Glen Shor explains more here:

 

The ‘Political Theater’ of Massachusetts Health Reform

Former Connector chief Jon Kingsdale


Jon Kingsdale is best known as the man who got the Massachusetts “Connector,” the first health insurance exchange in the nation, off the ground. Who knew that he was also a blogger extraordinaire? Don’t miss his new post, “Hypercostitis: Political Theater in Massachusetts” on the blog of the journal Health Affairs.

Jon makes no pretense of being a member of the elite buns-of-stone corps who sat through all four days of last month’s state hearings on health cost trends, but he draws on Health Care For All’s coverage to reach some conclusions:

Covering all four days of hearings in excruciating detail, HCFA’s blog called it “Boot Camp” for policy wonks. I call it political theater. It was this same sort of political show, staged over years at the JFK Library, which contributed to the enactment of near-universal coverage in 2006.

And:

Most of the substantive testimony at last week’s hearings focused on the twin culprits of fee-for-service reimbursement and hospital/physician consolidation. Building on a tradition of political theater, Massachusetts is poised to confront the evil twins of medical excess. Whether we do so, or dance around that political challenge, will be revealed in the next (legislative) act.

Jon has some other great turns of phrase; I particularly liked his summing up of the problem that hospitals with more clout can command higher prices from insurers: “The big get richer, and the rich get bigger! No wonder that three of the four hospital CEOs at last week’s hearings—all but Partners CEO Gary Gottlieb—called for government intervention to reduce such pricing disparities. (Now that’s theater!)” Continue reading