White Coat Notes

Outside review for state’s failed insurance website

An independent technology firm will review the state’s failed health insurance website and make recommendations about how to move forward in rebuilding a system that allows people to easily shop for and buy coverage online.

The state had a virtual insurance marketplace, created under a 2006 state law and run by the Massachusetts Health Connector, where people could do just that, but the system was overhauled in October to comply with the Affordable Care Act. Since then, technical problems have frustrated consumers and required the state to process applications offline in order to prevent tens of thousands of people from losing coverage.

Technology firm MITRE will review the Massachusetts marketplace and point to a path forward, with costs covered by the federal government. Asked whether the firm would also look at whether state officials did enough to supervise website developer CGI, Connector Executive Director Jean Yang said the review will mostly focus on technical problems but will examine project management as well.

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Connector board member Jonathan Gruber, an economist at Massachusetts Institute of Technology who helped to write the state and federal health laws, said such a review should give the state perspective on how to avoid such a major IT failure in the future.

“How did we not catch this earlier?” he said, after a Thursday board meeting.

Glen Shor, Connector board chairman and state secretary of Administration and Finance, said it was too soon to tell whether the state will continue working with CGI in building the website.

“No stone will be left unturned in assessing what has gotten us here,” Shor said. “Nothing will be taken off the table in determining what’s the best way to get us to the right place.”

Progress on the site has stalled and the state late last year stopped paying on CGI’s $69 million contract, because the firm failed to deliver pieces of the website and necessary fixes on time. Governor Deval Patrick has said the state must consider legal action against the company, which also was a major developer of the federal health insurance exchange.

Yang and several board members lauded efforts by the staff at the Connector and other agencies to create a secondary enrollment system, which involved processing applications on paper and using simple software tools to complete functions that the website would have done automatically. Though labor-intensive, the workarounds helped to preserve coverage for hundreds of thousands of Massachusetts residents who receive state assistance and provided new assistance this month to about 28,000 people.

But Yang acknowledged that the workarounds also have frustrated customers, including some who are confused about whether they have coverage this month and others who still have not been able to complete their applications after months of trying.

“I perfectly understand that not everyone is exactly where they need to be,” Yang told the board. “Our commitment is not to leave a single person out.”

Amanda Nichols of Boston hopes that’s true. The 36-year-old marketing coordinator applied for coverage in October for herself and her husband, hoping they would qualify for a subsidy and could get better coverage than they have had through employers.

The couple received a notice last month that they had been put into temporary coverage through MassHealth. The envelope was addressed to Nichols, but the letter itself was written to her husband, she said in an interview Thursday afternoon. It included just one ID number.

Nichols requires a monthly infusion to treat multiple sclerosis that costs about $20,000. She has an appointment next week. When she called the hospital to let them know about her new insurance, she learned that the ID number was linked only to her husband.

Calls to MassHealth and the Connector have been fruitless, Nichols said. She knows which plan she would like to select to get out of the temporary coverage, and she would pay for it without a subsidy if that would get her covered quickly. But, she said, she was told that is not an option.

“I have the check ready,” she said. “I want to give it to somebody.”

Between now and the end of March, tens of thousands of people—at least 152,000—who have been given temporary coverage or whose state-run plans have been extended through March must use the Connector system to select and get enrolled in a new plan. There is little indication that the website will be working by then.

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