White Coat Notes

Progress reported on reducing health insurance application backlog

Officials running the state’s troubled health insurance marketplace reported progress on Friday toward addressing its most immediate problem—a massive backlog in processing applications.

Legislators have been scrutinizing the problems with the Massachusetts Health Connector website and the confusing labyrinth many people not insured through an employer have had to navigate to get coverage. The website—which was created to help people shop for coverage after passage of the state’s landmark 2006 law mandating that most residents have insurance—was a model for the exchanges in the national Affordable Care Act. But it was revamped last fall to meet the more complicated requirements of the federal program, and it hasn’t worked properly since.

As a result, people were urged to file paper applications instead, both to replace expiring policies and to enroll for the first time. The nearest-term problem has been simply processing 72,000 applications, many of which come from uninsured residents.

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During a weekly update Friday, state officials said that over the last week, all 22,000 pending applications for health insurance that had been submitted through its website had been processed. Of that group, 15,000 people who did not have insurance have now been enrolled in transitional coverage that is retroactive to the beginning of February. The remainder were found to already have coverage, which has been extended until June.

A little more than half of a backlog of 50,000 paper applications have gone through a screening aimed at sifting out those that need to be prioritized because they come from people without coverage. So far, 9,000 such applications have been flagged, officials said. The rest already had coverage or were duplicate applications.

This week, 32,000 people covered under Commonwealth Choice insurance—private insurance not subsidized by the state—have begun to receive notices of a “fast path” that will offer them similar plans to the ones they currently have, which they can opt to sign up for and will begin April 1.

Sarah Iselin, a special assistant to Governor Deval Patrick hired to fix the Connector’s problems, acknowledged that there was still “lots of uncertainty from too many people waiting for coverage,” but said that the right team was now in place to address the problems.

Overall, a spokesman for the marketplace said that there have been about 11,000 people who have newly enrolled successfully for coverage since October, almost all in unsubsidized coverage.

There are 45,000 lower-income people who have been unable to enroll but were given temporary coverage that is subsidized. And 124,000 people are enrolled in subsidized Commonwealth Care plans, which were supposed to end in December but have been extended through June.

Iselin said that longer-term efforts to improve the functionality of the website, and to develop a tool that will dramatically reduce the two hours it takes to process each paper application, would be addressed at future briefings.

Optum, a company that has been brought in earlier this month to fix the insurance marketplace, has nearly 200 supplemental staff working on processing applications, with 318 expected by early March, the state said.

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