The consultant brought in to help fix the state’s troubled health insurance marketplace acknowledged Thursday that its website may not be fully functioning by the end of June, and that one option under consideration is to scrap the multi-million-dollar site and start over.
The lack of a working website may make it difficult to meet the June 30 deadline to move more than 200,000 people into insurance plans that comply with the federal Affordable Care Act, said Sarah Iselin, special assistant to Governor Deval Patrick.
But she said the administration would devise a backup plan so that residents would remain insured if the website is not ready — possibly by developing workarounds like the ones the state is already using to provide people temporary coverage without depending on the Health Connector website.
Iselin said that although there is no plan to request an extension from the Obama administration for compliance with the federal law, she can’t rule it out. The state was already granted one extension, from March 31, because of the flawed website.
“We are hedging our bets whether we will have a fully functional website for the June 30 deadline,” Iselin said at a meeting of Massachusetts Health Connector board Thursday.
Board member Jonathan Gruber, an economist at the Massachusetts Institute of Technology who consulted on drafting the state and federal health laws, said in an interview that it was smart for the Patrick administration to consider fall-back options given the extent of the problems.
“They’re not taking it for granted” that the website will work by June 30, Gruber said. “They’re working on both possibilities, and that’s the right thing to be doing.”
Concrete long-term plans will be announced at future meetings, Iselin said, but the options for fixing the website include starting over from scratch, rebuilding parts of the site, or continuing the current situation, which involves using workarounds such as paper applications. She did not address what these options might cost.
The website, created under Massachusetts’ 2006 landmark health insurance law, worked well for several years. But it was overhauled last year to meet the more complicated demands of the Affordable Care Act — by CGI, the same company that designed the federal health insurance website, which also had a disastrous rollout this fall. While the performance of the federal site has improved markedly, the Massachusetts site continues to have serious problems.
The website has been locking users out of accounts and providing confusing error messages. And parts of the system designed to automatically determine applicants’ eligibility for tax credits and to deliver key information to insurers simply have not worked. The flaws prompted the state to stop paying CGI on its $68 million contract — of which $15 million has been paid — and to bring in Optum, a separate health care technology firm, to fix the problems.
CGI issued a statement Thursday, saying the company “continues to work with the Commonwealth leadership around a shared set of priorities and bring focus to tasks and make progress that will move the system toward full functionality. CGI and its more than 300 team members continue to work tirelessly to deliver a health insurance exchange that effectively serves the people of Massachusetts and meets the requirements of the Affordable Care Act.”
Because of the problems, thousands of people have been unable to buy subsidized insurance through the Connector. The state has given them temporary coverage through the state Medicaid program. Others were allowed to keep expiring plans.
Some other states are confronting similar challenges with their insurance websites. The Maryland Health Benefit Exchange this week fired the company hired to build its online marketplace.
Iselin said she was encouraged by the progress being made in developing more efficient workarounds to the website, and that those should enable the state to soon chip away at a current backlog of 54,000 paper applications that need to be entered into computers and processed. The state has urged residents to submit paper applications instead of using the website.
A tool that began to be deployed on Monday can significantly cut down the time it takes to process a paper application, from 2 hours to 39 minutes. Additional staffing from Optum should be at capacity by early next week, with 318 additional people processing applications.
In the last week, 9,000 applications were entered into computers after they were flagged as a priority because they came from uninsured residents. A third of those applications were missing some data and need follow-up, but the remainder will be given transitional health coverage as of next week.
Even as the state has made progress in processing applications, however, new paper applications are arriving at a rate of about 1,000 applications per day. Two weeks ago, the state reported it had a backlog of 50,000 applications as well as 22,000 unprocessed applications made through the website. The web applications were processed last week and 21,000 residents have been granted health coverage over the last two weeks. But on Thursday, the paper backlog was still high, at 54,000 applications.
Iselin said she hopes that the rate of processing applications will increase with additional staffing and the new data entry tool, but she could not estimate yet how many applications would be processed per week.
One workaround the insurance marketplace has already embarked on is giving people who already have unsubsidized insurance a “fast path” — letters that describe a health plan that is similar to the one they have now. They can enroll simply by sending a check, bypassing the website altogether.
Those who want to apply for subsidized insurance or shop around for a different plan can use the website, she said. Officials said the website currently works for those seeking unsubsidized insurance plans. Some consumers have reported, however, that it is not working for them. State officials also said the website allows those seeking subsidized insurance plans to input their application information, although it cannot be used to go through all the steps of selecting a plan.
“We’re challenging ourselves ... if we’re continuing to rely on these workarounds, how to make them better,” Iselin said.