Massachusetts: New $254 Million Health Exchange Website is working

November 18, 2014 at 2:30 pm | Posted in Affordable Care Act, Health and Human Services, Health Care, Health Insurance Marketplace, HHS, Medical, Wellness | Leave a comment
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by Steve LeBlanc, Associated Press

BOSTON (AP) — Massachusetts officials are reporting a successful weekend launch of the state’s revamped health insurance website, but cautioned of possible “hiccups” in the system with expected heavier traffic during the week.

Officials said Monday that in the first two days of the new federal open enrollment period, nearly 5,000 eligible people were immediately registered for state Medicaid coverage.

Nearly 7,000 others were able to complete the process of determining eligibility for plans that comply with the federal Affordable Care Act. They still need to review those insurance plans, choose one, and make their first month’s premium payment.

The successful rollout was in sharp contrast to a year ago, when a failed health exchange forced the state to place hundreds of thousands of residents into temporary Medicaid coverage and led to a costly overhaul of the website. The website woes were also an embarrassment for the state that provided a blueprint for the federal health care law.

Maydad Cohen, a special assistant to Gov. Deval Patrick, said Monday that the new website has proven stable and reliable — handling more than 57,000 visitors over the first two days of open enrollment.

“During the weekend we saw excellent performance of the website,” Cohen told reporters Monday. “We had a very successful, very exciting weekend.”

Of the nearly 7,000 people deemed eligible to obtain insurance through the state’s health insurance exchange during the weekend, about 3,600 individuals and families already have selected a plan and 137 already have paid their first month’s premium, state Health Connector officials said.

Those numbers will continue to climb as more people sign up for insurance.
Hundreds of call representatives also are assisting those looking to sign up for coverage, having trouble with the website or are unsure how to use it.

Cohen said one of the main reasons for high call wait times is that many of those seeking one-on-one help want to go through the entire application on the phone, something that can take 45 minutes or more per application.

Cohen urged those seeking to sign up for coverage to try the website first.

As a result of the previous website troubles, the state ended up putting more than 400,000 individuals into temporary subsidized insurance programs, including MassHealth, the state’s Medicaid program.

Secretary of Health and Human Services, John Polanowicz said between 175,000 and 225,000 of those were expected to enroll in new coverage, including through MassHealth.

Polanowizc said the number is lower than the 400,000 because of what he called the natural “churn” of subsidized care, with individuals losing their eligibility because they’ve found a job that offers insurance, or have obtained health care through a spouse, or have moved out of state.

Dec. 23 is the deadline to ensure coverage that starts on Jan. 1. Fixing the website hasn’t been cheap. The original cost of Massachusetts’ website was estimated at $174 million. That has jumped to $254 million.

Although First in Universal Healthcare Requirement…Massachusetts Remains Near Last in a Functioning Website/Exchange

July 14, 2014 at 11:44 am | Posted in Affordable Care Act, Health Insurance Exchanges, Health Insurance Marketplace | Leave a comment
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As reported in the July 10, 2014 article from the Associated Press that follows, frustration abounds on Beacon Hill as the state is still hoping for a soon to be operational health insurance exchange/marketplace.

By BOB SALSBERG, Associated Press:

BOSTON (AP) Software ordered by Massachusetts to fix its hobbled health care exchange passed initial tests, renewing hopes that the state could finally have a fully operational website by year’s end, officials said Thursday.

The breakdown dramatically slowed the state’s transition to the federal Affordable Care Act from its own first-in-the-nation universal health insurance law that provided a model for President Barack Obama’s plan.

Massachusetts severed ties earlier this year with the lead contractor on its health exchange, CGI Group, and has been forced to shuffle more than 200,000 of its residents into temporary Medicaid coverage.

In May, state officials unveiled a “dual-track” approach that called for buying software that has powered insurance marketplaces in other states while also laying the groundwork for a switch over to the federal government’s health insurance market, should that be necessary.

Maydad Cohen, a special assistant to Gov. Deval Patrick, told the Massachusetts Health Connector board that the software cleared several key tests after its initial release last month, prompting federal officials to authorize the state to continue pursuing its current strategy.

A final decision on whether to go forward with the software solution is expected early next month following the rollout of an enhanced version of the program.

Cohen said the goal was a fully functional exchange before the next ACA enrollment period beginning Nov. 15.

“I don’t know where we are going to be at open enrollment right now, but I am increasingly, cautiously optimistic about our ability to deliver the product,” Cohen told reporters after briefing the board.

The total cost to taxpayers for the website breakdown remained unclear.

The state initially estimated the cost of the dual-track approach at $121 million. Officials said they would not be able to produce a final cost estimate until it finalized contract negotiations with Optum, a health care technology firm that was retained by the state.

Cohen said state officials hope the federal government agrees to pay the full tab for repairs. A separation agreement reached with CGI calls for paying the Montreal-based firm an additional $35 million on top of the $17 million the state already had paid toward an original $89 million contract.

The state also had paid out $138 million in fees for medical services through June 30 for the 237,000 residents forced into “provisional” Medicaid coverage because the connector was unable to determine their eligibility for ACA-compliant programs, Secretary of Administration and Finance Glen Shor said Thursday.

That total was before federal reimbursement, and Shor insisted the overall costs would not have been much higher had the state been able to enroll more people into permanent coverage. Officials remain confident that all residents will be moved off temporary coverage by next year.

Massachusetts has been given a waiver from most requirements of the federal law until Dec. 31.

HHS Releases Simple and Informative Health Insurance Coverage Options for Graduating College Students

June 5, 2014 at 10:29 am | Posted in Health and Human Services | Leave a comment
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HHS released a simple and informative menu of health insurance coverage options for graduating college students.

College students and recent graduates have several options for finding coverage in the Health Insurance Marketplace.

1. Special Enrollment Periods for College Grads

2. Medicaid and CHIP coverage

3. Coverage on a parent’s plan

4. Catastrophic coverage

ACA Pre-Existing Risk Pool Coverage Extended from March 31st until April 30th

March 17, 2014 at 2:21 pm | Posted in Affordable Care Act | Leave a comment
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The federal Pre-Existing Condition Insurance Plan risk pool will stay open until April 30th while individuals covered in the program search for PPACA coverage, the Obama administration announced Friday. The one-month extension is the program’s third. The program was due to end on March 31st, the same day as the deadline of ACA’s first open enrollment. The extension was announced Friday amid concerns that some of the nation’s sickliest patients won’t be able to find and buy health coverage ahead of the March 31st deadline.

“As part of our continuing effort to help smooth consumers’ transition into Marketplace coverage, we are allowing those covered by PCIP additional time to shop for new coverage while they receive the ongoing care and treatment they need,” Centers for Medicare and Medicaid Services spokesman Aaron Albright said in a statement.

The program offers health coverage to patients turned away by carriers, and was intended to end after 2013 as the pre-existing condition provisions of the law went into effect, but the administration extended the program first, until January and then until March 31st.

HHS Announces Increase in Healthcare.Gov November Enrollment Figures: Significant Number Going to Medicaid Expansion

December 11, 2013 at 1:02 pm | Posted in Affordable Care Act, Compliance, Essential Health Benefits, Health and Human Services, Health Care, Health Insurance Exchanges, Health Insurance Marketplace, Medical, PPACA | Leave a comment
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This morning HHS reported that nearly 365,000 individuals have selected plans from the state and federal Marketplaces by the end of November. HHS reported, among other things, that:

  • November’s federal enrollment number outpaced the October number by more than four times.
  • Nearly 1.2 million Americans, based only on the first two months of open enrollment, have selected a plan or had a Medicaid or CHIP eligibility determination.
    • Of those, 364,682 Americans selected plans from the state and federal Marketplaces; and
    • 803,077 Americans were determined or assessed eligible for Medicaid or CHIP by the Health Insurance Marketplace.
  • 39.1 million visitors have visited the state and federal sites to date.
  • There were an estimated 5.2 million calls to the state and federal call centers.

What “may” be a troubling sign is that, to date, the majority of enrollees have been directed into Medicaid or CHIP coverage and are not paying premiums for their coverage. HHS is hopeful that the premium-paying, working “young invincibles” (ages 19-35), who are a key actuarial pillar to the Affordable Care Act, will enroll closer to the end of the enrollment period in March 2014.

A copy of the HHS Release and accompanying report is here: http://www.hhs.gov/news/press/2013pres/12/20131211a.html

HHS Announces First Round of Exchange Open Enrollment Numbers: 106,000 Select a Plan; 396,000 Steered to Medicaid; 975,000 have completed Applications and are still waiting for HHS determination

November 14, 2013 at 9:18 am | Posted in Affordable Care Act, Health and Human Services, Health Care, Health Insurance Exchanges, Health Insurance Marketplace | Leave a comment
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Yesterday, HHS announced the open enrollment figures for the period of October 1st-November 2nd:  106,185 individuals have selected plans from the Exchange, and another 975,407 have made it through the process by applying and receiving an eligibility determination, but have not yet selected a plan.  An additional 396,261 have been determined or assessed eligible for Medicaid or the Children’s Health Insurance Program (CHIP).

Read the HHS News Release

Enrollments In Federal Exchange and Several State Exchanges Are Well Below Expectations: One Tenth of Plan

November 12, 2013 at 8:59 am | Posted in Affordable Care Act, Health Care, Health Insurance Exchanges, Health Insurance Marketplace | Leave a comment
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The Wall Street Journal reports today that fewer than 50,000 people have signed up for health insurance in  the 36 states where the federal government overseas the new health insurance exchanges. The 50,000 figure does not include those who signed up for health insurance but were directed into Medicaid. The Obama administration had been forecasting 500,000 enrollees for the month of October. Several states are significantly behind plan as well in light of their own technology problems as well. For example, the state of Oregon has yet to enroll a single person into its state-run healthcare exchange, according to reports by The Associated Press and NPR released on Monday. The Obama administration has promised to release official enrollment numbers this week.

HHS announces first guidance implementing Supreme Court’s decision on the Defense of Marriage Act: Application To Medicare, Nursing Homes, and Same Sex Married Couples Regardless of Where They Live

August 29, 2013 at 4:57 pm | Posted in Defense of Marriage Act (DOMA), Health and Human Services, Same Sex Marriage | Leave a comment
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Today, the Department of Health and Human Services (HHS) issued a memo clarifying that all beneficiaries in private Medicare plans have access to equal coverage when it comes to care in a nursing home where their spouse lives.  This is the first guidance issued by HHS in response to the Supreme Court ruling in Windsor v. United States, which held section 3 of the Defense of Marriage Act unconstitutional.

“HHS is working swiftly to implement the Supreme Court’s decision and maximize federal recognition of same-sex spouses in HHS programs,” said HHS Secretary Kathleen Sebelius.  “Today’s announcement is the first of many steps that we will be taking over the coming months to clarify the effects of the Supreme Court’s decision and to ensure that gay and lesbian married couples are treated equally under the law.”

“Today, Medicare is ensuring that all beneficiaries will have equal access to coverage in a nursing home where their spouse lives, regardless of their sexual orientation,” said Centers for Medicare & Medicaid Services (CMS) Administrator Marilyn Tavenner.  “Prior to this, a beneficiary in a same-sex marriage enrolled in a Medicare Advantage plan did not have equal access to such coverage and, as a result, could have faced time away from his or her spouse or higher costs because of the way that marriage was defined for this purpose.”

Under current law, Medicare beneficiaries enrolled in a Medicare Advantage plan are entitled to care in, among certain other skilled nursing facilities (SNFs), the SNF where their spouse resides (assuming that they have met the conditions for SNF coverage in the first place, and the SNF has agreed to the payment amounts and other terms that apply to a plan network SNF).  Seniors with Medicare Advantage previously may have faced the choice of receiving coverage in a nursing home away from their same-sex spouse, or dis-enrolling from the Medicare Advantage plan which would have meant paying more out-of-pocket for care in the same nursing home as their same-sex spouse.

Today’s guidance clarifies that this guarantee of coverage applies equally to all married couples.  The guidance specifically clarifies that this guarantee of coverage applies equally to couples who are in a legally recognized same-sex marriage, regardless of where they live.

Congress and Administration Battle Over Funds Necessary for Creation and Operation of “Federally Run” Affordable Care Act Exchanges

April 12, 2013 at 9:35 am | Posted in Affordable Care Act, Essential Health Benefits, Federal Laws, Health and Human Services, Health Care, Health Insurance Exchanges, Health Insurance Marketplace, Medical | Leave a comment
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Reported in Today’s HealthWatch

The Health and Human Services Department (HHS) said in budget documents Wednesday that it expects to spend $4.4 billion by the end of this year on grants to help states set up new insurance exchanges. HHS had estimated last year that the grants would cost $2 billion. HHS also is asking Congress for another $1.5 billion to help set up federally run exchanges in states that do not establish their own.

HHS Assistant Secretary for Financial Resources Ellen Murray punted Wednesday when asked about the consequences if Congress also denies the new request.

HHS is “determined to make them work,” she said of the exchanges.

Exchanges are intended to function as one-stop shops where consumers can compare and buy private insurance plans if they don’t get coverage through their employers. Each state’s exchange will determine whether customers are eligible for Medicaid or a subsidy to help pay for private coverage, and policies sold through an exchange must meet certain criteria.

The healthcare law did not provide any funds specifically for HHS to set up a federal fallback exchange because lawmakers envisioned most states setting up their own marketplaces

Read more: http://thehill.com/blogs/healthwatch/health-reform-implementation/293071-costs-mount-for-health-laws-exchanges#ixzz2QAO3KKjR

Nonpartisan Congressional Budget Office (CBO) Raises Estimate of the Cost of New Federal Health Care Law, Predicts More Employees Will Lose Employer Sponsored Coverage and Expresses Skepticism Regarding Timely Implementation of State Health Insurance Exchanges in 2014

February 7, 2013 at 9:29 am | Posted in Health Care, Health Insurance Exchanges | Leave a comment
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The February 5, 2013 Hill Newsletter reports that:

The CBO estimated Tuesday that healthcare reform will cost about $1.3 trillion over the next 10 years; a slight increase since last August, when budget analysts did not include projected costs for 2023. While the law’s price tag remained virtually the same, the nonpartisan budget office added to past projections of the number of future exchange and Medicaid enrollees. The CBO also predicted that seven million people will lose employer-based coverage because of the healthcare law.

Implementation of the healthcare law has continued steadily since last August, contributing new variables to CBO projections, but the report also blamed the fiscal-cliff deal for de-incentivizing employer-provided health insurance. The deal’s reduction in marginal tax rates “reduces the tax benefits associated with health insurance provided by employers,” report authors said.

Overall, more employers will pay penalties for failing to offer health coverage than had been previously expected, for a total of $13 billion in additional revenue, according to the report. Individuals, meanwhile, will pay $11 billion less in individual-mandate penalties than previously expected.

The CBO report was also skeptical that 50 state health insurance exchanges will be operational by January 1, 2014.

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