Last October, Gov. Peter Shumlin said his administration had finally eliminated the customer-service bottleneck that had long plagued Vermont Health Connect. The change-of-circumstance backlog has since returned, however, and the setback has further eroded confidence in the future of the online insurance exchange.
On Oct. 1 of last year, Gov. Peter Shumlin summoned reporters to the Statehouse to celebrate a Vermont Health Connect milestone. Shumlin said his team had finally worked through the backlog of people waiting to have changes made to their policies. Even more importantly, he said, no one would have to deal with long waits again.
“If you have a change of circumstance that you report in the first 15 days of the month, it will be reflected in your next bill,” Shumlin said.
As of Tuesday, however, the backlog is back up to about 3,000 customers. And the state’s largest insurance carrier, Blue Cross Blue Shield of Vermont, says technological shortcomings at Vermont Health Connect have made it impossible for them to process changes to their customers’ policies.
“We were definitely optimistic that the software upgrades that were put in last year … would bring about a fully functioning system, but it doesn’t seem like that’s the case today,” says Cory Gustafson, director of government relations at Blue Cross.
Lawrence Miller, chief of health care reform for the Shumlin administration, says he appreciates Blue Cross’ frustration.
“I think we’re very much on the same page in terms of feeling frustrated that the system is not where it should be,” Miller says.
"The specific issue is that the year-end closing process was built into a release that was supposed to be deployed in December, and frankly its not ready yet." - Lawrence Miller, Chief of Health Care Reform
Miller says the state’s inability to process changes to customers’ policies stems from the postponed delivery of another software upgrade related to the policy renewal process.
“The specific issue is that the year-end closing process was built into a release that was supposed to be deployed in December, and frankly it’s not ready yet,” Miller says.
Miller says he anticipates that Vermont Health Connect will have that update online within weeks. Once it does, Miller says the state will be able to work through the backlog rapidly. And he says the reemergence of the backlog is a one-time phenomenon that won’t resurface in 2016.
“It’s frustrating. It’s the nature of working with limited resources,” Miller says. “We are in a much better place than we were a year ago. We’re not yet where we want to be.”
Miller says other unforeseen events have contributed to the backlog. The state is trying to reenroll a larger number of Medicaid recipients than it customarily has to deal with. Also, a contractor on the exchange went out of business late last year, and Miller says that has complicated work on a major software component.
Gustafson says Blue Cross has grown accustomed to these sorts of setbacks.
"I think we're beyond being surprised at the technical difficulties anymore." - Cory Gustafson, Blue Cross Blue Shield of Vermont
“Well I think we’re beyond being surprised at the technical difficulties anymore,” Gustafson says.
He says the latest round of technological hiccups underscore the need for the type of independent assessment of Vermont Health Connect that Blue Cross has been calling for.
“If in the near term it isn’t fixable, that may answer the long-term questions,” Gustafson says.
The state is spending about $45 million a year to operate Vermont Health Connect. The federal government covers about 60 percent of the cost.