The next governor of Vermont will face a critical decision very early on in his or her administration: Continue on with Vermont Health Connect? Or abandon the state-based insurance marketplace in favor of something else?
The Shumlin administration says recent improvements to the system will make it an easy call.
A couple weeks ago, administration officials delivered their final monthly report on Vermont Health Connect to the Legislature. The document strikes a triumphant tone. Vermont’s insurance exchange, the report says, is succeeding at long last.
“There’s been improvement on almost every single metric in terms of customer service,” says Steven Costantino, commissioner of the Department of Vermont Health Access.
Costantino says the backlog of customers awaiting resolution to insurance issues is now below 1,500 people, half of what it was in May, and down eightfold from this time last year.
Error rates on Health Connect transactions have been halved since May. And 85 percent of requests for policy changes are being successfully processed within 10 days of receipt, according to the state.
“And to have the kind of improvement I think is an amazing story that has not really been talked about in a way I think should be talked about,” Costantino says.
"There's been improvement on almost every single metric in terms of customer service." - Steven Costantino, Department of Vermont Health Access commissioner
Vermont Health Connect has become one of political candidates’ favorite punching bags this election season. And it’s come to exemplify Vermonters’ worst fears about bureaucratic mismanagement and technical incompetence in state government.
But Costantino says the growing pains that have been so visible since the program’s launch in 2013 are finally being resolved, and that IT solutions and operational reforms bode well for the future.
“We are getting to the underlying causes – that’s the goal of this,” Costantino says.
Trinka Kerr is the chief health advocate for Vermont. She oversees Vermont Legal Aid's Office of the Health Care Advocate, an independent office that works to resolve consumer complaints about Vermont Health Connect, other insurers, state programs, hospitals and providers.
Kerr says she does “think things are getting better.”
Kerr says a complex Medicaid review is going “surprisingly well.” And she says her office is seeing fewer severe cases than it’s fielded in the past.
“Overall, Vermont Health Connect is able to resolve problems much faster than they used to before,” Kerr says.
There’s a major caveat to Kerr’s assessment, however.
"It's only good when you compare it to what it used to be like. We still get calls from people who are really upset." - Trinka Kerr, chief health advocate for the state of Vermont
“It’s only good when you compare it to what it used to be like,” Kerr says. “We still get calls from people who are really upset, really frustrated, really angry about problems that they’ve been trying to resolve for months.”
Just because Vermont Health Connect is better today than it was six months or a year ago, Kerr says, doesn’t mean it’s as good as it should be. The Legislature commissioned an independent review of Vermont Health Connect due at the end of the year.
“I guess I’d like to see the results of the study that’s being done to determine whether it is really worth sticking with the system,” Kerr says.
The future of Vermont Health Connect is very much up in the air as of now. Republican candidate for governor Phil Scott has said that, if elected, he’ll abandon the exchange in favor of a regional or federal solution.
A spokesperson for Blue Cross Blue Shield of Vermont, the state’s largest insurance company, says Blue Cross will withhold comment on the status of Vermont Health Connect until that independent review is complete.
Costantino says the criticism is fair and warranted. But as Vermonters become more acquainted with the new Vermont Health Connect, he says he’s convinced the mood will change. And he says the best way to improve the image of the beleaguered insurance exchange is to deliver results.
“It’s critical that we design a system and continue to redesign and re-strategize a system that meets the needs of our constituents, the constituents of the state of Vermont,” Costantino says.
Costantino says the state will have a chance to prove Vermont Health Connect’s worth when open enrollment begins this fall.
Clarification 1:31 p.m. 8/23/16 This story has been updated to clarify Trinka Kerr's role as a health advocate.