by Hamilton E. Davis
The cancer that has eaten away the vitality of Governor Peter Shumlin’s health care reform effort has finally been driven into remission. Vermont Health Connect, the federally financed insurance Exchange, now has a working computer system to manage the thousands of Vermonters who rely on it to guarantee their health care.
Flanked by more than a dozen of the staffers and others who have been working on the problem for the last year, Shumlin announced at a Monday press conference that the Exchange can now enter “changes of circumstances” for policy holders electronically. Since the Exchange went live in late 2013, that work has been done manually.
The manual system was so unwieldy that that tens of thousands of accounts fell into error in one way or another, and the whole Obamacare system appeared on the verge of collapsing completely. Why it got into that fix is set out in the previous blog entry. So the governor and Lawrence Miller, his lead administrator for health care reform, set a June 1 deadline to attain “change of circumstances” capability, and an Oct. 1 deadline for the capability to automatically re-enroll customers.
They said at the time that if Optum, their consultant, couldn’t meet those tests they would begin planning to shift from a Vermont-based system either to the federal computer platform, or to one developed by Connecticut. Those assurances may have been needed to manage the political environment, but in fact they were spurious: there is nowhere near enough time shift to another platform for the 2016 enrollment period, so failure was not an option.
When Shumlin, Miller and the others were laying out the issue, a palpably skeptical press corps probed to see whether what they were hearing was real, or whether it was just more blather from Shumlin. Could policy holders who get married or change their addresses get that information entered into the system immediately? Well, maybe not immediately, but reasonably soon. How long will it take to eliminate the backlog of such changes? By fall.
There are all sorts of technical issues involved, and there almost certainly will be glitches along the way, but it became clear even to the skeptics that the administration has taken a huge step forward. Think of it as a huge pile of dirt that has been piling up and has to be cleared away. For more than a year, a pitifully weak guy has been working at it with a teaspoon. As of today, it will be several powerful guys with steel shovels. The pile won’t be gone over night, but it’s on its way.
It would be hard to overstate how important that step is. The failure of the Exchange rollout has tainted the whole health care reform effort, even though the Exchange was not really part of the Vermont reform initiative. If the Shumlinites can’t manage an Exchange serving 40,000 or so Vermonters, the argument ran, how can they manage care for the whole state?
The Republicans particularly have had a wonderful time with this theme for the last two years, and that fact has showed up in the polls about Shumlin’s performance in office, and particularly in last fall’s election, which was catastrophic for the governor and his party.
A friend who likes football metaphors has commented that Shumlin has been trying to get to the Super Bowl, and yet he hasn’t scored a touchdown for two years. The announcement Monday wasn’t the Super Bowl, but it was a touchdown. The first since the original launch of his health reform, and his management of the aftermath of Hurricane Irene in 2011.
It will be interesting to see what he can make of it.