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December 02, 2013

"Milestone" or Millstone? In Vermont Health Connect Announcement, There's Good News and Bad


"Very pleased."

"Another significant step forward for us."

That's how Department of Vermont Health Access Commissioner Mark Larson characterized the latest news about the state's new insurance exchange, Vermont Health Connect, in a phone call with reporters Monday morning. 

The headline? After a two-month delay, the exchange will finally be able to bill Vermonters for the plans they bought through Vermont Health Connect. Starting Tuesday, the state will begin mailing invoices to individuals who enroll through the exchange. Consumers will have until January 7 to mail back a check.

"I think this is clearly a milestone and a significant step forward," Larson said.

Downplayed in Larson's announcement were two potentially bigger pieces of news, which weren't so good:


  1. The payment processing mechanism still doesn't work for small businesses and their employees — and state officials don't know when it will. As a result, Larson announced that as many as 1400 small businesses that chose to offer insurance to their employees through Vermont Health Connect will see their current plans extended into the new year — and remain in effect until the system is fixed. That's in addition to the unspecified number of businesses that elected last month to delay enrollment in Vermont Health Connect, an option extended by the administration following a previous setback.
  2. Though Vermont Health Connect has been promoted as an online marketplace through which consumers can buy insurance, its designers still haven't figured out how to securely process credit card payments. In other words, this may be an online exchange — but if you buy your insurance through it, you'll still have to send a check by mail.

Pressed on whether his announcement was really all that positive, Larson conceded during his phone call with reporters that he was "frustrated" the system was not yet fully functional. But he and Robin Lunge, Gov. Peter Shumlin's director of health care reform, argued that overcoming the technical hurdles preventing billing of any sort was a notable accomplishment.

Reached later Monday, Shumlin expressed satisfaction with the partial fix.

"Obviously I'm thrilled that individuals are going to be billed and have coverage on January 1," he said. "We all wanted to make sure there was no interruption on coverage. Because the businesses won't be getting billed yet, [extending their current plans] was a necessary step to keep them covered."

Noting that the payment processing system won't be launched until late Monday or early Tuesday, the governor said, "Fingers crossed, but I'm hopeful that it's going to work as promised." 

Larson declined to say when he expected Vermont Health Connect users to be able to pay by credit card, nor when small businesses and their employees might be moved to their new plans.

"That is not targeted to a specific date at this point," Larson said of the credit card processing system.

After missing several key deadlines, Shumlin and Larson have avoided publicly disclosing when they expect malfunctioning elements of Vermont Health Connect to be fixed. In September, the administration announced that the payment processing system would be deployed not in October, but in November. When that month came and it still wasn't working, Shumlin said he hoped it would be fully functional by December.

Vermonters for Health Care Freedom founder Darcie Johnston, an outspoken opponent of the exchange, called Monday's announcement "purely political."

"The commissioner wants to show forward progress — reality be damned," she said in a written statement. "Since October, Vermonters have been subject to a weekly drip of the failures of this ill conceived and poorly managed scheme."

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