Gov. Peter Shumlin for delivering what鈥檚 known as 鈥渃hange of circumstance鈥� functionality to Vermont Health Connect. The administration and House Speaker Shap Smith, however, may be at odds over the significance of that date.
And while Shumlin鈥檚 Chief of Health Care Reform, Lawrence Miller, says missing the deadline won鈥檛 spell the end of the state-run exchange, Smith on Thursday morning said he鈥檒l look to begin the transition to a federal version of the website if May passes without a change-of-circumstance fix.
鈥淚f nearly two years after we try to bring the exchange online we still don鈥檛 have an exchange that works in an effective way, then I believe that we need to move to another system,鈥� Smith says.
Shumlin said last month that the exchange to automatically input the particulars of customers鈥� life circumstances. The manual workaround in place since the launch of the exchange has created severe customer service backlogs, billing errors, and even delayed access to care.
In a , however, State Auditor Doug Hoffer says it鈥檚 anything but a sure thing that Vermont Health Connect will hit the May 30 milestone.
As recently as last week, according to Hoffer鈥檚 performance audit, Optum, the contractor overseeing the project, said the 鈥渞isk鈥� for meeting the May milestone was 鈥渉igh, due to the aggressive schedule.鈥� Insurance carriers, meanwhile, say 鈥渢here could be difficulties meeting one or more of the dates in the schedule,鈥� since the time frame to test and fix defects is so tight, according to the report.
"If nearly two years after we try to bring the exchange online we still don't have an exchange that works in an effective way, then I believe that we need to move to another system." - House Speaker Shap Smith
Miller says Hoffer is right about the aggressiveness of the schedule. He says he鈥檚 confident the state and Optum will have the change-of-circumstance functionality ready to go, for back-end office functions at least, by the end of May.
Miller says he won鈥檛 go live with an unfinished product.
鈥淲e put a tight schedule on this. We鈥檙e not going to sacrifice quality though,鈥� Miller says. 鈥淭his release has to have been fully tested, it has to be free of substantial defects, or it will not happen on time.鈥�
But Miller also says the May 30 deadline isn鈥檛 a make-or-break proposition for Vermont Health Connect.
鈥淚 have to make a recommendation to the [Legislature鈥檚] Joint Fiscal committee in November as to whether or not we should do something different. I鈥檒l make that recommendation based on where we are then, not where we are on June 1,鈥� Miller says.
Smith, however, is taking the May 30 deadline far more seriously. If the deadline goes unmet, then Smith says he鈥檒l begin working immediately to change course.
"I have to make a recommendation ... in November as to whether or not we should do something different. I'll make that recommendation based on where we are then, not where we are on June 1." - Health Care Reform Chief Lawrence Miller
鈥淎t that point in time I don鈥檛 think new can continue with the current exchange,鈥� Smith says. 鈥淚 think we have to look at whatever options are available for us to move to something that works.鈥�
The Legislature will have adjourned for the 2015 session by then. But Smith says the legislative apparatus needed to act will still be in place.
鈥淚鈥檒l work with the Joint Fiscal Committee and the Emergency Board, as well as the Health Care Oversight Committee, to ensure that the administration is working to find alternatives, and to implement them in a timely way,鈥� Smith says.
Smith says he doesn鈥檛 anticipate being able to switch to a federal version of the site until late 2016, when open enrollment begins for calendar year 2017 insurance policies. But he says he wants to pull the trigger on the decision to move in that direction in early June if the administration can鈥檛 adhere to its May 30 deadline.
鈥淚 can鈥檛 imagine that the administration would want to move forward with the current exchange if they haven鈥檛 met their targets in May,鈥� Smith says.
