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The decision is in: Massachusetts will go with a new state-run health insurance website.
The Patrick administration revealed Friday that it is no longer building out the option of sending residents shopping for coverage to the federal health insurance site, HealthCare.gov.
"We are poised to offer consumers a streamlined, single point-of-entry shopping experience for health care plans in time for fall 2014 Open Enrollment," Gov. Deval Patrick wrote in a letter to federal officials, dated Thursday.
About 450,000 residents are expected to use the state's new site, built with the Virginia-based company hCentive, when it is set to go live Nov. 15. The residents include:
-- at least 251,000 residents who've tried to enroll for free or subsidized coverage since last October and are in a temporary plan through MassHealth (this coverage expires Dec. 31);
-- another 98,000 people who were in Commonwealth Care when the website failed and have remained in those plans (this coverage also expires Dec. 31);
-- and residents who purchase private insurance through the Health Connector.
Many of these people are wary of state promises. They waited months after applying for coverage online, not sure if they had health insurance.
"We appreciate that some people experienced some poor issues last time," said Maydad Cohen, a special assistant to Patrick who is running the website project.
"The hCentive tool ... will really allow individuals to use this product and continue to use our call centers ... to make this year's experience a much better one," he added.
"Maybe second time’s the charm," said Anna Eves, who runs a fine art printing company in Gloucester.
After several months of trying on the original state website earlier this year, Eves was finally able to buy insurance for her family. She's wary, but says she’ll try the new site.
"We’re the guinea pigs," Eves said. "I guess in some ways we have to put up with this right now in order to reap the benefits of a program that is good."
Cohen says tests of the new hCentive site show it is already performing as well as HealthCare.gov. Cohen says it will be ready for consumers to register, shop for plans, determine what, if any, assistance they can get, and enroll — all online. Members will not be able to pay for coverage online, though; they'll have to put a check in the mail.
Everyone, Cohen stresses, will need to re-enroll beginning in November.
The Health Connector plans an extensive outreach campaign to help people re-enroll and review their insurance options.
The Patrick administration, guided by the Health Connector, opted to build a new state-run site rather than join the federal health insurance exchange so it could maintain control of insurance policies and programs. Massachusetts offers more generous subsidies for low-income residents. And insurers in Massachusetts weren't sure they could build billing and enrollment systems that worked in conjunction with HealthCare.gov.
Insurers say they're pleased with the administration's decision.
"We appreciate the collaborative and transparent process the Administration and Connector have undertaken with us and we commend them for the significant progress that has enabled the Commonwealth to reach today's decision," Lori Pellegrini, the president and CEO of the Massachusetts Association of Health Plans, said in a statement Friday.
Patrick says the state will have contingency plans in the event that something goes wrong on the hCentive site. But some critics say it should keep building out the federal option just in case.
That would be an expensive proposition for a project that has already cost $108 million — with nothing the public can use yet. That $108 million has come out of a set-aside $174 million for IT implementation of the federal Affordable Care Act. The Patrick administration expects to ask the Centers for Medicare and Medicaid Services for additional funds — roughly $80 million, but that number is in flux.
"I wish that there had been a more open public discussion about the costs of the program," said Josh Archambault, a senior fellow at the Pioneer Institute, a think tank. He pointed to many remaining questions, including, "how they are going to pay for [the website], what the federal government is going to pay for, the technology challenges that are ahead and will remain."
Archambault said the public needs to be wary of "this rosy picture that we seem to be getting. It looks eerily similar to the first time around."
Patrick says it's important to stay focused on the goal: expanding coverage for the uninsured. There, he says, Massachusetts continues to be a leader with the lowest rate of residents who do not have coverage in the nation.
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