By Katie Kerwin McCrimmon
Pitched to the public as a Travelocity-style online marketplace for health insurance, Colorado’s new health exchange won’t allow customers to get online tax credits for at least the first month.
Colorado exchange managers revealed Monday during a board meeting that customers who want tax credits to make health insurance more affordable will have to call for help, rather than navigating the multi-million dollar computer system on their own.
One of the target audiences for the new exchange is “young invincibles,” healthy 20-somethings, many of whom prefer to do research and make purchases for everything from athletic shoes to college tuition online.
Even customers working with hundreds of in-person navigators at a network of assistance sites across the state will have to dial in to a call center in Colorado Springs to speak with someone who can manually walk them through an application for tax credits.
That’s because the online system for determining eligibility for tax credits is not accurate enough to trust yet.
“It’s not as seamless as we would like,” said Ben Davis, a communications consultant for the exchange. “You have to use a customer service representative during the month of October.”
None of the board members asked questions about the delay in online functionality and managers did not offer any opportunity for public comment.
Problems with pricing are widespread across the country. The Wall Street Journal reported last week that glitches could affect 36 states where the federal government is operating health exchanges. Complications in Oregon have forced exchange managers there to declare that members of the public won’t be able to buy insurance online when its exchange launches next week.
Most buyers on Colorado’s exchange, Connect for Health, are expected to qualify either for Medicaid — public health insurance for low-income people — or the tax credits. Anyone earning 400 percent of the federal poverty level will qualify for tax credits. That’s an income of about $45,000 for an individual and $92,000 for a family of four.
In order to get those tax rebates, consumers first have to apply for Medicaid through the state of Colorado, which has had problems for years with its notoriously buggy Colorado Benefits Management System (CBMS). Consumers now apply through a portal called PEAK. Colorado’s chief technology officer said in March that CBMS is much improved and vowed that the state would be “ready to deliver” come October.
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The state of Colorado and its IT consultants have built and tested the software that would determine a person’s “modified adjusted gross income” for Medicaid. Additional data must be collected to get a tax credit through the exchange. That rules engine isn’t yet working accurately, prompting the October delay.
Sue Birch, head of Colorado’s Medicaid program, said people who qualify for Medicaid will do just fine enrolling entirely online.
She said the delay only affects people applying for tax credits and offers the opportunity “to test in a protected environment.”
Solutions has reported for months on sparring behind the scenes between exchange managers, who operate outside of state government, and the state officials who run Medicaid. Each is using a different IT consultant, but their systems must dovetail in order for the exchange to work as promised. Click here to read Mediator to triage health exchange problems.)
Davis, the exchange’s communications consultant, said he does not expect delays in online functionality to last long.
“We are asking folks in the first month, while we are still testing, working out the kinks, to work with customer service representatives when it comes to filing for tax credits in order to ensure that we are as accurate as we want to be,” Davis said.
He said the exchange is not hiring additional call center workers to handle the increased workload. Altogether, the exchange plans to launch with about 187 agents ready to take calls next week. Consumers can call for help at 1-855-PLANS-4-YOU (1-855-752-6749).
Davis and others are now downplaying the importance of “go-live” day on Oct. 1. Instead, he said the real big day is Dec. 15, the date by which consumers must mail in a check if they want health coverage to kick in on Jan. 1.
“Everything’s got to be working by Dec. 15 on its own,” Davis said.
Consumer advocate Dede de Percin, who is executive director of the Colorado Consumer Health Initiative (CCHI), downplayed the October delay, saying she expects most consumers to shop rather than purchase immediately.
“With any major launch, there are going to be some hiccups or bumps in the road,” de Percin said. “If people want to enroll right away, they will still be able to enroll. They’ll just have to take one additional step of having to call the customer service center.”
CCHI conducted focus groups across the state as Colorado prepared to launch health reform. She said consumers were clear that they viewed purchasing health insurance as a complex decision and that they wanted help and wanted to take their time.
“People are willing to spend a lot of time making this decision. They are going to spend days (thinking about it). It’s a big purchase,” de Percin said.
“There will be some folks who want to purchase on the first day,” she said. But she anticipates that demand will build over the first several weeks.
“We expect to see a ramp up to December 15.”