Board approves ‘Band-aid fix’ for IT system as health guides plead for help

By Katie Kerwin McCrimmon

Cancer patients desperately in need of critical care are among those unable to get health insurance because Colorado’s sign-up system is failing to work properly, health coverage guides told state officials on Monday.

“One has foregone her chemo last week,” said T.J. Dufresne of the Northwest Colorado Council of Governments. “I don’t want to see that for anyone.”

Gov. John Hickenlooper's deputy chief of staff, David Padrino, and Sue Birch, director of Medicaid for the state, declined to comment on what went wrong with the shared system between the state and Colorado's health exchange, how they plan to fix it or how much the system has cost altogether.

Gov. John Hickenlooper’s deputy chief of staff, David Padrino, and Sue Birch, director of Medicaid for the state, both declined to comment after Monday’s exchange board meeting about exactly what went wrong or what they plan to do to fix the shared system between the state and Colorado’s health exchange.

Dufresne was one of several health coverage guides from around the state who testified before Colorado’s health exchange board on Monday. Along with an insurance broker and a patient, all those who testified said the system — built by Colorado’s Medicaid managers and their contractor, Deloitte, and linked closely with the health exchange’s IT portal — has not been working properly and that many people are stuck and can’t get covered.

Jen Fanning, executive director of the Grand County Rural Health Network came to the exchange board meeting in Denver and said 57 percent of the 153 people her agency has tried to help have been unable to get health insurance because of system snafus.

“All are still unresolved today. That seems to be the norm in our community, rather than the (exception),” she said. “We’re not certain if our region is part of the perfect storm,” she said.

Exchange officials have acknowledged that they have a problem and that the challenges are affecting thousands of people. Others are managing to sign up for health coverage, with about 21,000 new sign-ups and 93,000 renewals so far. Board member Davis Fanster earlier tried to downplay the problem, saying only about 1 percent of people were affected.

Eileen Hunt, a health coverage guide from Broomfield, said the percentage of people having problems is significantly higher.

“There’s a problem and we really need to solve this,” she said.

Health News Colorado reported on Friday that IT snafus have prevented nearly 5,000 people from signing up for health insurance. (Click here to read Exchange snafus trip up thousands as more cost overruns mount.)

The Colorado health exchange board reluctantly voted on Monday to spend $322,000 over the next month to pay the exchange’s contractor, CGI, to do temporary “Band-aid fixes.” A majority of board members had initially voted against the cash infusion, saying contractors should fix the problems and make the systems work.

It’s unclear how much Colorado exchange and Medicaid managers will have to spend over the long run to fix the multi-million dollar system.

Neither exchange officials nor representatives from Colorado’s Department of Health Care Policy and Financing, who manage Medicaid, responded immediately to questions about how much they’ve already agreed to spend on the shared sign-in system, which was supposed to offer a simple, streamlined way for customers to find out of they qualify for Medicaid, and if not, to shop for insurance through the exchange, Connect for Health Colorado. Exchange managers have already agreed to spend about $6 million on the system. For Medicaid managers, their share has been at least $2.6 million.

Gov. John Hickenlooper’s press secretary sent a written statement in which the governor said he’s pleased that exchange managers have so far enrolled more than 120,000 people as either new or renewing customers for 2015. He also said that rates have remained steady this year over last and that Colorado has been hailed as one of the successful state-based health exchanges.

“Despite these important milestones, delivering high quality customer service is a critical goal for our health delivery system, and today’s Connect for Health Board meeting highlighted that there is room for improvement. We will continue to work with Connect for Health as they improve customer service and help more Coloradans get access to health care,” Hickenlooper said.

Hickenlooper did not respond to questions about who’s to blame for the problems or whether anyone should be fired.

Among those who spoke Monday was a man named Matt. He testified over the phone and said he’s been trying unsuccessfully to get coverage and hadn’t heard anything for five weeks from either Connect for Health or Medicaid workers until Friday.

He said workers told him they will get him retroactive coverage for Jan. 1 once they figure out what’s wrong. He said that’s not enough.

“I have an incorrect APTC (estimate of tax subsidies) and multiple problems,” he said. “I’m currently avoiding medical care due to lack of confidence in how these bills will be paid.”

He questioned what kind of liability exchange and state officials will have if someone who has been struggling to get health coverage, but can’t, has a major medical issue or dies.

That question stumped every single exchange board member, along with Hickenlooper’s Deputy Chief of Staff, David Padrino, Insurance Commissioner Marguerite Salazar and Sue Birch, head of Medicaid for Colorado.

Adele Work, an exchange consultant, simply said, “I don’t have an answer. That’s a fair question.”

Exchange board members expressed deep frustration that IT problems are once again dogging the exchange.

“It seems like these things should have fallen under the original scope of work,” said Nathan Wilkes, an exchange member and IT expert.

The exchange’s technology experts said they don’t believe the work falls under the warranty because they did not make specific requests. They also failed to complete the system until one week before customers started shopping on Nov. 15.

Inadequate testing failed to uncover the problems that are dogging customers now.

“Where did the plan go wrong?” asked board member, Dr. Mike Fallon.

Neither Birch, the Medicaid manager, nor exchange officials had a solid answer.

“We know there are improvements that have to occur. HCPF is absolutely going to be there to pay for its portion,” she said. “But we can’t use state government to pay for the share of the system (that the exchange must pay).”

Exchange interim CEO Gary Drews said at the moment about 1,900 people remain stuck. He apologized for the problems and said, “We are 100 percent committed” to solving problems.

Board members, customers and coverage guides remained dismayed.

“To say I’m disappointed is an understatement,” said Wilkes. “It’s confounding. How did we build a system that couldn’t handle changes? Is there somewhere we can pin the blame?”


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