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Mass. Health Connector still sucks, frustrated - and now former - user exclaims
By adamg on Sat, 12/26/2015 - 5:21pm
Steve Garfield of Jamaica Plain explains why he's thrown up his hands and given up on the Mass. Health Connector after more than a month of trying to figure out, without success, why the state accepted his first payment for a new health insurer yet never sent it to that company. So with five days left before his new insurance was supposed to start, he's now dealing directly with the insurer (video may take a moment to come up):
It's December 26, 2015 and I have given up on Massachusetts Health Connector. They ate my payment. They took my money (11/12) and my insurance provider has not seen the payment (12/26). Today, I paid my new insurance provider directly. I'm going to just have to wait and see what happens to that payment that got eaten by the Mass Health Connector.Happy New Year.cc Charlie BakerUPDATE:Within minutes of making this payment DIRECTLY to my new health insurance provider, I got an email confirmation from them. That's how you do it.
Posted by Steve Garfield on Saturday, December 26, 2015
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Comments
Progressives
Never understood how progressives can complain so bitterly about how government delivers the services it promises, and then argue that government should create more public monopolies to deliver more services to us. I guess it's enough to believe one's intentions are pure, even if one understands those intentions expressed into reality will be a fucking mess.
The Mass Connector is only putting the MBTA in charge of your health services delivery. Oh, yes, it's a total surprise it would not work.
And in fairness to Mass. Health ...
It does work for most people. I can't stand its interface, but we have health insurance, and even during the Anno Horibilis when everything got royally screwed up in the transition from Romneycare to Obamacare, we never lost coverage.
Also, you might want to read up more on it, if you can drop your Republican blinders for a moment, and I realize how hard that might be. If you are using it as a marketplace, as Steve was, it's not a monopoly, it's not single-payer health care. It's an option. You can still do what Steve finally did: Get insurance on your own. I thought conservatives liked that kind of thing.
Here's what most conservatives don't like
Conservatives tend to not like government-created gigantic projects that cost how many hundreds of millions of dollars but don't work worth a shit. Choices and free enterprise are great, but you tend to lose conservative report with a gigantic costly piece of shit that doesn't work.
No worries though! Conservatives are more rare than the Ploughshare Tortoise, so the system is safe!
Is it really an either or?
Either I'm Progressive or I'm Conservative. I'm no Republican or Libertarian.
I'm thoughtful. There's few of us compared to the knee-jerk majority. But there's a few. We don't always agree on solutions, but we can admit a mistake.
Mitt
Are you aware the whole idea of compulsory health insurance is a republican one and the person who instituted it initially in MA was Mitt Romney, AKA, GOP nominated presidential candidate in 2012?
"Progressives" like myself think the idea of compulsory health insurance is bogus.
As opposed to putting libertarian Uber in charge of health care? Doctors could freely reject sick or annoying patients and your bills would fluctuate depending on how many other people were sick at the same time.
But hey, the smartphone app would work great.
Actually an Uber for medical
Actually an Uber for medical care sounds awesome. People could shop around to find the hospital with the best price and shortest wait for a procedure and sort value vs. highest care rating.
doctor uber?
But they'd be relying on an app to show them where and how the surgery needs to be done..
OK
The government already runs a single payer system with a captive patient base. It is the VA medical system. Yes, that is the model for you progressives.
Not that I offered it as a solution Mr. Straw Man creator, but if those are my 2 options I'll take my chances with the Uber system.
Why don't you ask your Republican friends in Congress
To upgrade funding for the VA.
In the meantime, we also have Medicaid and Medicare, and one wonder why they weren't expanded instead of creating a new system captive to the insurers.
VA funding isn't the problem.
VA funding isn't the problem. It's a toxic management and worker culture (just like the MBTA).
It's become a bottomless pit of money where increased funding never works its way into better quality care.
There's no reason why the government should be running veterans hospitals.
For the same cost Vets could be given vouchers to go to ANY HOSPITAL THEY WANT and get much better quality care without the waste.
VA patient outcomes are
VA patient outcomes are actually really great compared to the private sector when you account for patient demographics - Vets are older, sicker, poorer, and have a much higher rate of behavioral/mental health comorbidities that negatively affect their care. The system does the best it can with a population that might not even have a consistently operational phone number, let alone the resources (personal and financial) to manage their care well. I'm not sure what private insurance is happily paying for 45,000 $ Hep C treatments for people like the VA is.
And the system offers Vouchers. It's called the Choice program and the VA over the fall was facing more budget woes because a ton of their funding was earmarked for exactly that purpose, sending vets to private hospitals, and vets were not using it in the numbers anticipated leaving overages in the choice funds and shortages in funding allocated to VA care.
I know
let's pass a new law or make some more regulations that say the website *has to* work. Everyone knows that piling more red tape on a complicated engineering problem fixes it in no time flat!
I keep saying: a measure of progress in streamlining/improving government services that gets completely ignored by everyone isn't lines of regs added to or subtracted from the MGL or USC, it's the number of useless government employees made to be out of work combined with the number of new (and better) employees brought in to replace them.
State services exist for the benefit of the taxpayer, not for the benefit of state employees or contractors on the inside track. SpaceX didn't stick their landing last week by having a mile-long length of red tape process to dismiss underperformers and GM & Chrysler *did* get tens of billions in the hole by having such a process.
Everything was fine with the site
When Romney was governor, at least with the website. Too bad he spent most of his time running for president bashing the Commonwealth and hoping people would forget he oversaw the predecessor to ACA.
Anyway, the problem isn't with government employees, at least not directly. In the goal of "efficiency" most big projects are farmed out to private contractors. These contractors don't give a shit about the general public and they know it's hard for anyone to hold them accountable. Worse, the government employees who select these contractors don't know how to write good contracts and either lack and ability or authority to oversee the project. They just need to hope the work delivered meets spec.
This is how to green line extension, Big Dig, 1st MA Connector overhaul, etc become so bloated and deliver nothing. Everyone gets up in arms about some MBTA employees making $100k+ yet they ignore the contractors overcharging millions for sub-standard work.
Of course
Why sweat the details yourself when the nice man in the nice suit assures you that his company will give you everything you've ever dreamt of, just write them the check please.
The federal Obamacare website debacle is exhibit one. The OPM data breach is exhibit two. I believe this was also the story behind the BP spill in the Gulf: the fabrication of the blow-out preventer was two or three layers of subcontracts away from the people paying the bills. I'm pretty sure if you were to dig deep enough into the private sector data breaches you'd find a similar story. And let's not get started on federal military and NASA procurements.
Maybe I'm just paying attention more now, or maybe there really is something in the water that makes people unable or unwilling to call bullshit on the snakeoil they're being sold.
Yup
Hard to say if there is more of this sort of corruption now or if it's just coming to light quicker. The problems have been so firmly institutionalized that good luck voting for any party to enact changes. It's only getting easier for corporations and wealthy "activist citizens" to buy politicians to ensure the laws/bids are written in their favor.
The annoying thing is how willing people are miss the big picture. I'd rather my tax dollars be used to hire an excellent project manager who will earn themselves a generous bonus if a project is completed on-time, on-budget, and fully functional. If this state employee made $4 million a year (with bonus) but was smart enough to save $400 million in contractor fraud, wouldn't that be worth it?
But that can never happen because "the government is the problem" so we're told privatizing services (AKA farming out to contractors) will somehow lead to lower costs and better services for all. We're also told anyone making more then $100k on the state payroll must be a scammer therefore anyone talented switches to the private sector where they won't be endlessly demonized.
This isn't the single fault of Romney, Patrick, or Baker -- it's the collective fault of all of them and their predecessors.
Well that 100k is part of the problem
There's no reason that bus drivers should be making 100k *because of overtime*
It creates two problems, the first of which is that (if it weren't for what I can only assume are union obstacles) if people are pulling that much overtime, it really means you need to be hiring more bus drivers.
The second problem is just like you said: it poisons the well. You can't hire your project engineers at market rate, so you don't get good--or even average--project management, because its damn near impossible for any elected official to defend the one high salary that needs to be there against a sea of many that frankly don't.
you seem to have forgotten something, roman
http://www.space.com/29789-spacex-rocket-failure-cargo-launch.html
Big things take time to do well, no matter who is doing them.
Indeed they do
but with the key prerequisite of being able to learn from your own (and others') past mistakes instead of continuing to repeat them.
It's also not entirely fair to compare a rocket launch (of which there are relatively few) to e-commerce, of which there is much. If the health connector and the Obamacare website were among the first of their kind, the way the Falcon 9 was*, I'd be less critical. But they weren't, not by a longshot.
Web-based marketplaces have been around in their more-or-less modern form for twenty years. The technology and techniques to make them happen is almost entirely off-the-shelf and open-source. You don't need a billion-dollar factory, you don't need to be employing the creme-de-la-creme of rocket scientists and controls engineers, and you don't need that fat of a wallet to do it.
Private companies stand up new ones all the time. Hell, I'm pretty sure that I could get something marginally functionally functional inside of a few weeks, and I wouldn't even need to purchase any equipment to do it because I can rattle of three or four web hosting companies with dirt-cheap hosting costs to actually house it. In fact, when the Obamacare website turned out to have just been a pretty website** with no back-end logic behind it, it took three guys one weekend to make something approximating most of the necessary functionality in their spare time.
The only technical thing that prevented them from making it a complete replacement was that they weren't actually plugged into the data exchange with participating insurance providers (but it turned out that neither was the "real" site! [rimshot]).
The bottom line is that in 2015, there is an excuse for having a rocket blow up on you*** but there is absolutely no excuse for bollixing up a website.
*Strictly speaking, a two-stage rocket isn't new, but the Falcon 9 design was new and evolving with every flight (only the 10th or so flight of that model), was using fabrication techniques relatively new to the spaceflight industry, and had a mission profile that was unprecedented in the 58 year history of orbital spaceflight.
**Also, the news releases coming out of HHS seemed to indicate that the pretty website was being hosted on exactly one physical box (possibly on someone's desk) as opposed to being properly distributed over multiple servers to handle load (10's of millions of hits) and for redundancy.
***Again, provided you're learning. Orbital Sciences had their rocket blow up on the pad in October of 2014, but then it turned out that the real reason wasn't anything that could even be charitably referred to as boldly going where no one has gone before. They were using 50-year-old engines they bought off of the Russians at the end of the Cold War and having a Ukrainian company assembling their rockets for them because they had no internal expertise in doing such things. With predictable results.
All True
More to the point, the contractor that was hired (a Canadian firm, no less) completely screwed the pooch on the project. The sign-up site isn't as trivial as a basic E-Commerce site since it needed to take into account many details of the users beyond basic name & address but by no means was this recreating Google or Facebook. The fact is the contractor was submitting absolutely non-functional gibberish code. A thousand monkeys at a thousand computers would have gotten a working website sooner.
DHS screwed up by hiring this horrible firm in the first place and then by not replacing them when they couldn't produce working alphas/betas in short order. Software development always takes longer then one expects but rule #1 is that you have frequent builds which let a separate team of testers look for bugs and it goes back and forth from there, periodically adding new features and locking down milestones. It isn't clear that any of this happened. The only thing we know is that DHS (and the Commonwealth, as it was the same Contractor) kept sending the checks.
So the big question (to me, at least) is why was this contractor hired in the first place? Secondly, why wasn't there people in DHS, etc who knew enough about software development to raise red flags? (Alternatively, why didn't anyone act upon the red flags if someone internally WAS sounding the alarm?)
Couple of quick answers
Firstly, CGI is actually pretty good at what they do. That's how they got the job.
Secondly, it's HHS but regardless, the answer is the same: ¯\_(ツ)_/¯. There didn't seem to be a heck of a lot of involvement from the Executive Branch of the government. They might have software people there, who knows?
Thirdly, raising the internal alarm. You can sound the alarm all you want but if no one is listening, is there really a problem?
I've never personally had a
I've never personally had a problem with the Mass Healthconnector site/setup. I do know people who have had trouble figuring out their options, but you can't please everyone--some people need hand-holding with this kind of stuff.
It is quite troubling when I see college-educated folks having trouble understanding what the hell this thing they're paying for exactly means. The average person without any healthcare experience is overwhelmed by the terms and conditions. Of course, there are staff available to explain this in person, but when people sign up online... This is a long-term concern to handle, and it wouldn't be a concern if we had the balls as a country to commit to single-payer healthcare.
The Healthconnector staff have also been far more than courteous and accommodating whenever I had a need to call and clarify (phone line wait aside).
I'm sorry that this gentleman is having such a negative experience, and I do hope that it gets resolved soon.
One of the reasons I posted this ...
Was because I know Steve has been doing Internet stuff for a lot longer than most folks and he's no dummy - if he's having an issue, especially one that's been going on for a month and a half now, it's not user error. Also note the error is not that he can't figure out the braindead interface (because as a UI, yes, it's kind of awful) but because they took his money and, yet, somehow, his insurance company never got paid. That's not a UI issue.
I'd like to share my
I'd like to share my experience. I signed up for my employer dental plan, and after going for periodontal work I found out there is a 12 month waiting period before I can have any work done under the health plan. I then went on the health connector to find a dental plan that had no waiting period.
After logging in, I couldn't find where it indicated waiting periods. I called the health connector and was told that's a question for Delta Dental. I hung up and called delta dental - after we were on the same page she indicated that x would be appropriate.
I went online to purchase the plan and received a message that stand alone dental plans cannot be done online and I needed to call. Ok. After getting all my information I was told to log back in after 24 hours to pay my first parent and bind the service. 24 hours and the health connector cannot find my enrollment. I call and they tell me it hasn't gone through yet - try tomorrow. The next day it again is not online so I call, and am told that I needed to go to the physical store to purchase this plan. I was told I don't yet have an enrollment number because I wasn't yet enrolled. It "takes a really long time to do a stand alone dental". It was December 23rd.
After waiting in line for 42 minutes I was immediately asked for my enrollment number. I explained the situation and was told to speak with a different person because "my computer is down". The other individual indicated that she could not find any record of my plan, and that I was not enrolled in anything. She sent an email to a colleague while I stood waiting. At that point she told me to write a check and she gave me a paper receipt. She was not able to enroll me because "it takes forever to do stand alone dental. You should have enrolled in person and not over the phone". At no point had anyone told me stand alone dental should be done in person. After 15 minutes she had not received an email back, so she put my check in a folder in her drawer and said to call back after the holiday. I was not able to leave with an enrollment number.
I lost almost 8 hours of work accomplishing what should have been a simple task. I'm not sure what you would have done differently that would have made this experience so simple for you, but clearly you must be right, despite my college education I'm simply an idiot.
This was for a stand alone dental plan for a single individual. I really feel for people trying to get health plans for entire families.
Perhaps you misread the tone
Perhaps you misread the tone of my post. I'm in no way implying that people using the Healthconnector are too stupid--it's that the plan details/terminology are overwhelming for most who aren't familiar with how the insurance/provider payment dance is performed.
Your situation does sound like a bureaucratic nightmare out of some old Soviet movie--that kind of cock-up is unacceptable, and I hope that you were able to get it resolved.
Mass Health Connector
Wait til you try to file your Fed/MA income tax. It's going to be a nightmare. Nobody knows what's going on. But if you have state (Mass Health) insurance you can't file your taxes without a paper document from Mass Health. It will be called a 1095tA. Guess how long it will take Mass Health to get those 1095As out to everyone? How many people will want to file early Jan to get their Earned Income Credit Refund and be stopped because they don't have the 1095A from Mass Health? Chaos.
That isn't usually what stops us from filing early
Nope. We usually get our forms for healthcare in mid-January.
My employer doesn't get around to their statements (W2) until ... Jan 31!
Yes,
it does indeed suck. Sorry if some are offended for ideological reasons, but the Affordable Care Act, AKA ObamaCare, has been a disaster IMHO. If the actual master plan is to crash the system with ObamaCare, then replace it with something like a nationalized, single payer system, sort of a Medicaid on steroids, well, yeah, that ain't gonna happen, IMHO.
All that needed to be done was tweek Medicaid, not implement this clusterfuck. Although I'm sure the healthcare, health insurance, and big pharma are pleased. They financed O's Campaign. Money talks.
Not everything online is better
Forget the billion dollar website and call centers. The best way to get something done *correctly* with the MA HEALTH CONNECTOR is to go to the office (at least once.) They are very nice in person.
The automated system(s) the MA HEALTH CONNECTOR has built and re-built do not work properly - as you stated so well, Steve.
I received THREE COPIES, mailed first class, of the exact same letter from MA HEALTH CONNECTOR, after signing up for a health plan in their office. The three identical letters stated approval for a plan and that a premium must be paid by the 23rd of December for coverage to begin on January 1st.
The MA HEALTH CONNECTOR and its vendors, however, did not send an invoice for the new plan or a written enrollment confirmation as to the selected insurance plan.
On a second visit to the MA HEALTH CONNECTOR office one month later, I was told the plan enrollment was fine and to pay the premium when a bill arrived or come back to pay in the office. Why would I come back a THIRD TIME to pay the premium when I was sitting there for a second time? I strongly requested paying the first month -January- premium then and there, receiving a hand written paper receipt.
As for an insurance membership card, well, that has not arrived. However, I was instructed to tell any health provider I see that I do have converage.
Yes, it is broken.
Counterpoint: I've done it
Counterpoint: I've done it all online from the start and have never had an issue (except for dental mangling both my extremely common first name and my extremely short last name on my membership card, even though they managed to get it right on the bills ... Huh? Easily corrected, anyway).
Yes it needs attention and yes it should have been more thoroughly tested. But these horror stories are so far outside my own experience, and so often exaggerated for political reasons, that they just read as a shrill child screeching "Woooooolllllfffff!!!"
Even if the problems are real, I have no energy left to care anymore.
that's good, but...
It's great that you had a positive, productive experience when you went to the office and spoke to a human, face-to-face, but not everyone can do that. One of the things about Romneycare/Obamacare/ACA (whatever you want to call it) is that it guarantees coverage for everyone - even if they have one of those dreaded pre-existing conditions. That means that there are probably some sick, disabled, immobile people relying on the MA Health Connector. They really, really, really need a functioning website.
Where to start with the Health Connector?
I am more familiar with the implementation of the Affordable Care Act in Massachusetts than I prefer so put in my two cents.
A couple of references for some of my points below
Mass Connector System Review
Report Blames Mass. Health Website Troubles On Lack Of Skills, Leadership
Pioneer Institute Report
1) The executive branch was non-existent with respect to building the original CGI/Connector site that was supposed to go live in 2014. No one ever saw them or heard from them during the debacle. I am not making this a political issue but if you want ask questions, start with Gov. Patrick who was completely disengaged from this project.
2) As for EOHHS (MassHealth, i.e. Medicaid) and the Mass Health Connector, a post-mortem done by MITRE blamed a fair number of the problems on infighting between the two state agencies. Massachusetts expanded Medicaid (MassHealth) substantially which made healthy communication between them and the Health Connector vital. Instead, of playing nice what we got was more akin to two rams butting heads.
3) Comparing Romneycare to Obamacare is pointless. Romneycare was simple and straightforward. The PPACA is a hot mess. On top of that, Massachusetts is a more complicated state than others which is why it was essential that we had our own exchange. A quick example:
Back then, there was no Federal recognition of same sex marriage so the Massachusetts system had to override that part of the implementation of the law. A same sex, legally married couple who applied as such would be deemed ineligible by the system because Federal HHS would return a value of "Not Married" and the Commonwealth would have to investigate the discrepancy to declare them married and process their application.
4) I know a lot of hard working people at the Connector who put their blood, sweat and tears into that project and were devastated when it didn't come together. Those people are not the problem. Let's put the blame where blame is due - at the top.
I can't find it now (it might be in the MITRE report or an old Boston Globe story) and I don't want to tell tales out of school but certain members of the board admitted that when the Health Connector executives tried to talk about the website and technology problems, their eyes would glaze over and they'd stop paying attention. I believe, and please don't come after me if it's not true, that the former board members admitted that they'd pull out their phones and start checking email or messages when the executives tried to tell them about the problems they were having. Why? Probably because none of them were the least bit technical and probably thought technology was the least important part of all of this.
And now, just for fun, and apropos of nothing, I leave you with a quick video of your friend and mine - our very own Dr. Jonathan Gruber.
Mhhmm
Awful easy to write laws when you don't even have to write law and just work with conceptual language. And thinking about implementation?!?!11one That's for the unwashed masses to fight over...