Health exchange website holds back reforms
Last Sunday, in order to learn more about Vermont Health Connect, I explored the VHC website to get information on insurance options for a hypothetical family of two adults and two children with Vermont’s median household income of $53,000.
The site is very slow. On several occasions, it froze up and I received an error message. When the site finally responded, it took more than five minutes to enter the data — monthly income and ages — for my hypothetical household and get a list of insurance plans available for them. If it took five minutes to get a list of plans on a Sunday afternoon, how long does it take on weekdays, when much larger numbers of individuals, businesses, insurance brokers and navigators are attempting to use the site?
More importantly, once I entered the data for my hypothetical household, the website gave me contradictory information. Before I started browsing for insurance options, I went to the “Vermont Health Connect Subsidy Calculator” on the VHC home page and put in the following data: household income $53,000, two adults, two children under age 26. The subsidy calculator told me that “your household’s monthly subsidy will be $909.”
When I re-entered the same data on the “Health Coverage Eligibility Screener” page on the VHC website, the site told me that “based on the information you told us, it looks like there might be people in your family who qualify for help paying for health coverage.” I assumed that once I went deeper into the site, I would be presented with insurance options that reflected a monthly subsidy of approximately $909, as indicated by the subsidy calculator. However, this was not the case.
When I went forward from the “Eligibility Screener” page to the “Plan Selection” page, I was told that “you are not likely to qualify for a tax credit to help you pay for health insurance. You should expect that the plan costs shown here will be similar to what you will pay if you enroll.” The costs on the website for a bronze family plan — a plan with relatively low premiums but high potential out-of-pocket costs — were between $650 and $700 a month. The Subsidy Calculator page had told me earlier that the cost of a bronze plan for my hypothetical household would be between $63 and $93 a month. So within the same website, there was a difference of approximately $600 per month, or over $7,000 a year, for the cost of health insurance for a family whose income is at the median level for Vermont.
The VHC website, like many other health insurance exchange sites around the country, appears to have been brought online without adequate testing. News reports also indicate that VHC’s site is not yet able to communicate robustly and accurately with the systems of Blue Cross Blue Shield and MVP, the two companies providing health insurance coverage to Vermonters through VHC.
Major reforms in how health care is delivered and paid for are essential. The health insurance exchanges are a step toward that goal. They will help bring down the costs of health care for many lower- and middle-income individuals and households. Unfortunately, the exchanges are being undercut by the inability of their websites to present consumers and businesses timely and accurate information about the health coverage available to them. The Shumlin Administration must put on a full-court press to make the VHC website work smoothly and accurately, so VHC participants will have the right health insurance coverage on Jan. 1.
Eric L. Davis is professor emeritus of political science at Middlebury College.