“Odious, Embarrassing” System Driving Down Health Sign-Ups

Colorado has no fast decision for a supposedly endless case of Medicaid application that health insurance marketplace members consider to be pushing away customers and reducing the number of patients buying health insurance at Colorado’s new multi-million dollar health care exchange.

Argues between state and health insurance managers aggravated on Monday as exchange board workers claimed that Colorado should have been better prepared and that the state’s slow system is embarrassing. “It’s painful. It’s disgusting. It’s embarrassing to be obliged to answer all these unnecessary questions if they’re going to be refused anyway,” said Nathan Wilkes, IT expert and board member for state’s health insurance marketplace, Connect for Health Colorado.

State and health insurance managers are now seeing Kentucky as an example and are offering a new, well run application that would be much less troublesome for customers. Colorado was expected to create a system like this, but disputes between the state of Colorado and exchange officials over IT systems induced Colorado to refuse that plan back in February. (Click 1here to read more.)

At present, state and exchange members are not announcing how much more Colorado will have to spend to manage a well run system that will be much more effective for consumers. To this moment, Colorado has spent nearly $200 million building its own health care exchange. The nearest time when a rebuilt system would be ready and running is next October, long after the deadline for consumers to get health insurance for 2014.

Both state and exchange officials claimed they don’t yet have any offers to eliminate short-term problems that are tailing consumers and bringing headaches for brokers and health insurance guides. State managers say they are trying to fix state’s clumsy Medicaid questionnaire that inspects applicants on everything from their assets to possible disabilities. The soonest they can apply changes for this year is December.

Gov. John Hickenlooper’s deputy chief of staff, Kevin Patterson, during exchange committee meeting on Monday claimed that Medicaid workers are trying to solve problems, but they are bound because there was a lawsuit against the state about its long-troubled benefits system in the past. If Colorado incorrectly qualifies or refuses people for Medicaid, the state could be responsible for all costs. They are working in a team to understand what else they can do to accelerate this process. They do their best to make sure they’re complying with C4 (Connect for Health) in all ways they can move forward.

Lorez Meinhold, deputy executive director for Colorado’s Medicaid programs, announced that Hickenlooper’s main priority is to involve as many people qualified for public and private health care insurance as possible. This is a completely new process for both the state and the exchange. There is a hope to observe both real time eligibility figures rise as well as reduction of time to get those denials.

Meanwhile, the clock is ticking. Patients who want insurance starting from Jan. 1, 2014 must apply for health plans by Dec. 15. While the federal health care exchange – www.healthcare.gov, has “successfully” failed because of IT problems, sales from Colorado’s home-made health insurance system have lagged because of high prices in areas of mountain resort (click 2here to read more) and problematic Medicaid application.

Health care exchange IT specialist showed on Monday how application functioned. Skipping multiple steps, he could only move half through a fake application in about 45 minutes. From this week, Coloradans are expected to be able to apply for federal tax subsidies online to allow them lower their health care costs. But, first all applicants will have to complete Medicaid application so they can be either qualified for insurance plan for low-income and disabled people or get a “denial” and buy private health insurance.

Complicating matters even more is that the federal government’s “data hub,” which should help state health exchanges confirm customers’ incomes, Social Security figures and immigration status, has not been functioning. The hub has poorly worked a lot during the last couple of weeks. It has been unavailable for other states. There have been lots of problems with it, as Patty Fontneau shared, the exchange’s CEO and executive director.

Board members were enraged on Monday at supposedly slow response to troubles with Colorado’s exchange. Dr. Mike Fallon said that Colorado urgently needs an effective solution or patients won’t be able to purchase health insurance by Jan. 1. He is concerned about what’s happening. “If I had to put in data for my own four kids into a program that I don’t qualify for, I’d be done. I guess I’m starting to better picture why our enrollment is questioned,” Fallon said.

Health exchange officials have not presented new sales numbers, but by Oct. 26, less than 4 000 people had actually obtained plans via Connect for Health. By Oct. 28, Washington State had registered almost 50 000 people in Medicaid and private plans, while New York got 37 000 patients by Oct. 24 and Kentucky reported nearly 32 500 applications in its first month. Colorado representatives have planned to have more than 130 000 clients by the end of 2014. The deadline for obtaining health insurance for next year is March 31. Customers who don’t manage to buy it could have financial penalties.

Fallon and other board members Nathan Wilkes, Richard Betts and Ellen Daehnick claimed on Monday that they want to see quick solution. Wilkes proposed allowing people with incomes likely to disqualify them for Medicaid to instantly proceed to selecting private health insurance. If it appears that they qualify for Medicaid, they could be included in the program post factum. But iа people miss opportunity to get private health coverage, they’ll be out.

Daehnick asked why health ensurance managers were not properly prepared for possible troubles with the Medicaid application. Why is this problem was new to them. Why didn’t they have a plan beforehand. Why didn’t they take measures to solve this problem earlier. Daehnick is one of the newest members of the board. She came this summer after managers and consultants had designed structure of Colorado’s health exchange. However, there have been lots of signs of coming trouble. My Canadian Pharmacy studied several reports about possible IT problems and argues between state and health exchange managers that induced a mediator to make a step in this spring. (Click 3here to read more.)

Colorado is included in the list of 14 states having its own health exchange. In most other states, health care exchange is a part of the state government, but in Colorado, lawmakers deliberately position Connect for Health as public entity not included in state government. On the top of hours or days consuming to complete, the Medicaid application fails to present real-time results to customers in 70 percent of cases, according to data provided by health exchange managers. On Monday, they claimed that customer service agents can only get real-time estimations of whether a patient is qualified for Medicaid about 30 to 50 percent of cases.

One potential client from Boulder, a therapist Andy Rose, told health insurance managers on Monday that he’s been waiting for 17 days and still didn’t get a response. Without clear answer about if he qualifies for Medicaid, he cannot move forward and said he’s stuck in a black hole. Medicaid managers claimed that their system was functioning better and health exchange managers confirm it. They say that the system provides real-time results in 50 to 60 percent of cases. They say that these were optimistic results and that they did not take measures about the problem because state managers guaranteed much better results. It wasn’t operational results that they expected.