Shap Smith: May 30 Deadline Will Make Or Break Vermont Health Connect

Apr 16, 2015

Gov. Peter Shumlin has set a May 30 deadline for delivering what’s known as “change of circumstance” functionality to Vermont Health Connect. The administration and House Speaker Shap Smith, however, may be at odds over the significance of that date.

And while Shumlin’s Chief of Health Care Reform, Lawrence Miller, says missing the deadline won’t spell the end of the state-run exchange, Smith on Thursday morning said he’ll look to begin the transition to a federal version of the website if May passes without a change-of-circumstance fix.     

“If nearly two years after we try to bring the exchange online we still don’t have an exchange that works in an effective way, then I believe that we need to move to another system,” Smith says.

Shumlin said last month that the exchange would, by the end of May, finally have the capacity to automatically input the particulars of customers’ life circumstances. The manual workaround in place since the launch of the exchange has created severe customer service backlogs, billing errors, and even delayed access to care.

In a report unveiled publicly this morning, however, State Auditor Doug Hoffer says it’s anything but a sure thing that Vermont Health Connect will hit the May 30 milestone.

As recently as last week, according to Hoffer’s performance audit, Optum, the contractor overseeing the project, said the “risk” for meeting the May milestone was “high, due to the aggressive schedule.” Insurance carriers, meanwhile, say “there could be difficulties meeting one or more of the dates in the schedule,” since the time frame to test and fix defects is so tight, according to the report.

"If nearly two years after we try to bring the exchange online we still don't have an exchange that works in an effective way, then I believe that we need to move to another system." - House Speaker Shap Smith

Miller says Hoffer is right about the aggressiveness of the schedule. He says he’s confident the state and Optum will have the change-of-circumstance functionality ready to go, for back-end office functions at least, by the end of May.

Miller says he won’t go live with an unfinished product.

“We put a tight schedule on this. We’re not going to sacrifice quality though,” Miller says. “This release has to have been fully tested, it has to be free of substantial defects, or it will not happen on time.”

But Miller also says the May 30 deadline isn’t a make-or-break proposition for Vermont Health Connect.

“I have to make a recommendation to the [Legislature’s] Joint Fiscal committee in November as to whether or not we should do something different. I’ll make that recommendation based on where we are then, not where we are on June 1,” Miller says.

Smith, however, is taking the May 30 deadline far more seriously. If the deadline goes unmet, then Smith says he’ll begin working immediately to change course.

"I have to make a recommendation ... in November as to whether or not we should do something different. I'll make that recommendation based on where we are then, not where we are on June 1." - Health Care Reform Chief Lawrence Miller

“At that point in time I don’t think new can continue with the current exchange,” Smith says. “I think we have to look at whatever options are available for us to move to something that works.”

The Legislature will have adjourned for the 2015 session by then. But Smith says the legislative apparatus needed to act will still be in place.

“I’ll work with the Joint Fiscal Committee and the Emergency Board, as well as the Health Care Oversight Committee, to ensure that the administration is working to find alternatives, and to implement them in a timely way,” Smith says.

Smith says he doesn’t anticipate being able to switch to a federal version of the site until late 2016, when open enrollment begins for calendar year 2017 insurance policies. But he says he wants to pull the trigger on the decision to move in that direction in early June if the administration can’t adhere to its May 30 deadline.

“I can’t imagine that the administration would want to move forward with the current exchange if they haven’t met their targets in May,” Smith says.