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HealthCare Checkup

The Seattle Times health-care team tracks the local impact of the Affordable Care Act.

December 4, 2014 at 6:30 PM

Exchange, insurance commissioner at odds over glitches and transparency

The most recent glitch on the Washington Healthplanfinder exchange has resulted in an unwelcome hassle for the 6,000 consumers whose enrollments were mistakenly canceled and in rising tension between the state insurance commissioner and exchange staff.

On Wednesday, the day after the glitch was disclosed in a press release, state Insurance Commissioner Mike Kreidler sent a pointed letter to Richard Onizuka, CEO of the Washington Health Benefits Exchange, which manages the exchange. In it, Kreidler sought answers to 11 detailed questions about the current problem, as well as ongoing problems with invoicing and payments that have plagued the exchange since its launch more than a year ago.

“It is essential that we resolve these issues by Dec. 23, 2014 – the last day to sign up for Jan. 1 coverage,” Kreidler wrote. “A public response to the following questions by Dec. 5 would go a long way to alleviating the anxiety expressed by consumers, insurers and legislators.”

“I am so wanting them to be successful,” Kreidler said in an interview later. “When things like this happens, it becomes hugely disappointing.”

Exchange communications director Michael Marchand said exchange staff is reviewing Kreidler’s questions, but did not say when a reply would be ready.

The latest problem involved the cancellation of enrollments of 6,000 new or renewed enrollments since the exchange opened up for the second year on Nov. 15. The exchange said the glitch occurred when Deloitte, the system’s integrator, ran an automated enrollment cancellation process in error.

Kreidler, the state’s top insurance regulator, said he wasn’t notified about the recent problem. “I didn’t know about the situation until 5:30 Tuesday afternoon when they issued a press release,” he said. “I sit on the board. I would think I would get a little bit more of a heads up.”

He said there were indications of a problem up to two weeks ago.
Exchange spokeswoman Bethany Frey, however, said the cancellation errors didn’t occur until Monday and were discovered on Tuesday.

Kreidler said that while many of the glitches are no doubt inevitable, greater transparency would go a long way to help it work better.

The exchange’s Marchand said CEO Onizuka notified members of the exchange board about the errors and sent them an advance copy of the press release, though he did not say how far in advance the board was notified. One board member, Don Conant, said he was notified about 4 or 5 a.m. Tuesday.

Exchange board member Bill Hinkle said that while he, too, has many concerns about the exchange’s problems, he is irked by Kreidler’s letter.

“I share a lot of his concerns. He is an asset for us in this struggle,” said Hinkle. “But this is not some political football. What is the purpose of his issuing a letter other than political points?”

Conant takes issue with charges that the exchange isn’t being transparent. “We meet every month in public. People can come and talk to us. The press is there. We talk about our business right out there in the open,” he said.

At the same time, he acknowledges that the numbers Kreidler and others want may not always be available. Kreidler’s first question in the letter asked how much the 6,000 represented of total enrollment for 2015.

Conant ascribed the difficulty to limited resources.

“We can task part of our people to run around and try to get numbers, but we don’t want them counting them; we want them fixing them,” Conant said. “We keep getting beat over the head with the same stick, and we keep answering, ‘Look, what do you want us to do? Do you want us to count or do you want us to fix?’”

Conant also acknowledges that serious problems remain to be fixed. “We have a big problem, and that problem is overshadowing everything else, as it should,” he said. “That problem is due 100 percent to the fact that we had to do a five-year IT project in two years. We are in a beta test state, and we will be in a beta test state for a couple more years. There’s no way around it.”

At a Nov. 19 meeting, the exchange board voted to hire a consultant to review the exchange computer system’s code and architecture and to recommend steps for fixing problems.

As yet, however, no review is under way, and Kreidler is concerned that even if the review could be conducted and completed within a month it would be too late for the current enrollment period, which ends Feb. 15 (people must enroll by Dec. 23, however, for policies to be effective Jan. 1).

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