State Exchange Executives Face Tough Questions From House Subcommittee

For some states, like California, things have gone well. But the rollout in states like Maryland and Oregon has been rocky. Mary Agnes Carey and CQ Roll Call’s Emily Ethridge discuss what we’ve learned about why some did better than others.

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MARY AGNES CAREY:  Welcome to Health On The Hill.  I’m Mary Agnes Carey. Executives of troubled state health insurance exchanges were on Capitol Hill today to discuss the bumps and glitches that hampered their enrollment efforts and what they’re doing to turn things around. Emily Ethridge of CQ Roll Call was at that hearing and joins us now. Emily, thanks so much.

EMILY ETHRIDGE:  Thanks for having me.

MARY AGNES CAREY: We’ve heard a awful lot about troubles with heatlhcare.gov, and this is the federal website overseeing insurance exchanges in 36 states.  Today’s hearing focused on exchanges run by states. For some, like California, things have gone really well. But for others, like Maryland and Oregon, the rollout has been a lot rockier.  So, based on what you heard today, what did California do to have their exchange go so well? And why are states like Maryland or Oregon struggling?

EMILY ETHRIDGE:  What this really comes down to is technology. The states all got to pick different contractors, different kinds of software to set up their exchanges, and some seemed to make the correct picks and some did not.

We heard Maryland say a lot of their software just didn’t work when they got it out the box and didn’t operate as it was supposed to, so it’s really the states that picked the right technology [who] got their exchanges up and running.

State Exchange Executives Face Tough Questions From House Subcommittee

MARY AGNES CAREY:  Were there different ways that they picked their vendors?  Several of the states that had a problem, did they hire the same vendor that had the same technological issues?

EMILY ETHRIDGE: Now Maryland is adopting the same IT platform and vendor used by Connecticut, because Connecticut’s exchange has worked really well. Maryland says they can do something similar, so they’re just really switching their entire IT platform over to this one that Connecticut used.

MARY AGNES CAREY:  Several Republican’s today mentioned the amount of federal money that has been invested in grants — millions of dollars in grants given to these state based exchanges. If contractors are really to blame here, is that money going to get recovered and returned to the federal government?

EMILY ETHRIDGE:  It’s a hard question. We heard some of the exchange officials today say that they will follow applicable law and if there is any money to be recouped they will certainly return it to the federal government. But it’s going to be a long process to figure out: Did this contractor really fail? Were they derelict in their duties? Did they not perform as they needed to under the contract? And how much of it was the exchange’s fault? 

Some Republicans were asking the exchanges if they should return the federal money they got back to the federal government, because they didn’t fulfill their part of the contract to have a working exchange.

MARY AGNES CAREY:  In addition to changing technology, what else are these states doing to get their enrollment numbers higher?

EMILY ETHRIDGE:  Well now that a lot of the exchanges seem to be working and the websites work and they’ve gotten over the big hurdles, all these states are trying to reach out to their populations and say: OK, it’s working now. Come back. We can process your application. We can work with you. 

So we’re seeing them adding people to the call centers, adding people to their outreach and education teams and really trying to make that effort now and say: We fixed it. Come back. Everything’s going to be fine now. And the outreach is going to be a huge part of the eventual success of these programs.

MARY AGNES CAREY:  Today’s hearing, as you well know, was one of several that the House Committee on Oversight and Government Reform has had on the health law. Many of these hearings have been partisan in nature. What was the tone like today?

EMILY ETHRIDGE:  It was similar to what we’ve heard before. It stayed fairly partisan. There was still a lot of debate over the health care law, whether we support it or not, whether it has benefits or not, whether it’s achieving its goals nor not. It wasn’t so much focused the entire time on really what went wrong with these exchanges and what can we learn from them and how do we improve things in the future. There was still a lot of just that back and forth we’ve gotten used to between both sides voicing their opinions – which haven’t changed on the health care law.

MARY AGNES CAREY:  Thanks for the update, Emily Ethridge of CQ Roll Call.

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