An article in Sunday’s edition of The Times Argus went behind the scenes of the controversial Vermont Health Connect.
Vermont Press Bureau Chief Neal Goswami took readers into the chronology of the exchange and showed, in no uncertain terms, how muddled and troubled the process had become between the Department of Vermont Health Access and CGI Systems and Technologies.
The reporting confirmed what we already knew — the timing and testing fell short — but it also points to important lessons ahead as Vermont moves toward a possible model for a single-payer health care system.
The federal Affordable Care Act, or Obamacare, required the online exchanges to go live Oct. 1. States were granted two options: Join a federal site or construct their own. Gov. Peter Shumlin, the second-term Democrat, decided Vermont would be one of 14 states to design and build its own.
The federal health care reform law, the signature achievement of President Barack Obama, was signed into law in March 2010.
But the law was challenged in court. The U.S. Supreme Court ultimately ruled it constitutional in summer 2012. The legal challenge, however, ate up time that states and the federal government badly needed.
That crunch, as the article explained through a series of interviews with insiders, put Vermont at a distinct disadvantage.
For certain, the project managers were overwhelmed with the monumental task, and they were not able to find the best people for specific tasks. Expertise went untapped, and the appointees named to oversee the process appeared to have too much to oversee.
Meanwhile, the technical side of making the exchange work — the coding and mechanics — was under contract to be done only at a pre-live testing requirement, not a real world level. So although the exchange worked in tests, when the website came live there were too many missing, or untested, pieces.
The governor, who likely did not know all of the ins and outs of the calamitous start until after a January evaluation was complete, fell on his sword to keep the process moving. He had to in order to stay on message about the exchange’s value, and he had to deflect politics from miring the project any more. We have sympathy for what he and his team were up against.
But now comes the reality.
Standing on principle, Vermont Health Connect was an idea Vermont, with its progressive roots, could get behind. But there was no measured process by which to invent and execute one of the largest reforms in our state’s history. From the starting gun of the president’s mandate, odds were good that Vermont’s health exchange could falter, with critics and naysayers lined up every step of the way.
The message was muddled and rushed; the execution was poor. And the steps since have been a slow, painful trickle of progress.
When staring deadlines in the face, especially when the stakes are as high as this, CGI and the Department of Vermont Health Access needed project managers to be honest, forthright, realistic and measured.
It appears no one was hiding anything, but the signs of trouble were there all along. Key people chose to ignore the truth and even insulated the governor and others from the harsh reality of the failure.
As the adage goes, haste makes waste.
There are many lessons to be learned in this process. Unfortunately, there is a high price to pay for doing the right thing the wrong way.