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Massachusetts won't switch to Healthcare.gov

CMS approves customized software to keep state running its own insurance exchange
Tools

Massachusetts will have a state-run health insurance exchange after all, and won't have to switch to the federal healthcare.gov site, officials announced Friday.

The U.S. Centers for Medicare & Medicaid Services approved software customized for the state by tech firm hCentive in tests Thursday, clearing the way for enrollment to begin Nov. 15, reports The Boston Globe.

The state spent $50 million more than planned last year to keep residents insured after the Massachusetts Health Connector website proved embarrassingly glitchy, according to MassLive.com. The state has been operating on parallel tracks in response: working the hCentive and preparing to join the federal exchange if that failed. 

It will drop preparations to go with the federal exchange after the hCentive software test satisfied CMS that the enrollment software could handle complex family situations and communicate with health insurers.

The federal exchange wasn't considered a good option for Massachusetts because that software could not incorporate state subsidies, which, along with federal tax credits, reduce premiums.

Nearly 100,000 people are covered under the state-subsidized Commonwealth Care program and 250,000 under the temporary MassHealth Medicaid program, both of which end Dec. 31. The state faces a massive education challenge to get those people covered under new plans, emphasizing the need for software that can handle large numbers of users simultaneously.

Massachusetts is just one of the states still struggling with its insurance exchange technology woes. A lawsuit filed on behalf of a Nevada man targets the state, Xerox and the Silver State Health Insurance Exchange, stating he doesn't have health insurance despite paying the premium online in November.

And Oracle has filed suit against the state of Oregon, which has blamed its vendor for the beleaguered Cover Oregon site that never launched to the public. Oracle, seeking $23 million in disputed payments, has blamed the state's mismanagement for the site failure, according to The Associated Press.

Both Nevada and Oregon have let the feds take over their exchange websites.

To learn more:
- read the Boston Globe article
- here's the MassLive story
- find the AP story

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Exchange glitches still cause coverage problems, frustrate insurers
Lingering exchange glitches could spark lawsuits
Can Massachusetts predict young adult exchange sign-ups?