The Hummel Report: HealthSourceRI Year One

The radio and television ads have been hard to miss: “Year one of HealthSourceRI was a success, and now it’s time to look forward to year two …”

It is true that the enrollment numbers are up and 80% of those who subscribed to HealthSourceRI in 2014 signed up again. But you might have a hard time convincing some Rhode Islanders that the state’s version of Obamacare is a success. Not yet anyway.

“It’s been very frustrating. Many nights I just wanted to pull my hair out,” says Beth Fitzpatrick, who moved to Rhode Island last year from Massachusetts where she was enrolled in that state’s groundbreaking health exchange system. Fitzpatrick submitted her first application to HealthSourceRI in early December.

“We did all the stuff, submitted the application online and heard absolutely nothing. We got no updates on the account they made us set up. Money was taken out of my bank account on Dec 15, and I thought everything was fine. I was told I would get my cards from the insurance company in seven to 10 business days.’’

But nothing arrived.

It is a familiar story, and one The Hummel Report first reported nearly a year ago when HealthSourceRI was ramping up. Fitzpatrick, who has a health condition that requires expensive medication,  said she began to get nervous as the end of the year and her coverage expiration date approached.

“It was frustrating,” she said. “I’ve spoken to many people there, many people. And probably the most frustrating part was getting one answer one day, another answer another day, another answer another day. It was not consistent whatsoever.”

We took Fitzpatrick’s case to Anya Radar Wallack, Gov. Gina Raimondo’s choice to lead HealthsourceRI, replacing Christine Ferguson, who helped launch the exchange. Wallack, who arrived in January, says she’s heard about the same problems.

“From the first day I walked through the door, clearly that was a problem for us. It’s not acceptable for us to have those kinds of customer service problems,” she said. “We have to get the kinks out of our information system, which is the source of most of those problems, and make sure this is really a well-oiled machine for our customers.”

Fitzpatrick, who took extensive notes, says she spent 550 minutes — more than nine hours — on the phone trying to get thing straightened out. And she is not alone. “I explained my situation, and (the customer service representative) said that I was the 5th person with the same exact situation she’d heard from that day.”

Ferguson told us last year that 10% of those trying to enroll were having enrollment issues. Wallack said they are still trying to pinpoint current figures. “It could be technology, it could be training and that people are giving out bad information. It could be people trying to fingerpoint. It’s really hard for me to say having been here only a couple of weeks, but we will investigate all of those potential problems.”

HealthSourceRI’s multimillion dollar advertising campaign and some of the positive media coverage the exchange has received rings hollow for Fitzpatrick. “They’re talking about enrollment numbers soaring and stuff like that. Technically I’m enrolled with HealthSourcRI, I just wasn’t covered. You don’t see that (statistic). Enrolled, but not getting covered.”

In late January, Fitzpatrick finally got her insurance cards. Now she is trying to get reimbursement for out-of-pocket expenses in January. Wallack acknowledges the challenge ahead: working out the kinks and proving that Rhode Island should keep its own health exchange, something House Speaker Nicholas Matiello has questioned. And despite the glitches, Wallack is upbeat about HealthSourceRI’s future.

“Like a lot of states, we’re dealing with all of the warts and bumps of the early years. We’re dealing with the fact that states tried to implement this on what was probably, by industry standards, a faster track than what you would normally do. But if we can even out the operations and provide excellent customer service, I think we have a great case to make for sustainability.”

The Hummel Report is a 501 3C non-profit organization that relies, in part, on your donations. If you have a story idea or want make a donation go to hummelreport.org, where you can also see the video version of this story. You can mail Jim directly at jim@hummelreport.org.