It is with sadness that I have seen the Covered California train derailed. But the program is not a train wreck. After a robust, if not rocky start of enrolling over 16,000 households, the Covered California website has become all but inaccessible to me and others as they work to correct flaws in the massive web portal known as CalHEERS (California Health Eligibility Enrollment, and Retention System).
Are web browsers the real problem?
CoveredCa.com website went from accessible to impenetrable last week for many consumers and agents. Just recently I learned that the problem stems from issues with both Google Chrome and Internet Explorer web browsers. I can confirm this since the stall in the login occurs with both web browsers as of the writing of this blog post, October 14th. Oddly, I was able to login on my iPad. Unfortunately, the Safari web browser on my iMac won’t correctly connect to Covered California.
Clicking here does nothing on the Covered California stalled login page.
Massive IT project
To get a sense of how massive CalHEERS is you can review the scope of the project in the solication for bids to design and develop it. This one little section is the part that is not getting fulfilled.
Solicitation HBEX4 – Request for CalHEERS Development and Operations Services
The Exchange expects the vendor to deliver a solution as follows:
Design, develop, test, and deliver a fully integrated, automated System that:
- Provides a first-class consumer experience and delivery of Services through a Web
Portal format that:
- Accommodates different consumers’ access needs and facilitates and simplifies the end-to-end process to attain and maintain health coverage.
- Takes advantage of and/or exceeds the consumer experience and framework defined by the UX2014 Project.
- Presents content in a format that is culturally sensitive, navigation that is straightforward, and simple tools or methods to enable consumers to provide and obtain information.
- Is presented in English and Spanish, with links to phone, online chat, or IVR assistance in the Medi-Cal Managed Care Threshold languages.
- Enables access for persons with disabilities and Limited English Proficiency (LEP) and meets all Americans with Disabilities Act (ADA) requirements.
- Provides a mechanism for the webmaster to obtain feedback regarding accessibility improvements, general comments, and other recommendations.
When I tried the online “Chat” feature, that crashed too.
Doctor Find gave odd results
When I was able to login, before system “maintenance” made Chrome inoperable, I was able to do a doctor search for a client. The doctor search I was able to conduct produced some questionable results. First, two of the six doctors I searched and found indicated they were not Board Certified. I called the physicians group they were associated with and they were a little surprised at the results. In addition, several of the doctors were listed as speaking Arabic and Tagalog which was another error. When I reported the results to Covered California on Thursday, the next day the doctor search function had been taken down according to the welcome screen I could access.
What happen to all the communication?
In light of the very transparent communications Covered California has offered with the development of the whole exchange, their silence on the latest CalHEERS web portal problems in simply deafening. In the face of a “public relations disaster” management needs to be clear as to the problems and the steps being taken to correct the issues. All Californians see are messages that the system is down for maintenance. The staff and management at Covered California are really terrific but they need to communicate to the consumers who are getting these frustrating messages. The first core value of the California Health Benefits Exchange is
- Consumer-focused: At the center of the Exchange’s efforts are the people it serves, including patients and their families, and small business owners and their employees. The Exchange will offer a consumer-friendly experience that is accessible to all Californians, recognizing the diverse cultural, language, economic, educational and health status needs of those we serve.
Who owns this problem?
I would like to point much of the blame at the contractor building the CalHEERS system, Accenture. As one former state employee mentioned, IT contractors usually deliver half of what they say they will and then request change orders to fix what they haven’t created. But without knowing all the facts it is hard to make that assertion in this case. There are thirteen different agencies involved with the CalHEERS project who are either partners or have an oversight role. Maybe there are too many cooks in the kitchen.
Derailed or wrecked?
A dysfunctional and over-hyped web site or application is not a train wreck. Last month Anthem Blue Cross attempted to launch a new agent web portal. So far it is half-functioning. It has been down for “maintenance” numerous times and the promised hype of easier information management has not materialized. Essentially, agents in California are being redirected back to the old website for the bulk of tasks we login for such as downloading documents, checking on renewals, accessing client information and generating quotes. Wellpoint, who owns Anthem Blue Cross, is far larger than Covered California and has been doing IT projects for health insurance enrollment for years. Yet, even they are having problems.
What doesn’t kill makes you stronger?
The Internet is littered with examples of websites that have had monumental crashes and failures and the majority those companies like EBay and Apple are just as strong providing value to their members. Covered California is no different from other companies whose websites failed a real world stress test. As troublesome as the CoveredCA.com website is today, it still doesn’t compare to the Employment Development Department with the new California Unemployment Benefit Services (CUBS) system. Just as CUBS is getting fixed and the “check’s in the mail”, so to will the challenges with Covered California’s system.
Patience is a virtue
I’m not very worried about the integrity of Covered California. The bulk of the program is in place. We have a variety of health plans that are guarantee issue and not rated for pre-existing conditions. I can wait a couple weeks before the system is aligned with my web browsers. The Affordable Care Act isn’t going away and there are too many dedicated and passionate Californians that will make sure it works.
Internet Explorer 10.0
The recommended web browser is Internet Explorer 10. The trick I stumbled upon to make the browser to connect was enabling some advanced settings. Both the SSL and TLS setting must be enabled. The SSL boxes are usually already checked marked. To do this open up IE
- Go to the Tools in the upper right hand corner that looks like a gear wheel
- Select Internet Options
- Click on Advanced tab
- Scroll down and check mark the boxes for “Use TLS 1.0, 1.1 and 1.2
- Click Apply
That enable my notebook with IE 10 to properly connect to Covered California.
If I stumble upon a fix for Google Chrome, I’ll post it here.
Bottle Neck
As of October 15th, Covered California had only 279 trained and certified enrollment counselors and 1,295 agents. While thousands more counselors and agents are waiting to be trained and certified, it is obvious that Covered California has a severe bottle neck of in-person assistance. From a period where Covered California hoped to have 20,000 educators and enrollment counselors last summer, I doubt that they have 1/4 of that today. The current training seems to be too much of a challenge for some people to accept. I think Covered California was surprised at the interest from agents to be certified and the lack of interest from people who just want to help.
Phone assistance gets worse
The Small Business Health Options Program telephone support has virtually become nonexistence. There are so many agents jamming the phone lines with technical questions to become certified that after 30 minutes on hold I just give up. I just have basic questions about how people delegate and agent to help them. These simple questions could easily be addressed in short PDF documents if anyone would have taken the time to set up the back-end training properly.
Income questions
Central to premium assistance is helping households navigate the tricky questions of what should or should not be include in the income estimate. The Covered California help desk folks are very nice, but they just refuse to answer some income questions. They say you’ll have to discuss that with your CPA or accountant. Turbo Tax is my accountant. Covered California should have the answers to the questions regarding income when it is their jurisdiction to provide the guidance for the premium assistance.
Is the “Schedule E Supplement Income and Loss” of the federal taxes figured into the Adjusted Gross Income. I had a question from a couple whose income was near zero because of a large loss on some rental property. If they use that figure they will qualify for Medi-Cal only. I read the tax forms and guidance from other sources that the Sch. E is considered. The catch is that we are estimating 2014 income, not using 2012 income.
Site Maintenance
I completely understand that somebody is working feverishly behind the scenes to make the website work. But when the site was suppose to be up at 6 am after being down all night for “maintenance” and it’s still not functioning by 9am; agents, counselors and the general public are due an explanation. Except for an occasional press release from Peter Lee apologizing for the Doctor Find function being pulled down, no one from Covered California is saying anything. I would rather them be honest about their challenges and how they are try to fix them than have this wall of silence.