California’s health insurance exchange, established under the Affordable Care Act, has been held out as a national model for Obamacare. In some ways—not all of them good—it is. Whether it’s falling far short of 2015 enrollment goals or sending out 100,000 inaccurate tax forms, Covered California is struggling with its share of challenges.
Now, several senior-level officials integral to the launch of Covered California—who enthusiastically support the Affordable Care Act—are speaking about what they view as gross incompetence and mismanagement involving some of the $1 billion federal tax dollars poured into the state effort.
Consultant Aiden Hill became a “foxhole convert” to Obamacare in July of 2010 when he lost his insurance, had a serious medical issue and couldn’t get a new policy.
“I lived through a health care nightmare. That’s one reason why I took a cut in my pay rate to work for Covered California.”
In March 2013, Hill was hired as project manager over Covered California’s massive $120 million call center effort. In just six short months, it would face an avalanche of customers seeking insurance mandated under the new law.
But five months on the job converted Hill from avid supporter to disenchanted whistleblower. He says the secretive and dysfunctional culture was more interested in cheerleading than real results. After he persistently raised concerns, Covered California abruptly terminated his contract. He says the experience drove him to raise allegations about waste and cover ups at a Covered California board meeting.
“I really believe that we’ve created a monster—and it’s an unaccountable monster,” Hill told The Daily Signal.
It’s against that backdrop that Covered California finds itself now grappling with a big disappointment: low enrollment growth. California ranked near the bottom in overall growth, with a scant 1 percent increase over last year.
As recently as last fall, the official says, California hoped to increase enrollment by 500,000 this year. But only an additional 7,098 have “selected a plan” for 2015.
Another telling statistic is Covered California’s poor retention rate. Even though people are required by law to have health insurance, only 65 percent of Covered California’s 2014 customers reenrolled in 2015. The rest dropped off.
The devastating crash of Covered California’s website and call centers on Oct. 1, 2013 was “the canary in the coalmine, an early warning of deep dysfunction,” according to Hill.
Pre-launch testing had proven disastrous. As with the national HealthCare.gov website, “it was breaking at the first click of the button,” says the former call center manager who worked under Hill. “Behind the scenes, states were worried. I know we were worried.”
Covered California contractors projected 10,000 calls the first day. The call center manager says he knew they were way off. “I and my training manager, who had launched call centers before, projected 20,000. We had 21,000 on day one. Our contractors were wrong.”
“The train was coming off the rails,” adds Hill. “The call center was going into meltdown.”
The meltdown lasted for months and fixes proved costly. Covered California would not provide a tally of expenses, but the agency ended up asking the federal government for an extra $155 million. That put the cost of Covered California at more than $1.06 billion federal tax dollars.
Covered California’s disastrous debut triggered a house of cards. When the website crashed, consumers were directed to fill out paper applications; they were 33 pages long and took at least an hour to complete. What’s more, they couldn’t be coordinated with the electronic version because of a major design flaw. The forms didn’t match.
But Covered California counted duplicate applications as if they were enrollments, giving the impression that more people had successfully signed up. (The Obama administration did the same with national HealthCare.gov applications.)
For example, Covered California’s Lee publicly touted 30,000 successful enrollments for the first month. Hill says the actual number was closer to 4,000.
“A lot of the information that came out of Covered California was misleading or outright lies,” Hill insists.