“Galloping Gertie” was the nickname given by construction workers to the infamous Tacoma Narrows Bridge, in the state of Washington. It got its nickname even before it opened to traffic, because of a major design failure. It allowed modest wind pressure to make the roadway visibly oscillate both side to side and end to end. In November 1940, four months after its opening, a crossways 40 mph wind started Gertie galloping, and within minutes it spectacularly collapsed into Puget Sound.
A good case can be made that the worst design failure disaster in Vermont history is the Vermont Health Benefits Exchange, Vermont Health Connect (VHC).
The Affordable Care Act of 2010 authorized the federal government to spend billions to underwrite the creation of health insurance exchanges in the states, and create a backup Federal exchange. Only 17 states, including Vermont, took advantage of this offer.
The task, for a state, was to create a web-based exchange where individuals and small businesses could review and select the insurance plan that best met their needs, from a menu of (overpriced) policies that contain the “essential benefits” lobbied into the Obamacare act, plus a host of Vermont mandates.
From its first halting rollout on October 1, 2013, VHC never came close to working as (supposedly) designed. For instance, when a policy holder has a “change of circumstance”, such as a marriage, divorce, new child, address change, etc., VHC’s website can’t cope with the change. VHC has had to hire hundreds of temp workers to manually work their way through thousands of requested changes. The April State Auditor’s report includes an exhaustive list of VHC failures, both of design and management. So far the Shumlin administration has expended an astounding 198 million (Federal) dollars on VHC, and has little to show for it but grief and ridicule.
How bad is this? An enthusiastic supporter of single payer health care, Bekka Mandell of Burlington, commented on VtDigger.org (May 6) that “my husband and I have been struggling to navigate the Vermont Health Connect system and I know we’re not alone. Between the two of us, we’ve spent dozens of hours on the phone with them trying to sort out our coverage. We’re expecting our first baby in May, so we’re terrified that some glitch in their system is going to end up costing us hundreds or thousands of dollars in hospital fees. After dealing with the Vermont Health Connect bureaucracy, it’s tempting to throw in the towel on the whole idea of a universal health care system if the state is going to have anything to do with it.”
If a Vermont Workers Center volunteer like Ms. Mandell has been driven to the brink of scrapping the idea of any universal health care system managed by the state, that ought to be an alarm bell for a lot of people who are naively clamoring for single-payer Green Mountain Care.
The House version of this year’s health care reform repair bill (S.139) includes a timid response to this failure. It directs the Joint Fiscal Office to analyze the advantages and disadvantages, of alternative options for the VHC “including continuing [VHC] , transitioning to a federally facilitated State-based marketplace, and other available options.” Whatever JFO recommends, it won’t become a live option until the legislature approves. That can’t happen until long after the October 1 enrollment period opens for 2016, which for the first time will include mandatory participation by businesses with 51-100 employees.
There is nothing wrong with the idea of an online insurance purchasing exchange. In fact, dozens of such exchanges operate now in the private sector, but they aren’t allowed to channel income-based Obamacare premium tax credits or state subsidies to their customers.
Whether VHC can ever be made to work appears increasingly unlikely. It’s pretty clear that Washington is not going to toss in another hundred million dollars to rescue the Shumlin administration.
Instead of giving the state government ever more control over Vermont’s health care and insurance sectors, the legislature should abandon Green Mountain Care (currently postponed indefinitely), roll back thirty years of foolish state mandates that have afflicted the Vermont insurance market, make a determined start toward a consumer directed health policy that will produce better quality outcomes at less expense, and finally put an end to Vermont’s Galloping Gertie.
- John McClaughry is vice president of the Ethan Allen Institute (www.ethanallen.org).