State Rep. Reuven Carlyle writes about the Washington Health Benefits Exchange’s (HBE) proposed 2015-17 budget:

At a time when state agencies are being asked to model and potentially cut 15% from their budgets, the Washington Health Benefits Exchange is poised to ask the legislature to lift the cap on their budget to an astonishing $147 Million over the next biennium. That’s almost twice the capped amount the legislature authorized in the last budget cycle. Among the largest pieces of the pie? Substantial new investments in technology.

The HBE’s budget proposal requests $66.9 million over and above the already-appropriated $80 million for 2015-17 “to maintain current operations and improve the customer experience to retain current enrollees and generate an additional 200,000 health plan enrollments.” The proposal also provides some background on the HBE’s budget:

The Exchange was initially funded through $266 million of federal grants for design, development, and implementation, and the first year of operations. This funding request moves the Exchange from federal, developmental funding to state-appropriated funds.

In 2013, the Legislature approved three funding sources for the Exchange. The first is allocation to the Exchange of the current two percent premium tax paid by commercial health insurance issuers participating in the Exchange. The second is an Exchange carrier assessment that is in the form of a per-member-per-month payment estimated on an annual basis. The third is the Medicaid cost allocation of services being provided by the Exchange on behalf of Medicaid. . . .

The Exchange Board has stated that a $40 million annual operating budget is insufficient to maintain current Exchange operations. The federal government has identified the Washington Health Benefit Exchange at operational risk with this level of funding. A $40 million annual budget would result in significant cuts to the call center, resulting in projected wait times of up to 90 minutes, a minimal outreach and marketing program, a minimal Navigator program, no additional broker support, and a reduction in staff that would result in decreased operational efficiencies.

Rep. Carlyle isn’t supportive of the request:

We are the home of technology, innovation and entrepreneurialism but too often our performance in government service delivery and the use of technology fails to take advantage of all that we have to offer as a state. Sate government is simply not a sophisticated technology customer. We depend upon proprietary vendors too much, we fail to adequately invest in our own technology professionals through adequate pay and professional development, and we frequently fail to deploy enterprise-wide strategies from applications to utility services.

I passionately support increasing access to quality health care. I believe the Affordable Care Act is a responsible step toward improving millions of lives across the nation, and I believe we have a strong executive team and approach here in Washington. But I don’t support tens of millions more for the Exchange’s technology systems in light of the lack of meaningful or independent technology oversight from anyone other than the agency itself.  Not only is it vital to hold the line on additional technology spending, it’s likely time to reconsider the governance structure of the Health Exchange itself as a quasi-independent entity.