Gruber:My2012remarkswere“aspeak-o”

Gruber: My 2012 remarks were “a speak-o”

posted at 12:01 pm on July 25, 2014 by Ed Morrissey

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In a sense, Jonathan Gruber’s response today to the emergence of his 2012 explanation for the language in ObamaCare mirrors the attempt to get courts to ignore the plain text of the statute and instead rule based on the most current interpretation. The New Republic’s Jonathan Cohn reached out to Gruber to get his reaction to the emergence of the Nobilis video in which the architect of ObamaCare explains that the restriction of subsidies to states with their own exchanges was a rational attempt to coerce states into creating those exchanges, rather than shifting the burden back to the federal government. Gruber calls that “a speak-o — you know, like a typo”:

I honestly don’t remember why I said that. I was speaking off-the-cuff. It was just a mistake. People make mistakes. Congress made a mistake drafting the law and I made a mistake talking about it.

During this era, at this time, the federal government was trying to encourage as many states as possible to set up their exchanges. …

At this time, there was also substantial uncertainty about whether the federal backstop would be ready on time for 2014. I might have been thinking that if the federal backstop wasn’t ready by 2014, and states hadn’t set up their own exchange, there was a risk that citizens couldn’t get the tax credits right away. …

But there was never any intention to literally withhold money, to withhold tax credits, from the states that didn’t take that step. That’s clear in the intent of the law and if you talk to anybody who worked on the law. My subsequent statement was just a speak-o—you know, like a typo.

In order to believe that, though, you’d have to ignore the plain meaning of the question Gruber was asked, and the plain meaning of the answer he gave. Gruber explicitly identifies states balking at running exchanges as one of the three main threats to the success of ObamaCare, at the 28-minute mark in the full video below. Note too at the time that Gruber stressed in the presentation that ObamaCare shouldn’t be seen as a federal takeover of health care in part because ObamaCare incentivized states to deal with the exchanges, an argument made at least in parallel to the point about the political threat to the law that balking states would create.

The second question after that argument went directly to that issue, with no misunderstanding the point (around 31:20):

Q: You mentioned the health implementation exchanges in the states, and it’s my understanding that if states don’t provide them, then the federal government will provide them. What do you say to that?

GRUBER: Yeah, so these health-insurance Exchanges, you can go on ma.healthconnector.org and see ours in Massachusetts, will be these new shopping places and they’ll be the place that people go to get their subsidies for health insurance. In the law, it says if the states don’t provide them, the federal backstop will. The federal government has been sort of slow in putting out its backstop, I think partly because they want to sort of squeeze the states to do it. I think what’s important to remember politically about this, is if you’re a state and you don’t set up an Exchange, that means your citizens don’t get their tax credits. But your citizens still pay the taxes that support this bill. So you’re essentially saying to your citizens, you’re going to pay all the taxes to help all the other states in the country. I hope that’s a blatant enough political reality that states will get their act together and realize there are billions of dollars at stake here in setting up these Exchanges, and that they’ll do it. But you know, once again, the politics can get ugly around this.

This answer is not a “speak-o” any more than the statutory language on subsidies and exchanges was a “typo.” Gruber explained the coercive policy correctly and in detail, along with the stakes involved in seeing the coercion succeed. It’s not a case of just using the wrong terminology, like “market” instead of “exchange.” Gruber clearly understood the statute at this time — in January 2012 — to provide the arm-twisting needed to get states to launch their own exchanges by stiffing consumers in states without them, which would then create more pressure on those states to get them the federal subsidies that they were funding but not receiving.

That is exactly what the plaintiffs argued in Halbig, and what the court ruled to be the intent of Congress as well as the statutory reality of the ACA. Just because that arm-twisting policy failed in its goals doesn’t mean it wasn’t deliberate, rational, and very much a part of the ObamaCare strategy then, and it doesn’t make it a “typo” now — or a “speak-o” either.

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Tags: exchanges, halbig, Jonathan Gruber, ObamaCare, subsidies, Supreme Court

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ObamaCarearchitectexplainedin2012videowhyonly

ObamaCare architect explained in 2012 video why only state exchanges pay subsidies

posted at 8:01 am on July 25, 2014 by Ed Morrissey

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This week, Jonathan Gruber appeared on MSNBC to assert that the DC Circuit appellate court got the ObamaCare statute all wrong in its Halbig decision. Gruber, one of the key architects of the ACA and of the Massachusetts “RomneyCare” law that preceded it, insisted that the state exchange requirement for subsidy payment was purely accidental. “It is unambiguous this is a typo,” Gruber told Chris Matthews. “Literally every single person involved in the crafting of this law has said that it`s a typo, that they had no intention of excluding the federal states.”

Two years ago, though, Gruber gave a much different explanation for this part of the ObamaCare statute. Speaking at a January 2012 symposium for a tech organization that this was no typo. It was, Gruber said, a deliberate policy to twist the arms of reluctant states to set up their own exchanges — and that a failure to do so would mean no subsidies for their citizens. Peter Suderman at Reason and William Jacobson at Legal Insurrection immediately grasped the significance of this contradiction:

What’s important to remember politically about this is if you’re a state and you don’t set up an exchange, that means your citizens don’t get their tax credits—but your citizens still pay the taxes that support this bill. So you’re essentially saying [to] your citizens you’re going to pay all the taxes to help all the other states in the country. I hope that that’s a blatant enough political reality that states will get their act together and realize there are billions of dollars at stake here in setting up these exchanges. But, you know, once again the politics can get ugly around this. [emphasis added]

Suderman gives the context of Gruber’s remarks:

Jonathan Gruber, a Massachusetts Institute of Technology economist who helped design the Massachusetts health law that was the model for Obamacare, was a key influence on the creation of the federal health law. He was widely quoted in the media. During the crafting of the law, the Obama administration brought him on for consultation because of his expertise. He was paid almost $400,000 to consult with the administration on the law. And he has claimed to have written part of the legislation, the section dealing with small business tax credits.

After the law passed, in 2011 and throughout 2012, multiple states sought his expertise to help them understand their options regarding the choice to set up their own exchanges. During that period of time, in January of 2012, Gruber told an audience at Noblis, a technical management support organization, that tax credits—the subsidies available for health insurance—were only available in states that set up their own exchanges. …

And what he says is exactly what challengers to the administration’s implementation of the law have been arguing—that if a state chooses not to establish its own exchange, then residents of those states will not be able to access Obamacare’s health insurance tax credits. He says this in response to a question asking whether the federal government will step in if a state chooses not to build its own exchange. Gruber describes the possibility that states won’t enact their own exchanges as one of the potential “threats” to the law. He says this with confidence and certainty, and at no other point in the presentation does he contradict the statement in question.

So is this a smoking gun in the Halbig case? Politically — yes. Legally? It certainly undermines one argument used by the administration to defend payment of subsidies through the federal exchanges, but it may not be entirely dispositive. What matters here is Congressional intent, not Gruber’s, to the extent that the statute itself appears ambiguous. The actual text of the law supports Gruber’s 2012 position, as both the DC and 4th Circuits found in their opposing rulings, but the 4th Circuit couldn’t quite believe that Congress intended to shaft Americans in states that didn’t set up their own exchanges. That might have changed had they heard from the 2012 version of Gruber.

Will this be enough at the Supreme Court to demonstrate that there was a rational reason for Congress to make the distinction in the law and force the court to adopt the DC’s Halbig decision? You’d have to ask Anthony Kennedy and John Roberts that question. And I’d say the odds are good that they’ll be asked it relatively soon.

Here’s the entire Nobilis presentation, in case anyone worries that this got taken out of context. The relevant remarks come at the 31-minute mark.

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Tags: exchanges, halbig, Jonathan Gruber, ObamaCare, subsidies, Supreme Court

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Dataproblems,hackerscontinuetoplagueObamacareexchanges

Data problems, hackers continue to plague Obamacare exchanges

posted at 7:21 pm on July 3, 2014 by Mary Katharine Ham

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Two reports from the government watchdog for Health and Human Services this week revealed serious data discrepancies among the sign-ups the Obama administration hailed as Obamacare’s triumphant comeback. Those data problems may mean some people got subsidies they shouldn’t have and would have to pay back hefty amounts to the federal government. Phil Klein reports:

Applications for insurance coverage through President Obama’s health care law submitted in the final three months of 2013 contained millions of inconsistencies in which information such as income and immigration status could not be independently verified by the federal government, according to a June report from the inspector general of the Department of Health and Human Services.

The inconsistencies may have resulted in individuals receiving an improper amount of subsidies, or subsidies that they shouldn’t have been eligible for in the first place — something that could require them to repay the money in future tax bills.

In other cases, inconsistencies led to bizarre outcomes. According to the report, “one marketplace cited situations in which infants and young children included on applications were erroneously identified as incarcerated.”

At issue is the information that individuals are asked to submit when they apply for coverage, such as income, citizenship status, Social Security number, or incarceration status. In theory, once data are submitted, they are supposed to be checked in a massive storage database known as the “hub,” which gathers data from multiple federal agencies.

Between October and December 2013, there were 2.9 million such inconsistencies in applications, according to the report, 2.6 million of which remain unresolved. As Klein makes clear, this doesn’t mean there are 2.9 million separate applications with mistakes because there are many potential data problems on each person’s application. The most common inconsistency had to do with citizenship and immigration status, with income shortly behind. In some cases, the federal government and states with exchanges were not using the verification processes required by their internal rules (well, knock me over with a feather). The AP reports:

Digging out from under the data problem is one of the top challenges facing newly installed HHS Secretary Sylvia Mathews Burwell.

The administration says it is doing just that. Spokesman Aaron Albright said more than 425,000 inconsistencies have been resolved so far, more than 90 percent of those in favor of the consumer. The administration is hoping to clear up the majority of cases this summer, but may yet have to resort to an extension allowed under the health law.

The inspector general found that the federal insurance exchange reported a total of 2.9 million inconsistencies with consumer data from Oct. 1, 2013 through Feb. 23 of this year.

At the time, the administration had limited technical capability that would have let officials resolve roughly 330,000 of those cases. Only about 10,000 were actually cleared up within the period. Albright said the situation is much improved.

The inspector general said several states running their own insurance markets were having similar problems.

Guy Benson reports on the inspector general’s take on state exchanges:

Democrats celebrated that “8 million new enrollments” figure in a failed attempt to improve public perceptions of the law. That number has always been highly exaggerated — not accounting for duplicates, a substantial non-payment rate, a high percentage of enrollees who were previously insured, and applicants whose coverage may be disrupted by these ongoing data issues. The watchdog report stated that approximately 1.2 million additional “inconsistencies” marred applications processed through state exchanges. More: “During our review, 4 of the 15 State marketplaces reported that they were unable to resolve inconsistencies” at all, including some of the usual suspects such as Oregon. How many data snags have affected the millions of applications filed over the first three-plus months of 2014? The final number will almost certainly be significantly higher.

Meanwhile in Vermont, considered one of the better state exchanges:

A Romanian attacker hacked the Vermont health exchange’s development server last December, gaining access at least 15 times and going undetected for a month, according to records obtained by National Review Online.

CGI Group, the tech firm hired to build Vermont Health Connect, described the risk as “high” in a report about the attack. It also found possible evidence of sophisticated “counter-forensics activity performed by the attacker to cover his/her tracks.”

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Tags: data, exchanges, healthcare.gov, implementation, ObamaCare

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Together,thosefourfailedstateObamaCareexchangesare

Together, those four failed state ObamaCare exchanges are costing taxpayers at least $474 million

posted at 3:21 pm on May 15, 2014 by Erika Johnsen

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A handful of the states that were most enthusiastic about rolling out ObamaCare and creating their own online insurance exchanges ended up crashing and burning pretty spectacularly; several of them are still without even remotely functioning websites, and a number are considering scrapping their respective endeavors and switching over the the federal site, or have already decided to do so. Considering that the federal government allotted a whole bunch of cash toward the states that elected to build their own exchanges, these state-exchange screw-ups taken together mean quite a bit of wasted taxpayer money, via Politico:

Nearly half a billion dollars in federal money has been spent developing four state Obamacare exchanges that are now in shambles — and the final price tag for salvaging them may go sharply higher.

Each of the states — Massachusetts, Oregon, Nevada and Maryland — embraced Obamacare, and each underperformed. All have come under scathing criticism and now face months of uncertainty as they rush to rebuild their systems or transition to the federal exchange.

The federal government is caught between writing still more exorbitant checks to give them a second chance at creating viable exchanges of their own or, for a lesser although not inexpensive sum, adding still more states to HealthCare.gov. The federal system is already serving 36 states, far more than originally anticipated.

Besides those four states, Politico notes, Hawaii and Minnesota could soon add their dysfunctional websites to that ignominious scrap heap, which could hike the price up even further — and that $474 million figure is only the amount that states have already spent and that officials have publicly detailed. As Phil Kerpen argues at The Federalist, that figure is liable to be much higher; although states like Oregon and Massachusetts have yet to run through the entire budget that the federal government so generously allotted to them, they aren’t likely to give the remaining balance of their federal marketplace-building grants back to the national coffers, either. Kerpen calculates that the cost of just Oregon, Massachusetts, and Maryland have already put us back by more like $655 million, and the total amount given away in federal grants is almost a whopping 5 billion smackers.

I know Democrats like to claim that they are totally on board with legislation that sincerely attempts to “fix” what they admit are ObamaCare’s obvious flaws, but we’ll see how they react to this latest offering from Senate Republicans Hatch and Barrasso, via National Journal:

Today, Sen. Orrin Hatch (R-UT) joined Sen. John Barrasso (R-WY) to introduce The State Exchange Accountability Act. The bill will force states that wasted hundreds of millions of taxpayer dollars on failed Obamacare exchanges to repay the federal government.  If a state chooses to no longer operate their own individual exchange, they will have to repay Washington for all of the taxpayer funding they received for their failed exchange. Specifically, the state will have to repay ten percent of their wasted federal grant funding each year over a ten year period.

“The American people are sick and tired of writing a blank check for the health care law’s complete failures.  After forcing taxpayers to pay hundreds of millions of dollars for the failed website, the Obama Administration now expects Americans to pay hundreds of millions of dollars for failed state exchanges,” said Barrasso.  “Enough is enough.  States that scrap their state-run Obamacare exchanges are admitting they’ve wasted millions of dollars in federal grants. It’s only fair that states have to pay American taxpayers and the federal government back for their total incompetence.”

I’m thinking that critics will likely frame this as mere petty squabbling over small potatoes to keep ObamaCare in a bad public light before the midterms, and that Republicans really need to just stop because the law is totally working — and as Ed already noted this morning, the law actually kind of is working the way it was supposed to… which is not to be confused with working the way it was advertised.

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Together,thosefourfailedstateObamaCareexchangeare

Together, those four failed state ObamaCare exchange are costing taxpayers at least $474 million

posted at 3:21 pm on May 15, 2014 by Erika Johnsen

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A handful of the states that were most enthusiastic about rolling out ObamaCare and creating their own online insurance exchanges ended up crashing and burning pretty spectacularly; several of them are still without even remotely functioning websites, and a number are considering scrapping their respective endeavors and switching over the the federal site, or have already decided to do so. Considering that the federal government allotted a whole bunch of cash toward the states that elected to build their own exchanges, these state-exchange screw-ups taken together mean quite a bit of wasted taxpayer money, via Politico:

Nearly half a billion dollars in federal money has been spent developing four state Obamacare exchanges that are now in shambles — and the final price tag for salvaging them may go sharply higher.

Each of the states — Massachusetts, Oregon, Nevada and Maryland — embraced Obamacare, and each underperformed. All have come under scathing criticism and now face months of uncertainty as they rush to rebuild their systems or transition to the federal exchange.

The federal government is caught between writing still more exorbitant checks to give them a second chance at creating viable exchanges of their own or, for a lesser although not inexpensive sum, adding still more states to HealthCare.gov. The federal system is already serving 36 states, far more than originally anticipated.

Besides those four states, Politico notes, Hawaii and Minnesota could soon add their dysfunctional websites to that ignominious scrap heap, which could hike the price up even further — and that $474 million figure is only the amount that states have already spent and that officials have publicly detailed. As Phil Kerpen argues at The Federalist, that figure is liable to be much higher; although states like Oregon and Massachusetts have yet to run through the entire budget that the federal government so generously allotted to them, they aren’t likely to give the remaining balance of their federal marketplace-building grants back to the national coffers, either. Kerpen calculates that the cost of just Oregon, Massachusetts, and Maryland have already put us back by more like $655 million, and the total amount given away in federal grants is almost a whopping 5 billion smackers.

I know Democrats like to claim that they are totally on board with legislation that sincerely attempts to “fix” what they admit are ObamaCare’s obvious flaws, but we’ll see how they react to this latest offering from Senate Republicans Hatch and Barrasso, via National Journal:

Today, Sen. Orrin Hatch (R-UT) joined Sen. John Barrasso (R-WY) to introduce The State Exchange Accountability Act. The bill will force states that wasted hundreds of millions of taxpayer dollars on failed Obamacare exchanges to repay the federal government.  If a state chooses to no longer operate their own individual exchange, they will have to repay Washington for all of the taxpayer funding they received for their failed exchange. Specifically, the state will have to repay ten percent of their wasted federal grant funding each year over a ten year period.

“The American people are sick and tired of writing a blank check for the health care law’s complete failures.  After forcing taxpayers to pay hundreds of millions of dollars for the failed website, the Obama Administration now expects Americans to pay hundreds of millions of dollars for failed state exchanges,” said Barrasso.  “Enough is enough.  States that scrap their state-run Obamacare exchanges are admitting they’ve wasted millions of dollars in federal grants. It’s only fair that states have to pay American taxpayers and the federal government back for their total incompetence.”

I’m thinking that critics will likely frame this as mere petty squabbling over small potatoes to keep ObamaCare in a bad public light before the midterms, and that Republicans really need to just stop because the law is totally working — and as Ed already noted this morning, the law actually kind of is working the way it was supposed to… which is not to be confused with working the way it was advertised.

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RandPaul:Let’sfaceit,it’sgoingto

Rand Paul: Let’s face it, it’s going to be difficult to repeal ObamaCare at this point

posted at 3:21 pm on April 28, 2014 by Allahpundit

Interestingly, it’s Cathy McMorris-Rodgers’s comments about “reforming” rather than repealing the O-Care exchanges that drew most of the blog chatter this weekend, not Rand’s equally eyebrow-raising remarks at Harvard on Friday. Is that because McMorris-Rodgers is guilty of a double heresy, having forecast a new amnesty push this summer too? Or is it because Paul’s conservative bona fides are still in good standing whereas no one trusts the House leadership on anything anymore, starting with ObamaCare? Whatever the reason, McMorris-Rodgers issued a statement this morning aimed at the gullible optimists among us insisting that she’s on Team Repeal all the way. Whew.

What about Rand, though? I can’t find video or a transcript of what he said in Cambridge; National Review says that he reiterated his strong opposition to ObamaCare but was fatalistic about repealing it — in the near-term at least. The Hill’s account makes it sound like his time horizon was longer than that, though:

“I think it’s going to be difficult to turn the clock back. People get assumed and accustomed to receiving things, particularly things that they get for free,” he told a crowd of students at Harvard’s Institute of Politics on Friday…

“I think one of the practical things you might be able to do, and I think the public at large might accept this, is to make ObamaCare voluntary. You make it voluntary, basically you get rid of the coercion,” he said, presumably by eliminating the penalty those without insurance are required to pay, known as the individual mandate.

He said he may keep some parts of the law, like the subsidies to help poor Americans afford insurance, or the Medicaid expansion — two of ObamaCare’s more popular provisions but potentially its more expensive.

“Does that get rid of the subsidies? Not necessarily, or the Medicaid. But I think also we’re going to find out we can’t afford to have everybody on Medicaid, we can’t afford to have everybody on subsidized insurance,” Paul said.

Alternate headline: “Ted Cruz’s ad team pulls all-nighter” — which would be ironic, since Paul’s logic here about the difficulty of weaning people off subsidies once they’ve begun is the same as Cruz’s was back in October in pushing the “defund” effort (which Paul tepidly supported). All Rand’s saying, really, is that repeal becomes much harder once a program’s in place and people have come to rely on it. Cruz couldn’t agree more, I assume, which is not to say he won’t have lots of fun punishing Paul for his “defeatism” in the primaries.

In a sense, all he’s giving you here is the ObamaCare version of his straight talk on abortion with David Axelrod. America’s not going to change its abortion laws, he said, because there isn’t enough consensus to do so. There may be enough consensus to draw a firm legal line at third-trimester abortions but there certainly isn’t a consensus for an all-out ban like social cons want. The trick for voters is deciding how much of that statement is descriptive and how much is prescriptive. How much political capital would President Paul devote to shaping a consensus on abortion? How much would he devote to shaping a consensus on ObamaCare’s repeal? The first requirement of a tea-party champion is that he resist establishment conventional wisdom and fight for his principles, even if he’s all but guaranteed to lose. It was Cruz’s insight that he could win politically that way by leading on “defund” even though he was destined to lose on the merits. I don’t know why, frankly, Paul would leave himself open to attacks from Cruz on that point by taking these quasi-fatalistic views about hot-button conservative issues. Presumably it’s because his top priority is showing the establishment that he can play nice, and hinting that he wouldn’t rock the boat terribly much on abortion and, especially, ObamaCare is one way to do that. But he’s got to get through the primaries first. Why make things easier on Cruz?

As for the merits, I don’t think repealing the mandate would do much to weaken the overall law at this point. It would be a moral victory insofar as it jettisoned the most overtly coercive element of O-Care, the one that got away at the Supreme Court two years ago, but yanking it out of the ObamaCare jenga tower now wouldn’t topple the whole structure. That might have happened if the Court had struck it down before the exchanges launched; without the mandate in place scaring twentysomethings into buying insurance this year, the risk pools might have been overloaded with the old and sick, premiums might have shot up in 2015, and suddenly we’re in death-spiral country. As it is, they’ve got somewhere between six million and eight million paying customers enrolled, roughly 28 percent of whom are “young invincibles.” That’s well short of their target of 39 percent last year but enough that premiums aren’t expected to skyrocket next year to make up for missing revenue. But even if the mandate had been nullified by the Supremes, that still might not have nuked O-Care; remember, for all intents and purposes, the mandate has already been repealed. It’s basically hortatory, a nudge to adults (especially young adults) to sign up but not something that’s being seriously enforced. It was the White House PR outreach to twentysomethings that did most of the work in getting them to sign up, I think, not the mandate. In which case, what’s really achieved at this point by getting rid of it?

Exit question: If we drop the mandate and keep the exchanges and the subsidies and the Medicaid expansion, as Paul envisions, then we’re basically adopting O-Care, right?

Tags: exchanges, mandate, ObamaCare, Rand Paul, repeal, subsidies

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CBO:ObamaCarepremiumsandhealthcarespendingwillrise

CBO: ObamaCare premiums and healthcare spending will rise by less than expected, because…

posted at 6:41 pm on April 15, 2014 by Erika Johnsen

The Congressional Budget Office released a report this morning that has received a lot of attention from ObamaCare’s many staunch media advocates because it essentially concludes that the cost of expanding coverage through the exchanges will be billions less than the CBO was predicting just a couple of months ago. That’s great news for the president’s crowning legislative achievement, right?

Health-insurance premiums for plans sold on the Affordable Care Act’s exchanges will be lower than previously expected, according to a report released Monday by the Congressional Budget Office.

The findings, by Congress’s nonpartisan spending analysts, result largely from the fact that insurance companies have redesigned plans on the government-run exchanges to shave costs. CBO found that individual policies on those marketplaces have narrower networks of doctors and lower reimbursement rates for health-care providers than is typical of employer-sponsored health plans.

As a result, CBO expects the federal government to spend about $165 billion less over the next decade on subsidizing health-insurance plans for lower earners than the office projected two months ago. Total spending on those subsidies is projected at $1.032 trillion between 2015 and 2024. The report was part of a broader federal spending update released Monday.

Did you catch that? Let’s go straight to the report for a closer look:

A crucial factor in the current revision was an analysis of  the characteristics of plans offered through the exchanges in 2014. Previously, CBO and JTC had expected that  those plans’ characteristics would closely resemble the characteristics of employment-based plans throughout the projection period. However, the plans being offered through the exchanges this year appear to have, in general, lower payment rates for providers, narrower networks of providers, and tighter management of their subscribers’ use of health care than employment-based plans do. …

The lower exchange premiums and revisions to the other characteristics of insurance plans that are incorporated into CBO and JCT’s current estimates have small effects on the agencies’ projections of exchange enrollment. Although lower premiums will tend to increase enrollment, narrower networks and more tightly managed benefits will tend to reduce the attractiveness of plans and thereby decrease enrollment. The net effect on projected enrollment in the exchanges is small.

In a nutshell, the CBO initially made its projections under the assumption that the plans offered through the exchange would be largely similar in terms of benefits to the sorts of plans being offered by employers — but that definitely isn’t going to be the case. The narrowed networks that insurers are using to keep costs down and the lower reimbursement rates for doctors and hospitals are things that neither consumers nor providers tend to like in the long run — which will likely mean more strain on the system and higher costs further down the road.

Tags: CBO, doctors, exchanges, health insurance, network, ObamaCare, premiums

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Gallup: Percentage of uninsured drops to lowest level since 2008

Gallup:Percentageofuninsureddropstolowestlevel

Hawaiiponders:Itmightbetimetostart

Hawaii ponders: It might be time to start taxing insurers for not participating in our ObamaCare exchange

posted at 2:41 pm on March 11, 2014 by Erika Johnsen

Five months and approaching a coupla’ hundred million dollars in federal grants later, Hawaii still hasn’t made much progress on mending their terrifically botched ObamaCare exchange website, and the clock is ticking. With barely a few weeks to go until the open enrollment period ends (for now — I have very little faith that His Highness won’t issue another royal decree somehow extending that deadline, too), the state government is entering panic mode over their super-low enrollment figures and their definitive lack of a long-term financing plan for the exchange, which needs to be self-sustaining by the start of 2015. As of mid-February, only about 4,400 people were signed up for health insurance through ObamaCare — a rather conspicuous dip from the hundred thousand people Gov. Neil Abercrombie once predicted would hop to it:

The exchange had originally planned to stay afloat by collecting a 2% fee on every plan sold through the exchange, but with the slow pace of enrollment and changing federal rules — delaying the employer mandate and allowing canceled plans to continue — Interim Director Tom Matsuda said Wednesday that the math simply does not add up. …

Of the 100,000 uninsured in Hawaii, about half are expected to be eligible for Medicaid — meaning just 50,000 people would buy individual plans through the Health Connector under the best-case scenario. And while Hawaii hoped to sell thousands of plans through the exchange’s small-business marketplace, Matsuda said so few small businesses are eligible for tax credits that officials are simply not seeing the demand. “What people can get on the Connector versus outside the Connector is the same, so there isn’t really a strong incentive for small employers to use the Connector,” he said.

Further complicating matters, only two insurers offer plans on Hawaii’s exchange, so many companies are continuing to rely on their longtime brokers (who, having essentially been cut out of the process, have no incentive to help Hawaiians buy plans on the exchange).

Hence, Hawaiian legislators’ latest proposal to cover their bums includes a plan to start charging a “fee” to insurers that decided not to participate in the state’s exchange.

The fee would help prop up the financially troubled Hawaii Health Connector, which could run out of money to pay its bills by year’s end.

“This is not something we want to do,” said Rep. Angus McKelvey, chairman of the House Consumer Protection and Commerce Committee. “It’s federally mandated that we have to have our exchanges be sustainable.”

The unspecified fee would be charged by the state insurance commissioner until mid-2018, based on the number of people the carrier insures. …

The new insurance fee is part of a flurry of House proposals that were rolled into one overarching bill (HB 2529) now being considered by the Senate. …

A “fee,” i.e., slapping a tax on any insurer (and, subsequently, its customers) that decided it was not in their company’s interest to participate in ObamaCare just yet. As the LA Times piece above notes, there are only two insurers currently participating in Hawaii’s exchange — meaning that, if the proposal passes, everybody else is going to have to pay to subsidize ObamaCare’s poor technical, logistical, and financial functionality in the state. And here I was, thinking that ObamaCare was supposed to improve the market and lower everybody’s costs, or something?

Tags: enrollment, exchanges, Hawaii, insurers, ObamaCare, taxes

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Hawaiiponders:Itmightbetimetostart

Hawaii ponders: It might be time to start taxing insurers for not participating in our ObamaCare exchange

posted at 2:41 pm on March 11, 2014 by Erika Johnsen

Five months and approaching a coupla’ hundred million dollars in federal grants later, Hawaii still hasn’t made much progress on mending their terrifically botched ObamaCare exchange website, and the clock is ticking. With barely a few weeks to go until the open enrollment period ends (for now — I have very little faith that His Highness won’t issue another royal decree somehow extending that deadline, too), the state government is entering panic mode over their super-low enrollment figures and their definitive lack of a long-term financing plan for the exchange, which needs to be self-sustaining by the start of 2015. As of mid-February, only about 4,400 people were signed up for health insurance through ObamaCare — a rather conspicuous dip from the hundred thousand people Gov. Neil Abercrombie once predicted would hop to it:

The exchange had originally planned to stay afloat by collecting a 2% fee on every plan sold through the exchange, but with the slow pace of enrollment and changing federal rules — delaying the employer mandate and allowing canceled plans to continue — Interim Director Tom Matsuda said Wednesday that the math simply does not add up. …

Of the 100,000 uninsured in Hawaii, about half are expected to be eligible for Medicaid — meaning just 50,000 people would buy individual plans through the Health Connector under the best-case scenario. And while Hawaii hoped to sell thousands of plans through the exchange’s small-business marketplace, Matsuda said so few small businesses are eligible for tax credits that officials are simply not seeing the demand. “What people can get on the Connector versus outside the Connector is the same, so there isn’t really a strong incentive for small employers to use the Connector,” he said.

Further complicating matters, only two insurers offer plans on Hawaii’s exchange, so many companies are continuing to rely on their longtime brokers (who, having essentially been cut out of the process, have no incentive to help Hawaiians buy plans on the exchange).

Hence, Hawaiian legislators’ latest proposal to cover their bums includes a plan to start charging a “fee” to insurers that decided not to participate in the state’s exchange.

The fee would help prop up the financially troubled Hawaii Health Connector, which could run out of money to pay its bills by year’s end.

“This is not something we want to do,” said Rep. Angus McKelvey, chairman of the House Consumer Protection and Commerce Committee. “It’s federally mandated that we have to have our exchanges be sustainable.”

The unspecified fee would be charged by the state insurance commissioner until mid-2018, based on the number of people the carrier insures. …

The new insurance fee is part of a flurry of House proposals that were rolled into one overarching bill (HB 2529) now being considered by the Senate. …

A “fee,” i.e., slapping a tax on any insurer (and, subsequently, its customers) that decided it was not in their company’s interest to participate in ObamaCare just yet. As the LA Times piece above notes, there are only two insurers currently participating in Hawaii’s exchange — meaning that, if the proposal passes, everybody else is going to have to pay to subsidize ObamaCare’s poor technical, logistical, and financial functionality in the state. And here I was, thinking that ObamaCare was supposed to improve the market and lower everybody’s costs, or something?

Tags: enrollment, exchanges, Hawaii, insurers, ObamaCare, taxes

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Source from: hotair

Hawaiiponders:Itmightbetimetostart

Hawaii ponders: It might be time to start taxing insurers for not participating in our ObamaCare exchange

posted at 2:41 pm on March 11, 2014 by Erika Johnsen

Five months and approaching a coupla’ hundred million dollars in federal grants later, Hawaii still hasn’t made much progress on mending their terrifically botched ObamaCare exchange website, and the clock is ticking. With barely a few weeks to go until the open enrollment period ends (for now — I have very little faith that His Highness won’t issue another royal decree somehow extending that deadline, too), the state government is entering panic mode over their super-low enrollment figures and their definitive lack of a long-term financing plan for the exchange, which needs to be self-sustaining by the start of 2015. As of mid-February, only about 4,400 people were signed up for health insurance through ObamaCare — a rather conspicuous dip from the hundred thousand people Gov. Neil Abercrombie once predicted would hop to it:

The exchange had originally planned to stay afloat by collecting a 2% fee on every plan sold through the exchange, but with the slow pace of enrollment and changing federal rules — delaying the employer mandate and allowing canceled plans to continue — Interim Director Tom Matsuda said Wednesday that the math simply does not add up. …

Of the 100,000 uninsured in Hawaii, about half are expected to be eligible for Medicaid — meaning just 50,000 people would buy individual plans through the Health Connector under the best-case scenario. And while Hawaii hoped to sell thousands of plans through the exchange’s small-business marketplace, Matsuda said so few small businesses are eligible for tax credits that officials are simply not seeing the demand. “What people can get on the Connector versus outside the Connector is the same, so there isn’t really a strong incentive for small employers to use the Connector,” he said.

Further complicating matters, only two insurers offer plans on Hawaii’s exchange, so many companies are continuing to rely on their longtime brokers (who, having essentially been cut out of the process, have no incentive to help Hawaiians buy plans on the exchange).

Hence, Hawaiian legislators’ latest proposal to cover their bums includes a plan to start charging a “fee” to insurers that decided not to participate in the state’s exchange.

The fee would help prop up the financially troubled Hawaii Health Connector, which could run out of money to pay its bills by year’s end.

“This is not something we want to do,” said Rep. Angus McKelvey, chairman of the House Consumer Protection and Commerce Committee. “It’s federally mandated that we have to have our exchanges be sustainable.”

The unspecified fee would be charged by the state insurance commissioner until mid-2018, based on the number of people the carrier insures. …

The new insurance fee is part of a flurry of House proposals that were rolled into one overarching bill (HB 2529) now being considered by the Senate. …

A “fee,” i.e., slapping a tax on any insurer (and, subsequently, its customers) that decided it was not in their company’s interest to participate in ObamaCare just yet. As the LA Times piece above notes, there are only two insurers currently participating in Hawaii’s exchange — meaning that, if the proposal passes, everybody else is going to have to pay to subsidize ObamaCare’s poor technical, logistical, and financial functionality in the state. And here I was, thinking that ObamaCare was supposed to improve the market and lower everybody’s costs, or something?

Tags: enrollment, exchanges, Hawaii, insurers, ObamaCare, taxes

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Source from: hotair

HHS:Why,no,wearenotmeasuringthe

HHS: Why, no, we are not measuring the very metric ObamaCare was passed to improve

posted at 8:31 pm on March 6, 2014 by Mary Katharine Ham

Allahpundit mentioned this in his earlier post, but I just want to emphasize it.

The federal government is not even measuring the very number ObamaCare was created to bring down. How many times did we hear 47 million uninsured? How many times did we hear it was necessary to pass a huge revamp of the entire system to insure them? Later we heard the prediction for how many of those 47 million we’ll actually insure is quite underwhelming. Now, we ask: Hey, how many of the uninsured are we actually insuring?

A: “That’s not a data point we are really collecting in any sort of systematic way.”

There is no clearer dereliction of duty for this law. They created an irresponsible reform behemoth, they failed to implement it responsibly, they spent irresponsible amounts of money building a bunch of exchanges that don’t work, and now they’re not even responsible enough to bother checking how much help or damage they’ve done with the most straightforward metric available.

They don’t care about how much of your money they spend and they don’t care about figuring out if they’re helping people with that money because they might have to admit to not caring about how much of your money they spend. This is why having government tackle complicated problems can be a problem in and of itself.

If only we could go back to the bad old days of the intolerable status quo.

Depressing:

There’s a lot we don’t know about how Obamacare enrollment is going. Apparently that’s also true even within the Obama administration.

Gary Cohen, the soon-to-be-former director of the main implementation office at the Health and Human Services Department, stopped by an insurance industry conference Thursday to offer an update on enrollment. The main points were familiar: People are signing up (about 4 million have picked a plan so far), and the administration is going all out to promote Obamacare over the last few weeks of the enrollment window.

But Cohen didn’t have much more to offer insurers—who need this to work just as much as the White House—on some of the biggest unknowns about the law’s progress:

How many uninsured people are signing up?

The Congressional Budget Office estimates that the health care law will reduce the number of uninsured people by about 24 million over the next few years, and that about 6 million previously uninsured people will gain coverage through the law’s exchanges this year. So, is enrollment on track to meet that goal? Overall enrollment is looking pretty decent, but how many of the people who have signed up were previously uninsured?

“That’s not a data point that we are really collecting in any sort of systematic way,” Cohen told the insurance-industry crowd on Thursday when asked how many of the roughly 4 million enrollees were previously uninsured.

New York state is collecting that data, and it says about 70 percent of its enrollees were not covered before, while about 30 percent are changing their coverage rather than gaining it.

How many people signed up directly with insurers?

When HealthCare.gov was broken in October and November, HHS and insurers agreed on “direct enrollment” as a workaround—encouraging people to sign up directly with insurance companies. It’s also an option for people who are too wealthy to get a subsidy to help cover their premiums (the main benefit of using the exchanges), or who had a plan canceled and want to stick with the same carrier. Cohen was asked Thursday how many people have signed up outside the exchanges.

“I don’t think we have done anything to try to collect that sort of data,” he said.

This is the law’s purported raison detre, as we were told countless times. But they can’t even be bothered to count. It’s easier to claim you’re helping people when you refuse to collect data that might say otherwise.

Tags: exchanges, implementation, ObamaCare, state, uninsured

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Source from: hotair