Yep,NevadaisofficiallydroppingtheirstateObamaCare

Yep, Nevada is officially dropping their state ObamaCare exchange, too

posted at 8:01 pm on May 20, 2014 by Erika Johnsen

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After much apparent pleading from the contractor, Nevada made the decision to drop their individual ObamaCare website builder Xerox and is now the next state hitching its wagon to the federal online exchange. It all looked like it could have gone so well back in October, until users started trying to actually sign up for health insurance and began to uncover the more than 1,500 defects embedded in the site, according to a report from Deloitte last month, and the Silver State has finally realized that the situation cannot be salvaged any time soon — and certainly not in time for this year’s open enrollment period. Via the Las Vegas Review-Journal:

The board of the Silver State Health Insurance Exchange voted this morning to dump the contractor that botched the building of its Nevada Health Link website, and to move partly into the federal system for at least the next year.

The move would let the state exchange keep its autonomy and its member-based funding, and to allow the marketplace to switch to an operational website from another state for its 2016 enrollment period.

The change to a new system could cost as much as $57 million in addition to the $72 million contract the exchange already had with Xerox. But exchange officials said they’ve already applied for federal grants to cover the cost. Plus, the cost of buying another system may drop considerably by the time the exchange is ready to go forward in late 2015, state officials said.

The board’s decision ends a troubled, two-year relationship with Xerox, which fell woefully behind schedule on its Nevada Health Link build. The system debuted on Oct. 1 to hundreds of technical flaws and software glitches, and sign-ups have been held to about a third of the initial enrollment target of 118,000.

The board had been considering a number of options, including bringing in a third-party manager to work with Xerox, transferring to another state’s functioning system, or moving to the federal exchange permanently, but they ultimately landed on the above — and in all of their forethought, they have “already applied for federal grants” to cover the potential $57 million in added costs. …How lucky.

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Tags: exchange, federal, healthcare.gov, Nevada, ObamaCare, website

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MassachusettsexchangeisoverhaulingtheirObamaCareexchange,too

Massachusetts exchange is overhauling their ObamaCare exchange, too

posted at 6:41 pm on May 5, 2014 by Erika Johnsen

Late last month, Oregon finally decided to cut its losses and dump its disaster of an online ObamaCare exchange, becoming the first of the fourteen states plus D.C. that built their own individualized website to give their failed endeavor the ol’ heave-ho. Barely two weeks later, Massachusetts is almost following in Oregon’s footsteps, via the Boston Herald:

The Patrick administration will hire yet another outside company to try to salvage the state’s disastrous Obamacare website as it tries to avoid the embarrassment of a federal takeover.

Virginia-based hCentive — which has worked on the Colorado and Kentucky Obamacare exchanges — will develop software to fix the Bay State’s site by open enrollment in November, the Massachusetts Health Connector announced. …

The Health Connector did not disclose a price tag for the hiring of hCentive or the cost of the entire project, or how it would be paid for. The state has received $180 million in federal grants to build the state exchange, and it’s unclear whether Massachusetts will ask for more money from the Centers for Medicare & Medicaid Services.

“At this point, I don’t think anyone’s concerned about the price,” said the Connector official. “They just think Uncle CMS is going to pay for it.”

Massachusetts’ exchange website was all kinds of problematic, with its own unique set of glitches requiring time-consuming manual workarounds and putting applicants for subsidized insurance plans into temporary Medicaid holding patterns, all of which slowed down their transition from their state-run healthcare system to fulfilling ObamaCare’s requirements:

The Massachusetts Health Connector website, the state’s version of a health insurance exchange implemented under the national Affordable Care Act, has been plagued with glitches since it became operational in October. …

According to the Health Connector, the automated determination process, through which the Connector figures out what subsidy someone is eligible for and what insurance program they should be in, has not worked. There have been problems in account creation log-in, slow performance, time-outs and sporadic error messages.
Viewpoint: Don’t expect Health Connector to work when you’re expecting

State officials have created workarounds to get people enrolled in insurance plans – using paper applications, call centers and multiple computer systems rather than the automated online system that the state contracted with technology vendor CGI to build.

CGI, you might remember, was also the creator of HealthCare.Gov, but now Massachusetts is ditching the contractor to hire hCentive in a last-ditch effort to salvage things with new software. At the same time, they’re going to be laying the groundwork for joining the federal website, lest they fail to get things fixed before November and the need arise — any bets on that one?

Tags: blue, exchange, health care, Massachusetts, ObamaCare, Oregon, website

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Quotesoftheday postedat8:01

Quotes of the day

posted at 8:01 pm on April 11, 2014 by Allahpundit

There’s a brute test of a policy: If you knew then what you know now, would you do it? I will never forget a conversation in 2006 or thereabouts with a passionate and eloquent supporter of the decision to go into Iraq. We had been having this conversation for years, he a stalwart who would highlight every optimistic sign, every good glimmering. He argued always for the rightness of the administration’s decision. I would share my disquiet, my doubts, finally my skepticism. One night over dinner I asked him, in passing, “If we had it to do over again, should we have gone in? would you support it?”

And he said, “Of course not!”

Which told me everything.

There are very, very few Democrats who would do ObamaCare over again. Some would do something different, but they wouldn’t do this. The cost of the blunder has been too high in terms of policy and politics.

***

During the darkest days of the website meltdown, Obama made it clear to those who asked that it was crucial for him not to fire any high-ranking administration officials. Sebelius and McDonough both reasonably feared they would be shown the door.

Numerous business executives, even those who wish Obama well, criticized Obama publicly and privately for failing to “hold someone accountable” and using the power of a bureaucratic beheading to demonstrate his fury. Whether this is a sign of strength or weakness, it is characteristically Obama…

In ways they’ve never discussed before, senior administration officials now admit they feared late last fall that the entire law might collapse under the weight of Democratic defections and aggressive Republican calls for repeal.

***

Sebelius brought two main assets to her job. She had experience regulating insurers and, as a successful Democrat in Kansas, she knew how to work with Republicans. But what Obamacare needed more was a deft, aggressive manager. Case in point: By all accounts, Sebelius did not grasp the severity of tech problems at healthcare.gov until the day it went live and crashed. If she got the warnings, then she should have heeded them. If she didn’t get the warnings, then she should have appointed people who would have kept her better informed. Either way, that’s a serious management failure.

Still, it’s not as if Obamacare’s implementation difficulties are entirely, or even mostly, the fault of HHS. It’s a typical, if predictable, failure of Washington to demand a fall guy when things go wrong. But responsibility rarely lies with just one person. (That’s one reason Obama resisted calls to fire her.) And this case is no exception.

Implementing Obamacare was never going to be easy. The law is full of compromises that, however politically necessary, weakened regulations and depleted funding that would have made introducing the new insurance system a lot easier. And Sebelius never had the kind of control a chief executive officer would. She was always dealing with a host of other players—from superiors at the White House to underlings at the Center for Medicare and Medicaid Services (CMS) to Democrats on Capitol Hill to lobbyists for the health care industry. And that’s to say nothing of her war with the congressional Republicans, who were trying actively to sabotage the law through repeal votes, funding cuts, and intimidation of would-be allies.

***

But I will say this. Behind the scenes, they did get to work. I could tell just from the way people talked, the things they said were happening there, that it really was getting better. They were (and I guess still are) sitting on this battery of IT stats about response times and how long a person had to wait to be logged in and so on and so forth, and those were being cut quickly. So Sebelius and the rescue team really did do their jobs once they were up against the wall.

Think of it this way. Did you think, last fall, that they’d actually hit the 7 million? Did you think they’d even come close? In a year-end column I wrote with my 2014 predictions, I said they’d make 5.8 million. And I thought that would be respectable. The latest report is that they’re approaching 7.5 million. So yes, there was utter failure. But there was one hell of a nice recovery. As time goes on, I think Sebelius will start getting less blame for the former, and more credit for the latter.

***

In a sense, the development of the Obamacare website offered a window into the thinking behind the program as a whole. The federal government spent three years building a system in an intensely centralized and consolidated way (refusing even to hand over the basic project management tasks) that is characteristic of the technocratic mindset of Obamacare’s larger approach to American health care. That system failed on launch and turned out to have been ill-designed, retrograde, and sclerotic. It seemed almost beyond repair, but a group of private sector engineers from Silicon Valley firms were able to come in at the lowest point in the crisis and essentially do in six weeks what the government couldn’t do in three years (and was probably never going to be able to do). And yet somehow, the president and others are trying to have people draw from this the lesson that the government actually can handle huge, complicated projects well after all…

Now, as the new insurance arrangements created by the law begin their real-world trials, Democrats argue that the fact that the system survived its earliest self-inflicted wounds should end all debate about its prospects.

That seems a pretty odd conclusion to draw from the past six months.

***

The pressure for further health care reform to “fix” Obamacare’s mess is already rising, and that political pressure will actually increase given the number of people enrolled in either plans they view as too expensive or in Medicaid programs which strain state budgets and fail to deliver access to care. The more those costs burden states and working families with higher costs, worse coverage, and restricted access, the louder the clamor to pass further reforms. Every candidate in 2016 is going to have a health care plan, and the people will decide which direction they want to go.

Why on earth do some on the left think Obamacare ended the health care reform process? There is no end zone in which to spike this football. And when the 2014 election is through, we can really start talking about what big health care reform is going to come next.

***

From the outside, then, Sebelius mostly seemed to play the role of a glorified flack for the president’s health care policies, dutifully making the rounds and mouthing talking points as necessary. And she wasn’t even good at this. Her responses at congressional hearings were so canned that they might have come from a phone-mail system, and they occasionally revealed that she didn’t quite know what she was talking about. Her speeches were ho-hum pablum, when they weren’t being quietly edited after the fact due to unverifiable claims.When she went on offense during the 2012 campaign, she was often wrong or misleading. She engaged in ethically dubious fundraising for outside groups that support Obamacare.

In the last few months, as a spokesperson for the health law, she’s made a fool of herself and the administration. She kicked off the launch of the exchanges with a disastrous, embarrassing interview on The Daily Show, hosted insurance sign-up events where no one could sign up for insurance, and responded to basic questions about Obamacare’s continued poor poll numbers with blank silence. Fitting, I suppose, given that Sebelius has never been one for worthwhile answers.

Maybe—probably—Sebelius doesn’t deserve all or even the majority of the blame for the administration’s health law screw-ups. But regardless of her impact, as the most visible official associated with the law aside from President Obama, she deserved to be shown the door—or at least be given the opportunity to show herself out.

***

Supporters of The Affordable Care Act are quick to brush aside the early problems with implementing the president’s “signature legislative achievement” as old news. “Kathleen Sebelius is resigning because Obamacare has won,” crows Ezra Klein at Vox, the new “deep journalism” website that is supposed to be beyond ideology. But, in fact, Sebelius is hustling out of town before any of the most important questions about Obamacare have been answered.

Among them: Of the 7.1 million people who reportedly signed up for health care in the individual market, how many were previously uninsured? How many have actually paid for coverage? Are they the right mix of young and old, healthy and sick? We know none of this information, which is not simply incidental to whether Obamacare is “winning.”

Sebelius’s abrupt resignation, then, is the fitting capstone of a cabinet tenure that did nothing to inspire feelings of competency and trust in government in a century that is so far replete with revelations of bipartisan secret surveillance, financial mismanagement of the nation, and failed foreign policy.

We deserved better than Kathleen Sebelius.

***

Tags: Department of Health and Human Services, enrollment, health care, healthcare.gov, obama, ObamaCare, sebelius, sign up, website

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CoverOregon’schieftechofficialresigns;sitehas

Cover Oregon’s chief tech official resigns; site has signed up exactly zero people

posted at 3:31 pm on December 20, 2013 by Erika Johnsen

And another one bites the dust. The leaders of each of Minnesota, Maryland, and Hawaii’s state-run exchanges have all hit the road, and earlier this month, the executive director of Oregon’s own epically botched exchange announced he was taking an extended “medical leave.” Now, it looks like the next-in-line at Cover Oregon is getting the boot, too, via OregonLive:

Carolyn Lawson, the embattled state technology executive who oversaw much of the development of Oregon’s troubled health insurance exchange, has resigned for personal reasons.

It was Lawson, chief information officer at the Oregon Health Authority, who decided the state could manage the complex exchange project itself, rather than hire a private-sector systems integrator, a decision since criticized by her superiors. Lawson also was close to Oracle Corp., the California technology giant that has been blamed for doing shoddy work and repeatedly missing deadlines. …

As The Oregonian reported Sunday, the exchange has been plagued by poor work by Oracle. Miscues by state managers have also figured prominently in the exchange’s issues.

An August 2012 report from the project’s quality assurance contractor found the exchange project was disorganized, lacked basic management and budget controls to ensure contractor performance. The exchange’s fate was further endangered by distrust and lack of communication between Lawson’s Oregon Health Authority and Cover Oregon, the public corporation that took over responsibility for the exchange’s contracts in May 2013.

Oregon’s exchange has been plagued with entirely prohibitive glitches since day one, and nearing three months and $160 million Oregonian taxpayer dollars later, they haven’t managed to make the site even just barely functional. Back in mid-November, they predicted that they’d have the site finally ready to go by December 16th — and yet, lo and behold, that deadline has come and gone and their refreshed estimate is kicking the date back by weeks or even months. They do have signups trickling in via paper application (they had to make 400 emergency hires to process applications when they realized their website didn’t have a snowball’s chance in hell of making it off the ground anytime soon), but the back-and-forth required to sign up for health insurance means that’s a mighty slow, complex, and error-prone way to do things. At the last count, Oregon had only enrolled 730 people in private plans — ranking them dead last for signups in the nation. Ouch.

Tags: exchange, health care, insurance, ObamaCare, Oregon, technology, website

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Totalnumberofone-on-onemeetingsbetweenObamaand

Total number of one-on-one meetings between Obama and Sebelius since ObamaCare was passed: One

posted at 10:31 am on December 6, 2013 by Allahpundit

Actually, says Peter Schweizer, the number is zero, but he’s crediting O for having once met with Sebelius and a single other cabinet member. More than three and a half years ago.

Remember, this is the same guy who said recently of the website, “We’re evaluating why it is exactly that I didn’t know soon enough that it wasn’t going to work the way it needed to.” A possible clue:

A new Government Accountability Institute (GAI) analysis finds that from July 12, 2010, to Nov. 30, 2013, the president’s public schedule records zero one-on-one meetings between Obama and Sebelius. Equally shocking, over the same period, the president’s calendar lists 277 private meetings with his other Cabinet secretaries (excluding full Cabinet meetings).

Given these startling findings, and the fact that the White House calendar did not reflect meetings prior to July 12, 2010, GAI researchers then performed a second analysis using another respected recorder of presidential activity, the POLITICO presidential calendar. The results: Just one April 21, 2010 entry was found listing a White House meeting between Obama and Sebelius—and even that was a joint meeting with then Treasury Secretary Timothy Geithner…

To be sure, presidents exchange emails and phone calls that are not recorded on White House calendars. Still, why would the White House calendar list by name one-on-one meetings with 16 other Cabinet secretaries but omit Sebelius if other meetings with her occurred? Wouldn’t Obama want to catalog for all to see his personal devotion to the law that bears his name?

Schweizer wonders whether O and his deputies deliberately kept Sebelius away just in case the project went to hell, so that Obama could plead ignorance later as a defense to the charge of gross incomptence. That was my first hunch too, but why would they have taken that approach so soon after the law was passed? If they were trying to quarantine Sebelius, I would assume they’d have done it once the first signs of development problems started showing, not a month after he signed the bill. There had to be some period, certainly longer than a month, where he was optimistic that this rocket could get off the launch pad.

Regardless, the irony of Schweizer’s piece is that it’ll ultimately prove more useful to the left than to the right. Liberals will sneer at him for it today, dismissing the lack of personal interaction between O and S as irrelevant and typical of how modern bureaucracies work. Obama’s their guy for the next three years so they’ll do what it takes to defend him. Three years from now, though, assuming O-Care’s still on the books and groggily stumbling along, they’ll point back to this piece as evidence that the real problem isn’t the law, it was Obama’s odd passivity and disengagement. A more proactive executive — like, say, Hillary Clinton — would have made time for Sebelius every day. Watch and see.

Via RCP, here’s video of the one pitch that Matthews threw him in yesterday’s interview that had a little heat on it. Simple question: Do you have “strong top-down authority”? What is it about your management system that would allow the website problem to snowball? Key bit from O’s reply:

Generally speaking, my theory has been, number one, that yes, I’ve got a strong Chief of Staff but I’m holding every cabinet member accountable and I want to have strong interactions with them, directly. Number two, is I have an open door policy where I want people bringing me bad news on time so that we can fix things. And, you know, the challenge, I think, that we have going forward is not so much my personal management style or particular issues around White House organization. It actually has to do with what I referred to earlier which is we had these big agencies, some of which are outdated.

He’s a hands-on manager saddled with a bloated bureaucracy who craves direct problem-solving interaction with his subordinates. And also, he met alone with his quarterback on ObamaCare once in three and a half years. What?

Tags: Department of Health and Human Services, exchange, gai, healthcare.gov, meeting, obama, ObamaCare, schweizer, sebelius, website

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Quotes of the day

Quotesoftheday postedat10:41

Sebelius: On second thought, we probably shouldn’t have launched that ObamaCare website on October 1

Sebelius:Onsecondthought,weprobablyshouldn’thave

Uh oh: Carney won’t say specifically whether Obama knew about Healthcare.gov’s problems back in March

Uhoh:Carneywon’tsayspecificallywhetherObama

NYT:Morethan50,000have“selected”anObamaCare

NYT: More than 50,000 have “selected” an ObamaCare plan on the federal website as of mid-November

posted at 4:41 pm on November 19, 2013 by Allahpundit

I initially wrote “enrolled” in the headline instead of “selected” but then I remembered that HHS wants to count people who’ve placed a plan in their virtual shopping cart on Healthcare.gov but haven’t proceeded to checkout as enrollees too. It pays to be precise with language when the White House is as slippery as it is. Maybe they mean 50,000 enrollees, or maybe they merely mean 50,000 prospective/potential/possible squint-hard-and-it’ll-look-like-an-enrollee enrollees.

Either way, if I’m reading this correctly, the 50,000 figure represents the grand total of people who’ve, ahem, selected a plan since the website went live on October 1. That’s improvement — it means that 23,000 or so made a selection on Healthcare.gov in the first two weeks of November, nearly equalling the total for all of October — but they’re still way, way off the pace.

The latest evidence detailing the Web site’s troubled startup came amid signs of progress in repairing it. As of mid-November, more than 50,000 people had selected an insurance plan — up from 27,000 in the entire month of October, people working on the project said.

That is still a fraction of the number the administration had hoped for. And specialists plowing through an initial list of more than 600 software and hardware defects remain worried about whether they can meet the administration’s goal of enabling four in five users to enroll through the online federal exchange, HealthCare.gov, by Nov. 30. One person said a more realistic goal was that four out of five people “have a positive experience,” which could include being redirected to customer service agents.

Remember, per Henry Chao, it’s the front end of the site where people sign up that’s in comparatively good shape.

The federal target for enrollments through November is 700,000, which means they’ll be lucky to be a quarter of the way there by December 1 given the current rate of enrollment plan “selection.” On the other hand, things are looking up on the state exchanges:

Despite the disastrous rollout of the federal government’s healthcare website, enrollment is surging in many states as tens of thousands of consumers sign up for insurance plans made available by President Obama’s health law.

A number of states that use their own systems, including California, are on track to hit enrollment targets for 2014 because of a sharp increase in November, according to state officials.

“What we are seeing is incredible momentum,” said Peter Lee, director of Covered California, the nation’s largest state insurance marketplace, which accounted for a third of all enrollments nationally in October. California — which enrolled about 31,000 people in health plans last month — nearly doubled that in the first two weeks of this month.

Several other states, including Connecticut and Kentucky, are outpacing their enrollment estimates, even as states that depend on the federal website lag far behind.

The “incredible momentum” in California comes courtesy of no fewer than a million plans being canceled there to move customers in the individual market onto the O-Care exchange. If the LA Times’s numbers are right, no more than 10 percent of that number have now enrolled in a more “comprehensive,” quite possibly more expensive ObamaCare plan. California was, in fact, one of the state exchange success stories in October too: 35,364 people had “selected” an exchange plan as of November 2nd — despite a first-month enrollment target of 91,000. That put them just 39 percent of the way to their goal, and yet that was still the fifth-highest rate in the country thanks to the Healthcare.gov catastrophe and independent tech problems on some of the state exchanges themselves.

But look: Even the clown show at HHS will, given enough time, pull its act together and get the federal website running. Enrollments will increase; the mandate and its attendant penalty will see to it. The threshold question is whether they’ll reach sufficient volume by next summer to avert premium hikes in 2015 and/or a partial federal bailout of the industry designed to indemnify them from losses caused by early adverse selection problems. The best-case scenario for Democrats is that “young healthies” answer the bell en masse starting next month; that, at least, might spare them the dilemma of whether to pass Jeanne Shaheen’s bill extending next year’s enrollment period, which would only make the odds of adverse selection worse. Assuming all goes well for the rest of this year and the start of the next, the “only” ObamaCare problems they’ll have to face are access shock, a new round of rate shock over deductibles and co-pays, grumbling from people who are forced to pay the penalty in April because they didn’t enroll, and then the grand dumping of small-business employees onto the exchanges next fall. That’s what “success” looks like for the White House.

Tags: enrollment, healthcare.gov, obama, ObamaCare, quota, sebelius, target, website

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Quotes of the day

Quotesoftheday postedat10:41

Openthread:SebeliustoannounceObamaCareenrollment

Open thread: Sebelius to announce ObamaCare enrollment figures for October at 3:30 ET; Update: 106,185

posted at 3:11 pm on November 13, 2013 by Allahpundit

Don’t bother turning on cable news. She’s doing this on a conference call, not in front of the cameras, presumably to minimize the embarrassment.

And it will be embarrassing.

"I promise you no one will be satisfied" with the enrollment numbers to be announced today, says @PressSec

— Mark Knoller (@markknoller) November 13, 2013

Sources told the Wall Street Journal last week that there were 50,000 or so enrollments through the federal exchange as of November 10, which, as Bob Laszewski pointed out a few nights ago, averages out to something like 50 enrollees per day in each of the 36 states served by Healthcare.gov. (Another 50,000 or so had enrolled on the various state exchanges at the time of the Journal report.) There’s no real suspense about the topline number; the suspense lies in whether Sebelius will offer any demographic breakdown of the data. How many of the 50-60,000 who have signed up are people with preexisting conditions? How many are low-income and need significant subsidies? ObamaCare will succeed or fail depending upon how many “young healthies” can be persuaded or coerced into signing up. How are they doing with that group?

ObamaCare supporter Jonathan Cohn says it’s time to start thinking unhappy thoughts about back-up plans just in case, as expected, Healthcare.gov isn’t ready to ramp up on December 1. None of the available options are good ones, though; if you missed my own post on “Plan B,” you can read it here. Even if they do get the front end working more or less efficiently, there are still back-end problems lurking:

Nijhawan also touched on a problem that has yet to be widely addressed. He said the exchanges that are expected to allow insurance companies to share information with the federal government are not close to being ready. Without this information, CMS would not know who enrolled in the plans.

“As soon as these enrollment issues get ironed out either by December or March, you have other issues relating to the back end, where there’s a lot of reconciliation that needs to be done between health care and CMS,” Nijhawan said.

When asked why these exchanges weren’t completed before the rollout, he said, “They were trying to desperately get ready for the rollout.”

It never ends. One other footnote about the enrollment data while we wait for Sebelius: Remember, their definition of what qualifies as an “enrollment” will include people who placed an insurance plan in their virtual shopping cart on Healthcare.gov but who, for various reasons, never actually proceeded to checkout. How many of those consumers intended to buy the plans but were sabotaged by a system glitch and how many had second thoughts after putting the plan in their cart and never intended to buy it at all? Watch Jason Chaffetz have some fun with the White House’s chief tech officer on that point at today’s House hearing. Exit question via Greg Pollowitz: Do Obama and Pelosi care whether House Democrats take a beating over this in the midterms? They passed ObamaCare knowing that it could mean an electoral wipeout. Why wouldn’t they stick by it now knowing that it might mean another one?

Update: The Journal’s sources claimed 50,000 had enrolled via the federal exchange and 50,000 on the state exchanges. They got the proportions wrong but the sum almost correct:

JUST IN: 26,794 people bought insurance on http://t.co/5P8uZYqqLk in 1st month, feds say; nearly 80,000 more signed up on state marketplaces

— NBC News (@NBCNews) November 13, 2013

To put that another way, over the 31 days of October, each of the 36 states served by Healthcare.gov managed to enroll … 24 people per day. Not surprisingly, the federal welfare component of ObamaCare, which doesn’t rely on stone-age technology, did much better:

HHS: 396,261 Americans have been determined or assessed eligible for Medicaid or CHIP

— Philip Klein (@philipaklein) November 13, 2013

The target for total ObamaCare enrollments in October (not including Medicaid) was just shy of 500,000. They got slightly more than 20 percent of the way there.

Tags: applicants, conference call, Department of Health and Human Services, enrollment, glitch, healthcare.gov, Medicaid, ObamaCare, sebelius, website

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WaPo:HealthCare.Gov,workingbytheendofNovember?

WaPo: HealthCare.Gov, working by the end of November? Yeah, about that…

posted at 8:41 am on November 13, 2013 by Erika Johnsen

A few weeks ago, the Obama administration blithely imposed upon themselves a deadline of November 30th as the target date by which HealthCare.Gov’s many prohibitive glitches positively should be and absolutely would be finally worked out:

“We are confident that by the end of the month of November, HealthCare.gov will operate smoothly,” said Jeff Zients, the former White House budget director tasked with finding a way to get the enrollment process back on track. He said a group of technology experts has developed a “punch list” of problems they need to fix in order to get HealthCare.gov on track. At the top of the list, he said, are problems with the information the site is feeding to insurance companies.

If [very] recent history is any indication, however, the Obama administration doesn’t really have much of a problem making promises they are egregiously well aware they have no way of keeping, and they seem to be well-poised to take yet another ObamaCare-related egg to the face. The evidence has been mounting that the website still won’t be ready after a full two months into the (as yet) six-month enrollment period, and the Washington Post has another report out on that front:

Software problems with the federal online health insurance marketplace, especially in handling high volumes, are proving so stubborn that the system is unlikely to work fully by the end of the month as the White House has promised, according to an official with knowledge of the project.

The insurance exchange is balking when more than 20,000 to 30,000 people attempt to use it at the same time — about half its intended capacity, said the official, who spoke on the condition of anonymity to disclose internal information. And CGI Federal, the main contractor that built the site, has succeeded in repairing only about six of every 10 of the defects it has addressed so far. …

Government workers and tech­nical contractors racing to repair the Web site have concluded, the official said, that the only way for large numbers of Americans to enroll in the health-care plans soon is by using other means so that the online system isn’t overburdened.

Ruh, roh.

Zients mentioned above that one of the biggest problems still plaguing the site is successfully feeding the inputted information to insurance companies, and in that same vein, as Politico reports, that transferring problem has some mightily inconvenient implications for the one part of ObamaCare actually showing signs of life: Medicaid signups. If the system was working like it’s supposed to, Medicaid applications submitted via HealthCare.Gov would be getting approved by the federal government and then transmitted to the states, who would then finalize them and begin coverage for new enrollees on January 1st. …Except that the system isn’t working.

But HealthCare.gov hasn’t begun transferring those applications yet. The Obama administration has delayed the process twice and hasn’t made public a new start date. If it’s not up and running by December, several state Medicaid officials meeting in Washington warned Tuesday, those would-be enrollees might miss the start of new coverage.

And they might not even know it until they show up at a clinic or a doctor’s office or a hospital and try to get care. After all, they had signed up — and wouldn’t necessarily know they were caught in another Obamacare glitch. …

Obama administration Medicaid chief Cindy Mann told reporters Tuesday that her agency is actively working with states to get the application transfer online.

“We’ve been testing those systems with states and hopefully soon we’ll be able to do the full account transfers,” she said.

Tags: Democrats, glitches, healthcare.gov, insurance, Obama administration, ObamaCare, technology, website

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Breaking:Fewerthan50,000peoplehaveenrolledin

Breaking: Fewer than 50,000 people have enrolled in health plans via ObamaCare website thus far, says WSJ

posted at 5:41 pm on November 11, 2013 by Allahpundit

Add in another 50,000 people or so who’ve signed up on the individual state exchanges and you’ve got roughly 100,000 total enrollees through all of October and 10 days of November. The program’s target for October alone was 494,620. And that figure represents what they thought would be a “slow” month, as the public gradually got up to speed on the need to sign up before December 15th. If you’re looking at the bigger picture, they’re aiming for seven million new enrollees by March 31 of next year. They’re 1.4 percent of the way there with almost 25 percent of the initial enrollment period having already elapsed.

They’re in trouble.

So far, private health plans have received enrollment data for 40,000 to 50,000 users of the federal marketplace, the people familiar with the figures said. The federal marketplace uses an industry-standard format to exchange enrollment information, known as an 834 transmission…

In some cases, insurers have reported duplicated 834s and other data-integrity problems, but the people familiar with the matter said they believed these figures reflected an accurate count of enrollments through late last week…

The initial federal numbers set for release this week are expected to show enrollment only through the end of October, so the figures are expected to be lower. Efforts to clean up the data and reduce duplications could further cull the formal count.…

The administration hasn’t said whether it will release demographic data such as ages when it announces the number of enrollees.

Fearless prediction: They’re not going to release the demographic data. The only way to make these numbers look more dismal than they are is if it turns out that many, or even most, of the 100,000 who’ve enrolled are older people or people with preexisting conditions. Which, in fairness to the feds, was always likely to be the case in the first weeks after launching the exchange, even if things had gone swimmingly with the website otherwise. It stands to reason that the people most eager to get coverage are those who’ve been locked out of it or been paying higher premiums in the past. It’s one thing to make that point, though, when you’ve got 500,000 new enrollees on the books and can cite such a robust figure as proof that the “young healthies” are out there and are on their way into the risk pool. It’s another to make that point when you’ve got one-tenth that number, which means a skewed pool and circumstantial evidence that maybe the “young healthies” have now been discouraged from even trying to sign up. In fact, the Journal published a story just a week ago quoting insurers as saying the early enrollees thus far are older than they expected. If, for the reason I just gave, they were already expecting an older, sicker crop among the early enrollees, how much older and sicker must the data they’re seeing be for them to be surprised at the extent of it?

Peter Suderman says it’s time to start thinking about worst-case scenarios:

The potential problems are not confined to the near term either. Very soon, the short-term technical troubles could begin to have meaningful longer-term policy consequences. Insurers must decide what plans to offer and what rates to charge in the first half of next year. If enrollment is low, if the exchanges are still broken, and if the president and his administration are still losing credibility and popularity as a result of the rollout debacle, how will insurers react? By pulling plans from the market? By raising rates?…

This could still be turned around, perhaps even soon. But it’s time to start considering the worst-case scenarios: that the exchanges continue to malfunction, that plan cancellations go into effect, that insurers see the political winds shifting and stop playing nice with the administration, and that significant numbers of people are left stranded without coverage as a result. Rather than reforming the individual market, which was flawed but did work for some people, Obamacare will have destroyed it and left only dysfunction and chaos in its wake.

Yuval Levin said not long ago that you can’t start talking about a “death spiral” until things have actually spiraled — not just higher rates next year, in other words, but higher rates year after year as the cost of maintaining coverage becomes prohibitively expensive for more and more middle class people and they end up dropping it, leaving only older, sicker people in the pool. As Suderman notes, if low enrollment persists into the spring and the 2015 rates are set based on that data, we might have our first full downward turn in the spiral. Exit question: How long before Obama announces some sort of extension of next year’s enrollment deadline? Over/under is Friday.

Tags: Department of Health and Human Services, enroll, enrollment, healthcare.gov, obama, preexisting conditions, sebelius, subsidy, website

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Source from: hotair

Quotesoftheday postedat9:01

Quotes of the day

posted at 9:01 pm on November 9, 2013 by Allahpundit

The setting is the February of 2010 health care summit with Republicans. Minority Whip Eric Cantor is addressing the president directly on the issue of people losing their insurance due to the Affordable Care Act:

CANTOR: …Because I don’t think you can answer the question in the positive to say that people will be able to maintain their coverage, people will be able to see the doctors they want, in the kind of bill that you are proposing:

OBAMA: Since you asked me a question, let me respond. The 8 to 9 million people you refer to that might have to change their coverage — keep in mind out of the 300 million Americans that we are talking about — would be folks who the CBO, the Congressional Budget Office, estimates would find the deal in the exchange better — would be a better deal. So, yes, they would change coverage because they got more choice and competition.

***

Obama insisted anew Thursday that the problem is limited to people who buy their own insurance. “We’re talking about 5 percent of the population who are in what’s called the individual market. They’re out there buying health insurance on their own,” he told NBC.

But a closer examination finds that the number of people who have plans changing, or have already changed, could be between 34 million to 52 million. That’s because many employer-provided insurance plans also could change, not just individually purchased insurance plans

Administration officials decline to say how many employer-sponsored plans could change. But those numbers could be between 23 million to 41 million, based on a McClatchy analysis of estimates offered by the Department of Health and Human Services in June 2010.

***

The nation’s largest health insurer, UnitedHealthcare, claims the Affordable Care Act is responsible for forcing it to boot doctors from its Medicare Advantage program that serves thousands of elderly patients in the New York metro region.

CEO Jack Larsen, under fire for separating seniors from their MDs, took out full-page ads to explain that cuts in Medicare spending forced the ­insurer’s hand.

“We are working to collaborate with a more focused network of physicians to help us provide higher quality and more affordable health care coverage to meet the needs of our members, and help them get more from their health plan benefits,” Larsen said.

“This work has become even more urgent in light of the severe funding reductions for Medicare Advantage plans that have come from Washington.”

***

Why is this an immediate challenge? Because the hundreds of insurers offering plans on the federal exchange will begin pricing for 2015 in just a few months. Their chief financial officers should be sweating bullets about the obstacles that HealthCare.gov’s glitches have put in the path of enrollees. Fortunately, October was an early shopping month, mainly for browsing and for those who are sick and highly motivated to get coverage. It wasn’t an important month for enrolling the “young invincibles” — uninsured young people who don’t think they need health care — who will subsidize older, sicker enrollees. But the longer HealthCare.gov remains clogged, the more young invincibles will be discouraged from joining. If that happens, enrollment in the 36 states using the federal exchange will resemble small, high-risk insurance pools composed mainly of the sick — potentially causing premiums to soar in 2015.

Insurers must set rates for 2015 in some states by the end of February, and in most states before June. They can’t raise their rates on plans in the federal exchange now; their prices are locked in for next year. Nor can most carriers recoup any 2014 losses by raising premiums for 2015: Unless most competitors do the same, hiking premiums will chase away any healthy customers they have. But that is the imminent danger — a general rise in rates among health plans on the federal exchange.

The administration can try to head off the problem, or it can blame insurers after the fact. To convince skeptical CFOs that October 2014 will be very different from today, first the Web site and the information systems behind it must work. Additionally, the administration has to prove that it can effectively manage the world’s largest commercial health insurance store. And the president has only a few months to do so…

2015 is essentially here already.

***

Louisiana’s Mary Landrieu is hoping to cauterize that crisis with a bill that supposedly allows people to keep their plan if they stay current on premiums. About 80,000 Louisiana policy holders—or half of the individual market—will be dumped in 2014, according to the state’s insurance commissioner.

Here again, complex insurance contracts take months to plan financially and negotiate with providers. They could be renewed for maybe a few months but not forever, which is why the Landrieu bill is simply a new mandate ordering insurers to continue offering these plans. But the hard business truth is that these plans are already gone. The only way to solve the problem is a time machine to go back to 2010 when HHS published its deliberately restrictive rule on “grandfathering.”

The Shaheen and Landrieu proposals are merely ploys for these Democrats to distance themselves from ObamaCare while still embracing it. But they can’t have it both ways. Either they can vote to take down the whole regulate-subsidize-mandate apparatus for a year and propose major reforms to prevent a reprise of the last six weeks. Or else they will be enablers of the current and future disruptions, cancellations and limited health choices.

***

Administration officials scrambled Friday to find a quick fix to a problem President Obama said would never come about — millions of insurance policies canceled for people who have health plans they want to keep.

But as the controversy threatened Obama’s efforts to reassure fellow Democrats that he had things under control, administration officials and policy experts said they didn’t yet have a plan to solve the problem without further bogging down the president’s signature health reform plan…

Reinstating canceled policies would be a scramble for insurance companies, whose coverage plans need to be approved by state regulators — a process that can take months…

If millions more people can suddenly invoke the grandfather clause, said one analyst, that would change the assumptions insurers made when they calculated the premiums they are now offering in the marketplace…

If millions of people who have coverage now can keep it as long as they wish without complying with new rules, Claxton said, the healthiest of them will probably choose to do so — until they get sick and decide to cash in on the benefits of the new marketplace.

***

The administration has run out of political bullets. Unless the Affordable Care Act starts working, and delivering big benefits to more people than are losing their insurance, it can’t do much to improve those sagging poll numbers.

The second sign is that the president actually said he was sorry that some people had gotten the misimpression from him that they could keep their health insurance, when they were actually going to lose their policy and be forced to buy a more expensive one. Conservatives may complain that the apology was inadequate, since the president did not admit that he’d misled people. But this is the first time I can remember this president apologizing like this. It may be sincere. It is also a sign that his administration is backed into a corner. It can’t deny that this is happening, nor can it blame anyone else. What’s left to it are expressions of regret.

Politico reports that the president has also ordered aides to explore administrative fixes for people who are going to be made financially worse off by their cancelled policies. This would probably involve grandfathering all the existing plans. That will create chaos, and may leave the exchanges with a poorer and sicker pool of the folks who couldn’t buy insurance before. It would also mean conceding that the administration made a grave mistake when it drew the regulations for grandfathered plans so narrowly.

But until the exchanges start working, this is all the Obama administration has in the political arsenal. It may not be enough.

***

Barack Obama is guilty of fraud — serial fraud — that is orders of magnitude more serious than frauds the Justice Department routinely prosecutes, and that courts punish harshly. The victims will be out billions of dollars, quite apart from other anxiety and disruption that will befall them.

The president will not be prosecuted, of course, but that is immaterial. As discussed here before, the remedy for profound presidential corruption is political, not legal. It is impeachment and removal. “High crimes and misdemeanors” — the Constitution’s predicate for impeachment — need not be indictable offenses under the criminal code. “They relate chiefly,” Hamilton explained in Federalist No. 65, “to injuries done immediately to the society itself.” They involve scandalous breaches of the public trust by officials in whom solemn fiduciary duties are reposed — like a president who looks Americans in the eye and declares, repeatedly, that they can keep their health insurance plans . . . even as he studiously orchestrates the regulatory termination of those plans; even as he shifts blame to the insurance companies for his malfeasance — just as he shifted blame to a hapless video producer for his shocking dereliction of duty during the Benghazi massacre.

It is highly unlikely that Barack Obama will ever be impeached. It is certain that he will never again be trusted. Republicans and sensible Democrats take heed: The nation may not have the stomach to remove a charlatan, but the nation knows he is a charlatan. The American people will not think twice about taking out their frustration and mounting anger on those who collaborate in his schemes.

***

Obama had to have a great deal of contempt for the American people to think he could pull this off without consequence, just as he needed it in the first place to think he could push the bill through against the will of the country without repercussions that were entirely justified. Some of his flacks have used the word “sabotage” to describe the choice of many governors not to set up state exchanges, ignoring the fact that these acts are (a) entirely legal and (b) represent exactly the sort of judgment governors are elected to make.

“Sabotage” hardly describes this—it is called politics—and it hardly describes the train of disasters that is in the process of self-repealing this program. The website is broken, and not likely to be fixed quickly. The people who have persevered and managed to enroll are mainly 50 and over or younger people who are going on Medicaid. Furious voters are besieging their elected representatives. Democrats, especially those running in 2014, must fear facing opponents quoting Edie Littlefield Sundby. Obama is a lame duck with an approval rating now around 40, and he can no longer save them.

However this ends, it will not go well for this president. He built it. He owns it. And now it’s all his.

***

“I really just wanted him to know … I was so hopeful that this plan was going to move us forward, but in fact I think it’s moving us backward.”

***

Via the Daily Caller.

***

This is what betrayal looks like.

Here you have hardworking people who were repeatedly told not to worry, that their coverage would stay the same and—if anything—their costs would go down. Just the opposite is happening…

That’s why I’ve authored a bill to delay this law’s individual mandate tax – as has the senior senator in our state, Dan Coats. After all, how can you tax people for not buying a product from a website that doesn’t work?

Tags: coverage, Department of Health and Human Services, doctors, healthcare.gov, industry, insurance, obama, ObamaCare, premiums, website

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Source from: hotair