Friday, November 22, 2013

ObamaCare news November 22 -24 , 2013 - Word of the Day - Delay ! As in : New delay: Deadline for ObamaCare enrollment moved back from December 15th to 23rd .... And : HHS delays 2015 enrollment to … just past the midterm elections ...... And how many people have actually ' enrolled " - well it true " enrollment involves following CMS guidelines which requirement payment of the first premium , the answer cannot be 106 ,000 . Since we have also heard the back end has not yet been built , is the correct answer ZERO ? Speaking of ZEROS , did HHS officials commit perjury or obstruction of Congress in their testimony before Congress ( CNN breaks story " Anonymous shopper " function was functional , despite testimony by Henry Chao to the contrary ) ..... Direct enrollment by insurance companies next desperate hail mary pass ? Any questions that won't be fixed anytime in the near term ? Florida , Texas and Ohio will take part in pilot hail mary pass program in the hope that something works right ! Will anyone mention to potential direct enrollees that if they go this route , forget getting a subsidy ?


New delay: Deadline for ObamaCare enrollment moved back from December 15th to 23rd


They continue to insist that they’re on track for “major improvement” or whatever to the website by November 30th, but if it was as major as they’d hoped, they never would have resorted to this. A little heads up for our twentysomething readers: In case you haven’t decided yet what you’ll be buying with the cash you get for Christmas, good news — Obama and the insurance industry have decided for you.
Wait a sec. I thought the reason they set December 15th as the deadline for enrolling if you want your new coverage to start on New Year’s Day is because it takes insurers at least two weeks to process an application. If they’re now pushing the deadline back a week to give people more time to enroll, that leaves insurers with just eight days to turn applications around — assuming that the applicant info they receive from is readable in the first place. How are they going to do that? They’re … not sure:
Asked via email whether this change complicates matters for insurers, Robert Zirkelbach spokesman for the insurance industry group America’s Health Insurance Plans, responded, “It makes it more challenging to process enrollments in time for coverage to begin on January 1. Ultimately it will depend on how many people enroll in those last few days. It is also important to keep in mind that consumers need to pay their first month’s premium before their coverage can begin.”
Did the White House even … consult with the industry about whether they can manage a new deadline of December 23rd? I ask because, according to several reports, Obama didn’t consult with them before announcing last week that he was going to let them un-cancel plans. Some of them, in fact, had spent the days leading up to his White House presser assuring people that there was no way, no how, no chance dead plans would or could be resurrected. I asked Philip Klein, who listened in on CMS’s conference call today, whether anyone brought that up. Ahem:
  1. @philipaklein Did they even ask insurers in advance if this new timeline is feasible?
@allahpundit On the call, somebody asked, and CMS spox just gave boilerplate answer about being in constant contact w insurers

Oh well. They work for Obama now. Enjoy the new insurance regime you’ve helped create, guys.

If you missed it in Headlines earlier, here’s an AP report quoting tech experts as saying it’ll cost a lot of money to get to the point where it really needs to be in terms of handling users. How much money? It’s unclear because, amazing as it may seem, they still haven’t identified all the problems yet. Exit quotation via CMS honcho Henry Chao, in an e-mail to staffers four days before went live: “I DO NOT WANT A REPEAT OF WHAT HAPPENED NEAR THE END OF DECEMBER 2005 WHERE MEDICARE.GOV HAD A MELTDOWN.” Actually, it didn’t end up being a repeat; was fixed relatively quickly. Success!

HHS delays 2015 enrollment to … just past the midterm elections


Guess who’s worrying about the 2014 midterms?  It’s not Republicans, but the White House. In a nonsense move, HHS has announced a one-month delay in 2015 open enrollments in the ObamaCare exchange, which will mean … nothing at all for the elections:
Health and Human Services plans to delay the start of the second year of Obamacare enrollment by one month to allow insurers more time to set rates after assessing their plan experiences during 2014, a department official said Thursday night.
The decision means that sign-ups for the 2015 plan year would begin on Nov. 15, 2014 and end on Jan. 15, 2015 instead of the Oct. 15-Dec. 7 window previously announced. The date change, first reported by Bloomberg, also lengthens the enrollment period by a week. Doing so would give companies more opportunity to account for individuals, particularly young adults, who come in late during the plan’s first year, which has gotten off to a rocky start. The goal is premiums that more accurately reflect costs for those insured.
The new calendar would move the start of the 2015 open enrollment season to shortly after the November midterm elections.
This is, of course, nonsense.  Insurers will have plenty of time to calculate their rates for 2015 based on their experiences in the first half of 2014, as they have every year they have been in business.  This is just a transparent attempt to push off major price increases created by an inability to convince younger consumers to buy comprehensive insurance they don’t need, which will force insurers to raise premiums sharply again in the next year to make up the costs of all the mandates imposed on them for 2014. Those costs and the participation rate for various demographics will be well known in time for an October enrollment.
However, this misses the real risk for the White House, which isn’t in the individual market in 2015.The people in that market will have been battered all year with higher premiums and ridiculous deductibles, and another round of escalation in both will only have a limited shock value.  The risk is in the employer-provided group market, where costs will either skyrocket or employees will get kicked out of their coverage and forced into the individual market.  Those decisions will come in the late summer or early fall, as businesses have to prepare 2015 budgets in those time frames.  By the time the standard October 1 open enrollment date hits for those consumers, the enormous impact of ObamaCare will be well known — even if they can’t access price information in the individual exchanges. When tens of millions of Americans get handed huge price increases or get pushed out of their group coverage altogether at that point, the outrage and political meltdown will dwarf whatever pricing changes take place in the individual markets.
This is a desperation move in more ways than one, and yet another example of the ignorance of private-sector strategic processes in the Obama administration.

Obama HHS breaks its own rules with Obamacare enrollee claim

Obama HHS breaks its own rules with Obamacare enrollee claim

An official flow chart from the Department of Health & Human Services’ Center for Medicare & Medicaid Services contradicts the White House claim that more than 100,000 Americans have enrolled in Obamacare exchanges.
The U.S. Department of Health & Human Services reported last week that 106,000 eligible people enrolled in the Obamacare exchanges, a far cry from the stated goal of seven million covered Americans.
But a flow chart [pdf] from the Center for Medicare & Medicaid Services (CMS) indicates that even that 106,000 figure may be inflated.

That’s because the CMS doesn’t consider someone to be enrolled until that person has paid his or her first premium and Health and Human Services (HHS) mails out a “Welcome Packet.” The question is not how many have chosen a plan, but how many “Welcome Packets” have been mailed out.
But in announcing its enrollment figure, HHS included people who had merely “selected a marketplace plan.”
In order to reach that 106,000 figure, the White House is almost certainly counting people who have not completed the legal definition of an enrollment — a statistical fudge President Obama has alluded to in his public comments. (RELATED: Salesman in chief pitches Obamacare to midday TV audience)
“Keep in mind the insurance doesn’t start until January 1st,” the President said in his October 21 “ShamWow” speech in the White House Rose Garden. “That’s the earliest that the insurance can kick in.  No one who decides to purchase a plan has to pay their first premium until December 15th.”
Critics of the unpopular healthcare law have pointed out that counting selected, rather than purchased, plans is statistically slippery. But the CMS flowchart indicates it’s also prohibited by HHS rules, in which people who have not paid premiums do not count as Obamacare enrollees.
The CMS did not respond to multiple requests for comment.
The byzantine end-to-end enrollment process flow chart from details the processes from the moment a potential enrollee logs onto the online marketplace and the data processes and the administrative steps from start to finish.
A U.S. Senator who asked not to be identified told The Daily Caller this week his office had learned that enrollees in the exchange have 90 days of free health insurance before they ever even have to pay a premium.

More lies ? Are we at a perjury point yet ?

CNN: HHS lied about “Anonymous Shopper” delay in


Why is this CNN exclusive important?  The ObamaCare website forced Americans to create accounts before looking at prices and plans, which for the first several weeks they couldn’t access anyway.  HHS officials told Congress that the part of the website that would have allowed people to see plan and pricing data wasn’t provided because it failed its tests, but documents obtained by CNN show it was one of the few functions that actually worked as planned:
When the troubled federal health care website came online, the key “Anonymous Shopper” function was nowhere to be found — even though it passed a key test almost two weeks before launched.
That successful test, noted in documents obtained by CNN and confirmed by a source close to the project, contradicts testimony from an Obama administration official overseeing, who told lawmakers earlier this month the function was scrapped because it “failed miserably” before the October 1 launch.
Like much of the rollout, the subject has become political fodder for Republicans, who claim the decision to nix the anonymous shopper was made by administration officials worried it would produce rate estimates so high they would deter potential enrollees.
Ironically, the Anonymous Shopper function actually would have spared the White House a lot of bad press, had HHS turned it on. For one thing, it would have diverted a lot of the lookie-loo traffic that arrived on the first few days of the rollout, which might have helped others get through account creation — although probably not. Another part of the frustration of the main site was the inability to even create an account to get to the data, while at the same time getting cancellations from existing insurers.  This function would have provided a little certainty to consumers, as well as a rough estimate at least of their subsidies.  Or perhaps not; the price shocks even with subsidies have outraged Americans, and maybe HHS wanted to delay the access to that bad news as long as possible.
Either way, this puts Henry Chao on the hot seat — again.  The Deputy CIO of HHS was the man who informed Congress this week that the back end of hasn’t even been built yet, estimating that 30-40% of the overall system is still missing.  That includes the mechanism for paying those subsidies to the insurers, which leaves in question whether anyone in the exchanges will actually have coverage at the beginning of the year. Insurers don’t begin coverage until they have full payment.
Now Chao has a much bigger problem. This is what Chao told Congress last week about Anonymous Shopper:
Chao said he made the decision in conjunction with colleagues and testified before Congress last week that it was because the feature “failed so miserably that we could not conscionably let people use it.”
Yet a CMS document made public by the same committee last week tells a different story. The agency and one of its subsidiaries, the Center for Consumer Information and Insurance Oversight, was working with government contractors on the website. It determined the Anonymous Shopper feature “tested successfully,” revealed “no high severity defects open” and that “remaining lower severity defects will not degrade consumer experience.” …
The source close to the project, however, said the anonymous shopper function did pass testing conducted in the weeks ahead of the launch.
First, let’s point out the laughably absurd proposal that HHS found any function within to have “failed so miserably that we could not conscionably let people use it.” Isn’t that a good description of the entire site? That would seem especially true considering Chao’s later testimony that up to 40% of the system was missing altogether.
But the falsehood goes farther than that:
The successful test occurred on September 17, according to a source familiar with the project. The next day, in an internal e-mail obtained by CNN, Chao wrote the shopper function “isn’t needed and thus should be removed.”
So HHS knew it had passed the testing, but Chao pulled it because “it wasn’t needed,” not because it “failed so miserably,” etc.  That looks like a pretty classic case of either perjury or obstruction of Congress. That seems to be a running theme this year in the Obama administration.

Here we go: HHS announces pilot program in three states to encourage direct enrollment in ObamaCare plans via insurers


In case there was any shred of doubt left that they’re deeply worried about breaking down under the crush of traffic next month, this ought to take care of it. First theymoved the deadline for enrollment back, now they’re lining up insurance companies to start handling enrollments directly as December 23rd approaches.
Kitchen-sink time:
Another one of those options is allowing insurers to sign up consumers from start to finish —called, “direct enrollment.” If consumers choose to directly enroll in a Marketplace plan through an insurance company, they still will be able to compare products, and choose the one that offers them the best value for their dollar. Consumers will be informed that they can compare and select other plans on, and prior to buying a health plan, consumer’s application will be securely routed to to assess their eligibly for coverage along with potential discounts on premiums and cost sharing. Consumers must have their eligibility verified through the Data Services Hub – regardless of which path they use to enroll.
The option of direct enrollment has been there from the start, and although some issuers have already begun using this option, it has been limited by recent problems with the website. However, we recently announced that we have put in place fixes for more than two-thirds of the high priority bugs related to the website. For this reason, today, we are announcing that issuers in Florida, Texas, and Ohio are ready to participate in a pilot program using this direct enrollment feature, which will help inform our efforts to make this option work better for issuers and consumers in the coming weeks. Under the new pilot program being launched today, issuers utilizing direct enrollment in these three states will provide detailed feedback on their experiences to feed into our real-time work to make improvements for both consumers and issuers. This will help make direct enrollment a viable option for all issuers that wish to use this feature.
Insurers have been pressing them to do this for weeks. The big problem to date was that there were too many privacy concerns involved in giving insurance companies access to federal data hubs about Americans in the name of verifying eligibility. Sounds like they’ve solved that problem somehow — or maybe they just think they’ve solved it. Despite tech experts testifying before Congress that presents “critical” security risks, newly-legendary tech moron Kathleen Sebelius says she’s confident it’s fine. Could be they’re rolling this out as a pilot program precisely because they don’t know how secure it’ll be in practice. Good luck, America.
But never mind all that. Isn’t there a bigger problem? Here’s how the Times described the logistical challenges in its story about direct enrollment 10 days ago:
The main stumbling block for some consumers is the need to determine their eligibility for subsidies, and the amount. Insurance companies can now only estimate the amount for them. It is up the government to verify eligibility, using personal financial information from tax returns and the like.
“The question is, can they create a separate direct pathway so consumers can get that information on their subsidies?” asked one industry official. “If they don’t have up and running by the end of the month, direct enrollment is critical.”
Actually, insurance companies don’t need to estimate the subsidies an applicant is eligible for because … you can’t get subsidies if you don’t enroll through an exchange. Remember? Read this post to refresh your memory. Sebelius herself is sufficiently worried about people being unwittingly disqualified from subsidies by enrolling directly with insurers that she took care to say a few days ago that only people who know they earn too much income each year to qualify for help from Uncle Sam should consider going that route. And yet, the issue isn’t mentioned in today’s HHS press release. Could be, I guess, that the reference to “potential discounts on premiums and cost sharing” is a veiled reference to subsidies. If so, is HHS suggesting that … they will allow people to apply for subsidies even if they enroll outside an exchange? That would be the third highly illegal move Obama’s made in the name of doing triage on this policy car crash. First was delaying the employer mandate, second was his declaration that insurers can go ahead and un-cancel plans if they like, and now this. Maybe the press release is simply written ambiguously, and what they really have in mind is insurers gently informing lower-income people who qualify for subsidies that they’ll just have to be patient and wait until the website’s working. But either way, I want to know. Either they’re breaking the law or they’re encouraging a de facto two-tiered enrollment system for the lower and middle classes, respectively.
Exit question: Chin up, Democrats. What could go wrong?
I was at yesterday's off-the-record session with . Can't report it, but can say: he's all in on ACA.

Knives out from HHS and Outside Contractor .....

Tension and Flaws Before Health Website Crash

WASHINGTON — On a sultry day in late August, a dozen staff members of the Centers for Medicare and Medicaid Services gathered at the agency’s Baltimore headquarters with managers from the major contractors building to review numerous problems with President’s Obama’s online health insurance initiative. The mood was grim.
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Henry Chao, a 19-year Medicare agency veteran with no formal background in software engineering, was eventually left with day-to-day management of the president’s signature initiative.

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Despite the behind-the-scenes crisis, the president expressed confidence about the exchange just days before its grand debut.

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The prime contractor, CGI Federal, had long before concluded that the administration was blindly enamored of an unrealistic goal: creating a cutting-edge website that would use the latest technologies to dazzle consumers with its many features. Knowing how long it would take to complete and test the software, the company’s officials and other vendors believed that it was impossible to open a fully functioning exchange on Oct. 1.
Government officials, on the other hand, insisted that Oct. 1 was not negotiable. And they were fed up with what they saw as CGI’s pattern of excuses for missed deadlines. Michelle Snyder, the agency’s chief operating officer, was telling colleagues outright, “If we could fire them, we would.”
Interviews with current and former Obama administration officials and specialists involved in the project, as well as a review of hundreds of pages of government and contractor documents, offer new details into how tensions between the government and its contractors, questionable decisions and weak leadership within the Medicare agency turned the rollout of the president’s signature program into a major humiliation.
The online exchange was crippled, people involved with building it said in recent interviews, because of a huge gap between the administration’s grand hopes and the practicalities of building a website that could function on opening day.
Vital components were never secured, including sufficient access to a data center to prevent the website from crashing. A backup system that could go live if it did crash was not created, a weakness the administration has never disclosed. And the architecture of the system that interacts with the data center where information is stored is so poorly configured that it must be redesigned, a process that experts said typically takes months. An initial assessment identified more than 600 hardware and software defects — “the longest list anybody had ever seen,” one person involved with the project said.
When the realization of impending disaster finally hit government officials at the Aug. 27 meeting — just 34 days before the site went live — they threw out nearly 30 requirements, including the Spanish-language version of the site and a payment system for insurers to receive government subsidies for the policies they sold.
Even then, the system failed a test of only 500 simulated users in late September. Panicked, agency officials sent out an urgent order to almost double the system’s data capacity, technicians involved in the project have now confirmed. But the site was still down more than half the time in mid-October.
The acrimony between the Medicare agency and CGI had built steadily over the preceding months, the new interviews show. By late summer, teams of agency officials had parked themselves in CGI Federal’s headquarters in Herndon, Va., demanding on-the-spot reviews and demonstrations of new code that was never tested. Agency officials complained that CGI missed crucial deadlines and that it could not control other contractors, although the company said it had no power to do so.
CGI and other contractors complained of endlessly shifting requirements and a government decision-making process so cumbersome that it took weeks to resolve elementary questions, such as determining whether users should be required to provideSocial Security numbers. Some CGI software engineers ultimately walked out, saying it was impossible to produce good work under such conditions.
“Cut corners, make date,” said one specialist, who like most of the people interviewed for this article would not allow his name to be used because the Obama administration has requested that all government officials and contractors involved keep their work confidential.
Another sore point was the Medicare agency’s decision to use database software, from a company called MarkLogic, that managed the data differently from systems by companies like IBM, Microsoft and Oracle. CGI officials argued that it would slow work because it was too unfamiliar. Government officials disagreed, and its configuration remains a serious problem.
Thanks to a huge effort to fix the most obvious weaknesses and the appointment at last of a single contractor, QSSI, to oversee the work, the website now crashes much less frequently, officials said. That is a major improvement from a month ago, when it was up only 42 percent of the time and 10-hour failures were common. Yet an enormous amount of work remains to be done, all sides agree.
In a statement on Friday, the Medicare agency said officials held hundreds of meetings in the month before the start-up and tried their best to manage a highly complex project in a short time. “There were issues in meeting deliverables in a timely fashion,” the statement said. “We expected there would be issues. However, we did not anticipate the degree of the problems in the system.”
One computer expert with intimate knowledge of the project said, “Literally everyone involved was at fault.”

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The Medicare agency was not everyone’s first choice to run the $630 million project. White House officials at first debated whether to name an outsider, such as Jon Kingsdale, who set up the landmark Massachusetts health insurance program, or even to create a new agency.

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Both those ideas fell through, and over the past three years five different lower-level managers held posts overseeing the development of, none of whom had the kind of authority to reach across the administration to ensure the project stayed on schedule.
As a result, the president’s signature initiative was effectively left under the day-to-day management of Henry Chao, a 19-year veteran of the Medicare agency with little clout and no formal background in software engineering.
Mr. Chao had to consult with senior department officials and the White House, and was unable to make many decisions on his own. “Nothing was decided without a conversation there,” said one agency official involved in the project, referring to the constant White House demands for oversight. On behalf of Mr. Chao, the Medicare agency declined to comment.
Sixteen companies were prequalified to bid on the project, according to administration officials. CGI was picked as the prime contractor over three other bidders: IBM, QSSI and Computer Sciences Corporation. But the Medicare agency reserved the role of general contractor, or system integrator, for itself, even though it lacked the necessary in-house software engineering resources to handle such a task.
A pattern of ever-shifting requirements persisted throughout the project, including the administration’s decision late last year to try to redesign the site’s appearance and content to make it more informative to consumers, according to many specialists involved. The administration also decided to reconfigure it as a national site, instead of one where each state had its own front page, after many states decided not to open their own exchanges.
IDEO, a consulting firm based in Palo Alto, Calif., that had done some early design prototypes, was enlisted to help revamp the site’s front end. The team at IDEO ended up as frustrated with the Medicare agency as other vendors.
“It was monstrous, a monstrous impact,” said one specialist about the amount of code that had to be rewritten because of the redesign and other similar changes. Administration officials strongly dispute that, saying the impact was minimal.
Within the Medicare agency itself, conflicts raged over priorities and revenues for the project. In July, for instance, officials argued over how many CGI employees should be devoted to the particular system that would handle payments to insurers.
“We are one week out from production deployment, and we are being told already that it doesn’t work,” Jeffrey Grant, a Medicare agency official, wrote in an email to colleagues. “We believe our entire build is in jeopardy.”
Eventually, Medicare agency officials began to suspect that staff members at CGI were intentionally trying to hide flaws in the system, to cover up for their inability to meet production deadlines. They ordered CGI technicians to drive from their offices near Dulles International Airport in Virginia to the agency headquarters near Baltimore to review their code with government supervisors.
The Medicare agency was also growing frustrated with tension among contractors, noting that initial tests of parts of the system were being delayed because of “coordination issues” between CGI and QSSI, which won another part of the job after losing the lead contractor role.
Mr. Chao seemed to colleagues to be at his wit’s end. One evening last summer, he called Wallace Fung, who retired in 2008 as the Medicare agency’s chief technology officer. Mr. Fung said in an interview that he told Mr. Chao to greatly simplify the site’s functions. “Henry, this is not going to work. You cannot build this kind of system overnight,” Mr. Fung said he told him.
“I know,” Mr. Chao answered, according to Mr. Fung. “But I cannot talk them out of it.”
In the last week of September, the disastrous results of the project’s inept management and execution were becoming fully apparent. The agency pressed CGI to explain why a performance test showed that the site could not handle more than 500 simultaneous users. The response once again exhibited the blame-shifting that had plagued the project for months.
“We have not identified any inefficient and defective code,” a CGI executive responded inan email to federal project managers, pointing again to database technology that the Medicare agency had ordered it to use as the culprit, at least in part.
Despite the behind-the-scenes crisis, the president expressed confidence about the exchange just days before its debut.
“This is real simple,” Mr. Obama said, during a speech in Maryland on Sept. 26. “It’s a website where you can compare and purchase affordable health insurance plans side by side the same way you shop for a plane ticket on Kayak, same way you shop for a TV on Amazon. You just go on, and you start looking, and here are all the options.”