Later day news slices....
http://hotair.com/archives/2013/11/11/cant-the-white-house-rewrite-obamacares-regs-to-reinstate-canceled-plans-before-the-end-of-the-year/
(White House hung by their collective petards ? Part 1....)
Can’t the White House rewrite ObamaCare’s regs to reinstate canceled plans before the end of the year?
POSTED AT 6:31 PM ON NOVEMBER 11, 2013 BY ALLAHPUNDIT
The House is set to vote this week on Fred Upton’s “Keep Your Plan Act,” which would “re-grandfather” the insurance plans that were canceled because of O-Care’s new regulations. I myself floated the idea of re-grandfathering in a post or two last week, just because it seems like an obvious stopgap solution until the website is fixed. If millions of people who’ve had their plans dropped are now at risk of not having coverage on January 1 thanks to Healthcare.gov’s Glitchapalooza, there’s an obvious solution: Reinstate the canceled plans. Easy peasy, right?
Nope, neither easy nor peasy. For starters, each state has regulations of its own that a plan needs to comply with before it can be offered there. (Obama conveniently neglects to mention this when he dismisses canceled plans as “cut rate” and “bad apples.”) Some of the canceled plans may no longer meet those state regs; even ones that do would somehow need to be approved by the responsible state agency with less than two months to go in the calendar year. Even if you could get the states to waive their regs for previously offered plans as an emergency solution, though, there are other logistical difficulties insurers would have to deal with. The man to read on this, as usual, is Bob Laszewski:
Ideally, we could just say, never mind––let these people simply stay on their current policies. But here’s maybe the biggest irony in this whole mess. The Obama administration may not be ready for Obamacare but the insurance industry is. The health insurance companies spent the last many months rolling their old policies off the books and replacing them with the 2014 Obamacare compliant products––Bronze, Silver, Gold, and Platinum.Cancellation letters have been sent. Their computer systems took months to program in order to be able to send the letters out and set up the terminations on their systems. Even post-Obamacare, the states regulate the insurance market. The old products are no longer filed for sale and rates are not approved. I suppose it might be possible to get insurance commissioners to waive their requirements but even if they did how could the insurance industry reprogram systems in less than a month that took months to program in the first place, contact the millions impacted, explain their new options (they could still try to get one of the new policies with a subsidy), and get their approval?
The solution to government tech chaos can’t be insurance industry tech chaos. But never mind the logistics: The real problem with re-grandfathering healthy people is that healthy people are only part of the equation. What happens to the sick people who’ve been doggedly signing up for new plans on the exchanges over the past five weeks? They’re not going to be deterred by Healthcare.gov’s failures; they’ll go to individual insurers and buy directly from them. They’re not going to be deterred by the fact that they don’t know what subsidies they’re eligible for yet either; when you have a preexisting condition that costs hundreds of thousands of dollars to treat, you’re happy to have insurance at virtually any cost. Thousands of these people have signed up since October 1, undoubtedly, and now insurers need to figure out how to pay for them. Letting healthy people revert to old, comparatively cheaper plans doesn’t solve that problem because the revenue target for those plans was set before the law required insurers to assume much greater expenditures by letting the sick enroll. Greater costs from the sick mean you need greater revenue from the healthy, which is why so many middle-class people are now finding themselves gouged by premiums for their new “comprehensive” plans. Letting them go back to the old plans at this point would be like losing your management job as a 50-year-old and deciding to resume the burger-flipping job you had when you were 18. It’s a nonstarter. Your expenses are much greater now than they were then.
So what now? Experts have no idea:
Obama has directed his health care advisers to look for a way to deal with the wave of cancellation notices hitting some policyholders. But health policy experts have no idea what the White House could actually do to alleviate the sticker shock some consumers are facing.“I can’t imagine what they’re thinking about,” said Tim Jost, a Washington & Lee University law professor and an expert on the Affordable Care Act…Insurance companies have already set their premiums for 2014, so the high prices some consumers are experiencing aren’t going to change this year. And insurers’ business models already account for moving people into the health care law’s new insurance marketplaces.“In short, I’m flummoxed,” University of Michigan law professor Nicholas Bagley wrote at the Incidental Economist blog. “Maybe the administration has something creative up its sleeve, and it’s certainly prudent to reserve any kind of final judgment until we learn more. For now, though, color me skeptical.”
If the White House could figure out a way to let the healthy be re-grandfathered, it could offer insurers some sort of bailout to cover the sick temporarily, until people are willing and able to enroll on Healthcare.gov en masse. I don’t know where that money would come from. Lori Gottlieb discovered recently that her liberal friends who support O-Care don’t seem to give one wet shinola that she’s paying thousands more for coverage this year, so maybe Obama could test their largesse by proposing an excise tax to pay for preexisting conditions. Let’s see how that plays before the midterms with America’s generous centrist Democratic voters. Even that would only solve part of the problem, though, since there’d still be millions of people whose plans have been canceled who are staring at a lapse of coverage on January 1 unless they can enroll within the next month. Maybe there’s some sort of one-size-fits-all (or two- or three-sizes) coverage scheme insurers could cobble together for the healthy, with the feds on the hook for any losses until risk pools start to normalize next year. Again, though: Where’s the money coming from? Is a temporary one-size-fits-all plan even logistically possible? We’re only beginning to grasp the magnitude of this train wreck. Frankly, I don’t know what insurers were thinking in relying on Obama and Sebelius to have Healthcare.gov working perfectly by October 1 given the massive disruption to the industry that might result if they proved to be grossly incompetent. For people whose business is measuring risk, that was a glaringly poor measurement.
http://hotair.com/archives/2013/11/11/breaking-fewer-than-50000-people-have-enrolled-in-health-plans-via-obamacare-website-thus-far-says-wsj/
( White House hoisted by their own collective petards ? Part 2 .... )
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.
http://hotair.com/archives/2013/11/11/possible-plan-b-for-obamacare-website-meltdown-tell-people-to-visit-individual-insurance-company-websites-instead/
( White House hoisted on their collective petards ? Part 3 .... )
Possible Plan B for ObamaCare website meltdown: Tell people to visit individual insurance company websites instead
POSTED AT 3:11 PM ON NOVEMBER 11, 2013 BY ALLAHPUNDIT
This has been an obvious fallback plan since the beginning and the feds have resisted it for reasons that are equally obvious. Proposal: If Healthcare.gov won’t let people comparison-shop, why not just put up links on the site to the home pages of all the insurers who are participating in the exchange and let people comparison-shop by clicking around? Click the link to insurer A and check their price and provider networks, then hit the back button and click the link to insurer B, etc. It’ll take a lot more time than a properly functioning Healthcare.gov would, but look at it this way. If you were intent on going on vacation and Expedia and Kayak were both offline for some reason, you wouldn’t cancel your trip, would you? You’d surf over to the individual airlines’ webpages and start researching fares that way.
Two obvious problems with Plan B. One: It’s painstaking, which is yet another disincentive for “young healthies” to sign up. The point of Healthcare.gov was to make comparison shopping so fast and easy that the Internet generation could do it within 20 minutes of hearing Obama mention it on TV. If you’re now telling twentysomethings to set aside four hours to bounce from one insurance website to another in order to find the perfect plan for them, they’re either going to (a) sign up with the first or second insurance company they research, just to be done with the process, or (b) say “to hell with it” and put off signing up. Either they end up with a plan that’s sub-optimal or the industry ends up with an even bigger adverse selection problem. Or both, of course.
Two: Insurance companies can’t tell an applicant whether he/she is eligible for taxpayer subsidies or what amount those subsidies might be. That leaves the consumer shopping blind. If you sign up for a plan that costs $300 a month by guesstimating that you’ll receive $200 in subsidies and it turns out you qualify for only $50 in subsidies instead, that’s an $1,800 shortfall you need to make up. Given that uncertainty, what sort of sane, young, healthy person would roll the dice on signing up now? This is why I can’t understand why the “tech surge” team is messing around with stuff like front-end access instead of throwing everything they have at the subsidy calculator. If they could get that working, maybe they could farm the software out to individual insurers so that they can tell applicants definitively how much of their premiums will be covered by Uncle Sam.
But perhaps there’s a Plan B for that too:
On their own, insurers can help consumers through almost the entire enrollment process, but they need to rely on the federal online system for people to enter their incomes and find out whether the government will pay for part of their health plan. Since the enrollment period began Oct. 1, insurers have not had access to that feature — and, as a result, some have a lineup of potential customers unable to choose a plan and complete their purchase.Part of the discussions lately between insurers and administration officials has been about what to do if that function is not fixed soon. One idea circulated within the insurance industry would be for HHS to approve a method to estimate subsidies and give preliminary tax credits based on those estimates — with the accurate amount determined later, once the system works better.According to several people familiar with these conversations, insurance industry leaders have said that they would insist on a guarantee that they would be compensated for any underpayments — and that they have asked to keep any overpayments. Said one health-care consultant who is knowledgeable about insurance exchanges and who has been in touch with administration officials: “The concern is: Who bears the risk?”
They get compensated for underpayments and get to keep overpayments? Go back to the hypothetical about the $300 monthly premium; assume that the applicant will eventually discover that he’s entitled to $100 each month in subsidies, but for now he and the insurer are forced to guesstimate and they guess that he’ll be entitled to $200 each month. What happens once they discover their error? Does the applicant, who’s been inadvertently shortchanging the insurer each month, suddenly need to come up with hundreds of dollars he didn’t realize he owed, or is Uncle Sam going to apologize for the inconvenience of the process by covering that shortfall for him instead? On the flip side, imagine the same scenario except that the applicant and insurer guesstimate that he’ll be entitled to only $50 in subsidies each month. Once they discover that he’s been overpaying, it seems logical that the insurer should refund $50 per month to the applicant — but, per the WaPo quote above, they don’t want to do that. They want to keep the overpayment and have Uncle Sam refund the applicant’s money instead. One way or another, the feds end up paying more in this process than they would have if the subsidy calculator was working correctly from the beginning. Where’s the money coming from to pay for that screw-up? I realize Obama’s sense of his own unilateral executive powers is, shall we say, overly broad, but it can’t be so broad that he can appropriate extra cash for O-Care’s mess all on his own.
While you mull that, watch Todd Young deliver the GOP’s weekly address. On Friday, Rush Limbaugh warned that it’d be a “grave error” by Republicans to agree to let Obama delay the individual mandate to mitigate the website catastrophe. On Saturday, at 3:35 of this clip, Young calls for … delaying the individual mandate. It’s not just Democrats who’ll be arguing in a few weeks about how best to manage the website crisis. Although their arguments will be the most fun.
early morning news slices......
MONDAY, NOVEMBER 11, 2013
The ObamaCare Rollout, Organizational Dysfunction, and Public Relations in the Administration
By Lambert Strether of Corrente.
Administration officials and defenders often claim that demand and volume overloaded the Federal exchange when it was rolled out. This claim is, in fact, not true, and I’d like to see what that lie tells us about organizational behavior inside the administration, and how it will react to future ObamaCare problems — which will be numerous.
First, some examples of the false claim, both from the administration and its defenders:
Barack Obama (U.S. President) 2013-10-01: [W]e found out that there have been times this morning where the site has been running more slowly than it normally will [1]. The reason is because more than one million people visited healthcare.gov before 7:00 in the morning. And we’re going to be speeding things up in the next few hours[2] to handle all this
demand that exceeds anything that we had expected.”
demand that exceeds anything that we had expected.”
Joan McCarter, Senior Political Writer for Daily Kos, 2013-10-01 [3]. “The glitches that the administration warned would be inevitable, that Republicans have been pre-gloating about for weeks so far, all come down to the primary glitch of our broken health care system:
overwhelming pent-up demand for affordable health insurance, available to everyone.”
overwhelming pent-up demand for affordable health insurance, available to everyone.”
healthcare.gov error message (the Federal Exchange), 2013-10-02: “”We have
a lot of visitors on our site right now and we’re working to make your experience here better. Thanks for your patience!”
a lot of visitors on our site right now and we’re working to make your experience here better. Thanks for your patience!”
Paul Krugman, Op-Ed writer and blogger, the New York Times, 2013-10-3: “[T]he glitches of October won’t matter in the long run … [a]ppear, for the most part, to be the result of the
sheer volume of traffic, which has been much heavier than expected.”
sheer volume of traffic, which has been much heavier than expected.”
“Senior Administration Official”, 2013-10-04: “The amount of
demand is really driving the issues. But we’re adding capacity every hour.”
demand is really driving the issues. But we’re adding capacity every hour.”
Todd Park (U.S. Chief Technology Officer) 2013-10-05: “These bugs were functions of
volume. Take away the volume and it works.”
volume. Take away the volume and it works.”
Kathleen Sebelius (U.S. Secretary of Health and Human Services), 2013-10-17 “[Sebelius] said that some of the website’s glitches wouldn’t have been identified
‘unless millions of people flooded the marketplace.’ The system had been pressure-tested at five times the highest volume that the Medicare.gov website had ever seen, she added.[4]
‘unless millions of people flooded the marketplace.’ The system had been pressure-tested at five times the highest volume that the Medicare.gov website had ever seen, she added.[4]
Nancy Pelosi (Minority Leader of the U.S. House of Representatives), 2013-10-20: “They were
overwhelmed to begin with. There is much that needs to be done to correct the situation, but 19 million people, 19 million people, unique visits. …. [A]ny system that deals with that many
millions of people frequently does have a glitch.”[5]
overwhelmed to begin with. There is much that needs to be done to correct the situation, but 19 million people, 19 million people, unique visits. …. [A]ny system that deals with that many
millions of people frequently does have a glitch.”[5]
How do we know these statements are not true? Two reasons:
1. The site crashed when it opened at midnight on October 1. It immediately crashed for me, and for others. Capacity problems build slowly as visitors consume site resources. It beggars belief that volume instantly overwhelmed the Federal Exchange at midnight, especially in the absence of “Black Friday”-type marketing done for the opening. (Seriously, couldn’t the vaunted administration marketing team have gotten some cute, telegenic kidz to “camp out” somewhere waiting for “the doors to open”?) Also, whatever it is that Americans do on the Internet after midnight, it’s probably not buying insurance.
2. Pre-launch testing that the White House should have known about showed the site crashed with 200+ users. CBS:
CBS News has learned the website failed with a small test pool of
200 to 300 people that included employees from the government and insurance companies. The government employees worked at their own computers and desks within the Centers for Medicare and Medicaid Services, which oversaw the health care implementation.According to sources familiar with the process, CMS employees were provided fake personal information to enter into HealthCare.gov rather than their own data and were given a date that testing would begin. However, on that date, the employees were told it was being postponed.When the testing finally took place in late September, the testers started trying to create an application. Just a couple of pages into the process, everything “ground to a stop,” said one source.“It froze. It couldn’t go forward. It crashed,” the source said.A couple of days later, testers tried again and had a similar outcome. They were never able to successfully browse plans for cost estimates.“It was unequivocally clear from testing … this wasn’t ready,” said a source close to the testing.
C’mon. 300 people crash the site? That’s not volume. That’s not demand. That’s a broken system!
So, how did such a large group of nominally reputable people come to make this false claim? Easy enough for administration defenders like Krugman and McCarter; they assumed the guys on their team were telling the truth and really, if not, so what? But how about the insiders and the decision makers? That’s an interesting question in organizational behavior. Generally, I fall back on the eternal question: Are the elites — in this case, the Democrats — stupid and/or evil? I think we’ve got “evil” covered; cementing pure rent extractors like the health insurance industry into the heart of the health care system is evil, no two ways about it, so how about stupid? I think this article from WaPo gives some clues to the particular form of stupidity that pervades this administration. Going back way before the pre-launch test above:
Inside CMS, meanwhile, some staffers were aware by late 2012 that the work of building the federal exchange was lagging, according to a former HHS official — a much earlier timeline than has been previously disclosed. Some employees in the main office involved with building the exchange repeatedly warned at meetings late last year and in January that so many things were behind schedule that there would be no time for adequate “end to end” testing of how the moving parts worked together, the former HHS official said.“People were just like, well . . . it’s a dynamic we can’t change,” the former official said. “There wasn’t a way to push back or challenge it up the line. You had the policy people, largely at the White House, pushing the deadlines and tinkering with the policy, rather than the people who had to run the critical operating path design and program the system.” …White House officials say they were focused on whether there would be enough insurance plans for sale in the new marketplaces and on whether enough people would enroll. They say they didn’t have a clue how troubled the Web site’s operation was.Only during the weekend after HealthCare.gov’s Oct. 1 opening did the president’s aides begin to grasp the gravity of the problems, the White House official said. Obama soon began getting nightly updates on the performance of the Web site, which has still been unavailable to Americans for hours at a stretch over the past week.But that was still to come. A month earlier, on Sept. 5, White House officials visited CMS for a final demonstration of HealthCare.gov. Some staff members worried that it would fail right in front of the president’s aides. A few secretly rooted for it to fail so that perhaps the White House would wait to open the exchange until it was ready.Yet on that day, using a simplified demonstration application, the Web site appeared to work just fine.
Let’s unpack that “simplified demonstration application” just a little. We have an earlier report from the Wall Street Journal:
When CMS presented HealthCare.gov to White House officials over the summer, they displayed a demonstration version of the website composed of screen-shots of the real exchange and overlaid with interactive features.That version re-created the user interface, but didn’t include the underlying mechanics—such as identity verification and eligibility determinations—that have foiled the site’s launch. Displaying such versions for demonstration purposes is common in the computer industry. But it left senior officials unaware of the more complicated and ultimately troubled workings of the exchange.
We can’t know whether the “summer” “demonstration version” was the “September 5″ “demonstration application”; I’m guessing yes. But look at what we have here: We have organizational behavior that is so dysfunctional, so unable to pass bad news up the chain to the White House[6] that three or four months before launch (“summer”) the developers won’t say the project is out of control, and less than one month the developers are still showing a fake site! And rooting for it to fail! Did nobody blow the whistle?
Until the tell-all biographies are written, we can’t know why the administration’s organizational behavior is how it is. But we can speculate freely!
‘The president has a real woman problem’ was the assessment of another high-ranking female official. ‘The idea of the boys’ club being just Larry and Rahm isn’t fair. He [Obama] was just as responsible himself.’ … ‘[L]ooking back,’ recalled Anita Dunn, when asked about it nearly two years later, ‘this place would be in court for a hostile workplace … Because it actually fit all of the classic legal requirements for a genuinely hostile workplace to women.’
And at this point we remember that Obama’s HHS report, Kathleen Sebelius, is a woman, as is Marilyn Tavenner, head of CMS, and any bad news from them could have been discounted, much as CEA Chair Christina Romer’s counsel was discounted. (Summers made Romer feel “like a piece of meat.”) To be fair, Sebelius says nothing to this effect, but then she’s almost visibly falling on her sword to protect her boss.
2.) Or perhaps there’s an Emperor’s New Clothes dynamic going on, a case of “pluralistic ignorance.” CNN:
“They had been claiming that the Obamacare rollout was his top priority and that he was receiving regular updates, which was inaccurate. And he gave remarks on October 1 about how great it was and that people should go sign up,” the aide said. “Assuming that he didn’t know that the website didn’t work, why did they let him make that speech when they knew it had crashed in testing? Did really no one recommend a delay to the President? It just seems odd.”
Well, it didn’t seem odd to the courtiers to let the Emperor walk through the streets naked! Or, if it did, they successfully suppressed their qualms.
3.) Or perhaps we’re looking at the group dynamics of a sociopathic ruling class. I wouldn’t even have raised a tinfoil hat-type possibility like this except Obama’s remark that “[I'm] really good at killing people.” But consider:
We can think of the entire hierarchy of elites within elites within elites that comprises the political class as a sorting mechanism that filters sociopaths to the top strata, rather like the CIA’s lie detectors sort people who can beat lie detectors (again, sociopaths) to the top. From Confessions of a Sociopath:Sociopaths, mimicry, and blank slates
I think mimicry is interesting, and I think a lot of empaths think it’s freaky. What I find more freaky is what constant mimicry suggests — that you have no baseline “you,” that you are always just reactions to outside stimuli. …I have a good friend who was initially very frustrated that I didn’t seem to have defaults: no default understanding of right and wrong, no default beliefs, no default personality even. Everything had to be reasoned, everything had to be constructed anew. It can be frustrating for me too. It’s time consuming. And sometimes it disturbs me how impressionable I am. Being a blank slate [or screen?], sometimes I can surprise even myself with non sequiturs or unpredictable behavior. It’s sort of scary.So what happens when you have a relatively self-contained class or faction composed mostly of sociopaths, and they all start trying to mimic each other? Nothing good, I would imagine. Their fate would be, perhaps, like Terry Pratchett’s Auditors– or the humans in Phillip K. Dick’s Game Players of Titan.
I don’t know what outcomes the group dynamics of sociopaths would produce, but making sure bad news is heard seems unlikely to be at the top of the list.
Finally, whatever the outcome, we’ve seen (and Yves has many times pointed out) that the White House, and Obama, personally, seem to think any problem can be solved with better public relations:
–“[O]n February 14 [2011], the president meditated on the most important things he’d learned as president … ‘The area in my presidency where I think my management and understanding of the presidency evolved most, and where I think we made the most mistakes, was
less on the policy front and more on the communications front. I think one of the criticisms that is absolutely legitimate about my first two years was that I was very comfortable with a technocratic approach to government … a series of problems to be solved.
Yeah, well, how’s that technocratic thing workin’ out for ya on healthcare.gov, big guy?
So, given those two characteristics of organizational behavior at the White House — inability to hear bad news, and using public relations to solve every problem — what’s challenges are in store for ObamaCare until the New Year?
1.) This week’s enrollment numbers will be bad. That’s baked in because of the website fail. But what kind of numbers will there be? Reuters:
The Obama administration will release healthcare enrollment numbers for Obamacare’s rocky October rollout this week that could be more important for what they fail to say, than for what they do.U.S. Health and Human Services Secretary Kathleen Sebelius told the Senate Finance Committee last week that the early tally would be “very low.” … Before the October 1 website launch became a debacle, internal administration memos anticipated 494,620 enrollees in October and 706,000 in November nationwide, according to congressional investigators. Administration officials declined to confirm the numbers, saying projections are subject to rapid change.But administration officials have not said whether the data will provide clues to other important questions, including whether young healthy adults, needed by insurers to offset older people with higher health costs, are eager to obtain coverage.“They could give us very granular data showing enrollment by state, by plan level, how many enrollees had subsidies and at what level – all that stuff. But I think they’re going to give us something aggregated nationally,” said one aide.
It’s actually OK that the numbers are low in absolute terms; the MA enrollment for RomneyCare was initially low, and built to the final deadline. There are two metrics that matter: First, the order of magnitude of the enrollees compared to projections. 494,620 vs 49,462 is just barely passing; 494,620 vs. 4,946 would be very bad or, in Washington parlance, a “concern”; and even I don’t think there will be 494 enrollees. Second, the actuarial soundness of the pool; if the entire pool has a pre-existing condition, the insurance companies can’t profit. Unfortunately, the website debacle selects for the already ill, since only they have the incentive to sit through the days and the hours it takes to sign up. So I would expect the administration PR effort to: (1) roll out the heart-tugging YouTubes; (2) conceal the actuarial soundness, to avoid any hint that ObamaCare is already entering a death spiral; and (3) Focus on Medicaid signups, which are, after all, a success. And (4) claim next month will be better. Leading to….
2.) healthcare.gov will still be a mess by December 1. Here’s Czar Zients walking it back last Friday:
In a conference call with reporters, Zients said progress this week has been marred by roadblocks. He described HealthCare.gov as being “a long way from where it needs to be.”
And a figure of much greater clout, Leon Panetta yesterday:
“The president’s trust on this program is really going to be dependent on his ability to fix it,” Panetta said in an interview aired Sunday on CBS’s “Face the Nation.” “They said that they want to fix it by the end of November, but that’s going to be tough. These are complicated processes, and you’ve got to make very sure that you are, in fact, fixing it.”
And insurance figure Bob Laszewski writes:
It is now becoming clear that the Obama administration will not have Health.care.gov fixed by December 1 so hundreds of thousands, or perhaps millions, of people will be able to smoothly enroll by January 1.Why do I say that? Look at this from the administration spokesperson’s daily Healthcare.gov progress report on Friday:Essentially what is happening is people [those working on the fixes] are going through the entire process. As we have fixed certain pieces of functionality, like the account creation process, we’re seeing volume go further down the application. We’re identifying new issues that we need to be in a position to troubleshoot.Does that sound like the kind of report you would expect if they were on track to fix this in less than three weeks? Their biggest problem is that they admittedly don’t know what they don’t know.
That sounds like a lot of bad news for the White House to process, especially the unknown unknowns part. And I don’t know of Zients has the clout to bring bad news up the chain; he’s really just a short timer. (Perhaps that’s why Panetta suggested a task force.) Nevertheless, I would expect the White House public relations effort to (1) declare victory, in that the “vast majority” of people can enroll, no matter what the reality of the situation. After all, this is the crowd that launched the website for one of the largest IT projects in American history without end-to-end testing, so having leaped over that block, why would they stumble at the straw of declaring it fixed? (2) If the back-end gets overwhelmed from a surge of new applicants, (a) stress the heroic efforts of the phone and paper processors, (b) blame the Republicans, and (c) even blame the insurance companies. (3) Roll out the Silicon Valley types they roped in for alibis; doubtless they were selected to be photogenic as well as technical. Also too (4) roll out the heart-tugging YouTubes.
3.) ObamaCare health insurance plans on the Exchanges will include a lot of junk. The website woes have kept the quality of the plans in the background, but we expect to be hearing more on this from Michael Olenick. (Also keep in mind the phrases “out-of-network” and “balance billing.”) Bad news delivery here depends not only on internal channels but on ombudsmen, consumer complaints, and so forth, which will be much harder to suppress. I’d expect administration efforts to (1) depend heavily on blaming the policy holder, and, naturally, (2) heart-tugging YouTubes.
Pass the popcorn.
NOTE The ObamaCare Czar, Jeffrey Zeints, also made the false claim that volume/demand Big Lie, but since I don’t have a direct quote, I’m leaving him off the list for now. Today is my day to be kind!
NOTES
[1] BWA-HA-HA-HA! Also note lawyerly parsing of “will.”
[1] BWA-HA-HA-HA! Also note lawyerly parsing of “will.”
[2] “In the next few hours” could that Obama’s staff still can’t tell him the truth,
[3] That was fast. Whatever else the adminsitration can or cannot do, it can certainly get its paid shills to snap to attention and begin to regurgitate with impressive speed. No problems with volume there!
[4] This is a two-fer!
[5] Interestingly, Pelosi is repeating the long-abandoned “millions of hits” talking point three weeks into the process. That transcript is weird, too. Full of word salad. If the Democrats don’t win back the House in 2014, I don’t think Pelosi will last as Leader. She doesn’t make sense when she talks.
[6] We see a similar dynamic in Connecticut.
http://globaleconomicanalysis.blogspot.com/2013/11/obamashock-hits-employees-of-sodexo.html
( Another aspect of ACA is how many folks are going to lose coverage from Employer plans..... this impact is not being discussed enough)
Sunday, November 10, 2013 8:44 PM
Obamashock! Hits Employees of Sodexo, "World's Largest Quality of Life" Service Company
Some employees of Sodexo, the "World's largest quality of life services company" have been hit with a massive case of "Obamashock!" because of the way Obamacare identifies part-time employment.
An email from reader "Mark" will explain.
An email from reader "Mark" will explain.
Hello MishMike "Mish" Shedlock
I thought you would be interested in another new angle regarding fallout from the ACA.
Yesterday we received a notice of cancellation of our eligibility in the large group health plan through my wife's employer. They state that this is due to the Affordable Care Act.
My wife has worked for Sodexo, USA for about 3 years.Sodexo is a contract food service provider at literally thousands of institutions around the world. Her job is at a small private college in Iowa.
The notice we received states that, "Sodexo has aligned how we define full-time employees eligible for benefits with the Affordable Care Act". As such, she no longer qualifies as a full time employee, and can no longer be part of the benefit plan, as of January 1, 2014.
The new definition is that a full time employee must average 30 hours a week over the past 12 months. The cafeteria at a private college is not open 12 months of the year, and does not operate an average of 30 hours per week over 12 months. It is impossible to attain this number of hours when they are not available.
I am self employed. We will not qualify for any 'exchange subsidies'. She worked this just over minimum wage job solely for access to the health plan.
Now our options seem to be either to pay $19,600.52 per year for the COBRA plan, or $12,636 for an individual family plan with a deductible that is 3 times our current plan.
We are definitely in Obamashock!
http://www.thegatewaypundit.com/2013/11/st-louis-woman-is-victim-of-id-theft-after-signing-up-for-o-care-video/
It Begins… St. Louis Woman’s Personal Information Stolen From O-Care Website (Video)
Posted by Jim Hoft on Friday, November 8, 2013, 10:46 PM
Warning: If You Sign Up for Obamacare – Your Information Can Be Accessed By Complete Strangers
We were warned this could happen. A St. Louis woman found out she was a victim of identity theft this week after she signed up for Obamacare.
We were warned this could happen. A St. Louis woman found out she was a victim of identity theft this week after she signed up for Obamacare.
Lisa Martinson called customer service after she forgot her password. That’s when she was told three different people were given the password to her account, her address and her Social Security number. Then she was told it would take up to five days to get her personal information offline.
O-Care officials say they are investigating the situation.
Via News 4 KMOV:
Hat Tip Ed
Via News 4 KMOV:
Hat Tip Ed
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