Today's updates .....But first recall the prior post......

http://www.washingtonpost.com/national/health-science/healthcaregov-tech-team-scrambling-to-create-workaround-for-site-before-deadline/2013/11/27/f5affc7c-577c-11e3-ba82-16ed03681809_story.html

HealthCare.gov tech team scrambling to create workaround for site before deadline

Days before the Obama administration’s self-imposed Nov. 30 deadline for fixing HealthCare.gov, its technology team is scrambling to build a new part of the Web site as a workaround that would enable more people to buy health insurance without relying directly on the site.

The new mechanism, EZ App, would permit people who are eligible for financial help from the government to enroll for coverage without calculating an exact subsidy amount, which has been a major stumbling block, according to government and insurance industry officials who spoke on the condition of anonymity in order to be frank. It would allow call centers, and eventually insurance companies and brokers, to help people enroll based on estimates of what their federal subsidies would be.

But insurers are uncomfortable with the add-on because they do not want to shoulder the financial liability for customers signing up for plans with a rough estimate of their final premiums, rather than a precise figure verified through the site.

The workaround, aimed at diverting consumers from the Web site, is the latest indication that significant uncertainty remains about how the government will handle the large number of people who are likely to want to sign up for health plans soon.

Meanwhile, the Obama administration announced Wednesday that it will delay a significant piece of the health-care law: the online small business insurance marketplace.

The Small Business Health Options Program, known as the SHOP exchange, will not offer online enrollment until November 2014, a one-year delay from a launch that was initially planned for last month.

Small businesses will still have the option to purchase SHOP plans through a broker or agent, who will help the employer file a paper application. The federal government expects to process those filings for eligibility within three to five days, according to a document circulated to business groups.

Administration officials described the decision as necessary while they made fixes to the individual health exchange, which the White House has promised will “work smoothly for the vast majority of users” by Saturday.

But the administration will not be able to meet another internal target by then, said a person involved in the project who spoke on the condition of anonymity because of the matter’s sensitive nature. The goal was for tens of thousands of users to be able to register for an account and then log in on an hourly basis.

In a conference call with reporters Wednesday, Julie Bataille, spokeswoman for the Centers for Medicare and Medicaid Services, said that between now and Saturday, technical workers will be trying to fix the site’s hardware so that 50,000 people can use it simultaneously, as the White House has promised.

“We are still on track to make sure by the end of the month the vast majority of users will be able to go through the site smoothly,” she said, cautioning that more changes will be needed to ensure that the system is able to accommodate 50,000 users at once. “We have a lot of work left to do in the next few days, both some software fixes and some hardware upgrades.”

Even as the administration prepared for a new wave of customers to log onto the Web site next week, it cautioned its allies and reporters that there could be hiccups.

An administration official, who spoke on the condition of anonymity to discuss the matter freely, wrote in an e-mail Wednesday that on Monday, the White House asked allies — including Enroll America, the Service Employees International Union and Planned Parenthood — not to encourage large numbers of people to use HealthCare.gov in the first week of December so the administration can see how many people are visiting on their own.

Graphic

The federal health-care exchange is falling short of expectations

All your Affordable Care Act questions answered

We’ve compiled questions and answers around the topics discussed most, so you can browse what others have asked and get answers of your own.

Have you used the new health insurance exchanges?

Charity Brown NOV 7

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Three states are in. Three states are out. And a lot more are still deciding.

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Everything you need to know about the rollout of the new health insurance marketplace.

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LATEST UPDATES | What you need to know about the new health-care law as it begins to take effect.

Bataille told reporters that the administration plans to install a new function “in the next few days” to address times when demand exceeds the site’s capacity, such as the peak time of 2 p.m. Under this system, visitors will receive an e-mail telling them when to return to the site.

“We aren’t sure what traffic will be on Dec 1, 2 — but think high volume is quite possible and don’t want users to be frustrated by more waits,” the administration official wrote, adding that consumers will have an easier time accessing the site during mornings, evenings and weekends.

Meanwhile, at a CMS command center in Columbia, Md., and at IT contractors’ offices in Northern Virginia, work to improve the site is sometimes producing results. In one hopeful sign, the number of consumers who were able to enroll in a health plan reached a record Tuesday of about 10,000, said an official familiar with the project, who spoke on the condition of anonymity about information that is not public.

The official said that IT workers have been striving to reach a different capacity goal that won’t to be attained before the deadline. This private, second goal, focusing on the early stages of using the Web site, calls for 80,000 people per hour to be able to create an account, and for 320,000 per hour to be able to log in. Technical workers attempted to upgrade the site to meet this goal, but the fix did not work, and the next attempt is scheduled for late this weekend at the earliest, administration officials said.

EZ App aims to address a key problem that has hindered the ability of call centers, health-care companies and insurance brokers to enroll consumers.

Their role is important because administration officials have made clear that the Web site alone is not going to be able to handle all the people who are likely to want insurance before the new year, when the 2010 federal health-care law requires most Americans to have coverage or risk a fine.

The idea behind the subsidy tool is to bypass the technical problems that make it difficult for the call centers and industry representatives to find out the size of the federal subsidy that, in most instances, will help people pay for their health plans.

Work on EZ App began about three weeks ago. When it is built, it will contain 35 “scenarios,” each of which will consider consumers’ income, age and the number of people in their family. For each scenario, the system will have defined an estimated subsidy, and whoever is helping a given consumer enroll will choose the one that most closely matches the person’s circumstances, said the official familiar with the project.

Insurance industry leaders are worried that customers may owe more than the estimate and don’t want to have to collect more money from them.

“The health plans want to make sure whatever estimate of subsidy is used, they want to make sure it’s final,” said an insurance industry official, who spoke on background to discuss private conversations that industry representatives have had with administration officials. If health plans were at risk of losing money, the official said, they “wouldn’t go along with it.”

An administration official who spoke on the condition of anonymity to discuss ongoing operations did not confirm the existence of the subsidy tool. This official said that this weekend, the government will begin deploying two new features of the system. In the part of the site where consumers can browse plans but not buy them, they will see 35 scenarios giving them a better sense of the plans’ prices. And some call centers will use a tool that will make it easier for consumers to enroll by asking them a few screening questions.

Obamacare Online Sign-Up Delayed By One Year For Small-Business

Submitted by Tyler Durden on 11/27/2013 13:27 -0500

Obamacare

In a move reminiscent of the "radical" Tea-Party demands of a few weeks back, the administration has decided:

*OBAMA DELAYING ONLINE INSURANCE ENROLLMENT FOR SMALL BUSINESS
*SMALL BUSINESSES SAID TO USE `DIRECT ENROLLMENT,' NOT WEBSITE

The one-year delay - to Nov 2014, follows the initial Oct 2013 delay citing "sometime in November 2013" availability. The delay applies only to the federal-run SHOP exchanges in almost three dozen states.

Via HHS,

“We’ve concluded that we can best serve small employers by continuing this offline process while we concentrate on both creating a smoothly functioning online experience in the SHOP Marketplace, and adding key new features, including an employee choice option and premium aggregation services, by November 2014,”

Via Bloomberg,

Small businesses won’t be able to use the federal government’s health-insurance website until November 2014 in most U.S. states, the latest delay for the Obama administration’s health-care system overhaul.

“Direct enrollment” will be available in the meantime, said an official with the U.S. Department of Health and Human Services who asked not to be identified because the decision hasn’t been made public.The change applies to 36 states where the federal government is running insurance exchanges.

The exchanges for small businesses, available forcompanies with 50 or fewer full-time workers, had already been delayed from a scheduled Oct. 1, 2013, start.

So far so good eh?

White House to skip big PR push for ObamaCare enrollment in December — for fear that traffic will overwhelm the website

POSTED AT 12:01 PM ON NOVEMBER 27, 2013 BY ALLAHPUNDIT

A month ago, the goal was to have Healthcare.gov working in time for the anticipated post-Thanksgiving crush of enrollments before the December 15th deadline. A month later, here’show Sebelius defines “working”:

[A]dministration officials said Tuesday that they had decided not to inaugurate a big health care marketing campaign planned for December out of concern that it might drive too many people to the still-fragile HealthCare.gov.

With a self-imposed deadline for repairs to the website approaching on Saturday, the administration is trying to strike a delicate balance. It is encouraging people to go or return to the website but does not want to create too much demand. It boasts that the website is vastly improved, but does not want to raise expectations that it will work for everyone.

“We are definitely on track to have a significantly different user experience by the end of this month,” Kathleen Sebelius, the secretary of health and human services, said Tuesday. “That was our commitment.”

In an alternate universe where the website worked fine on day one, Obama’s spent the past eight weeks chatting with any media outlet that’ll have him to encourage people — especially young people — to sign up. In that universe, mid-November to mid-December is when the White House PR machine goes into overdrive to convince holdouts to beat the deadline and make sure they’re covered on January 1st. The more “young healthies” enroll, the more sustainable the program is and the rosier the expectations are that insurers won’t have to raise premiums in 2015 to cover any losses. And of course, the closer the White House gets to its enrollment target, the more I-told-you-so’s there are at the GOP’s expense.

In this universe, not only hasn’t Obama done any sustained media tours to promote enrollment while the website is in limbo, he’s actually abandoning the big home-stretch overdrive push because, even now, it just can’t handle the load. Imagine how “fragile” it must be, to borrow the Times’s word, for the White House to decide that the prudent thing to do when they’re desperate for more sign-ups is not to encourage people too much lest Healthcare.gov crash again and the resulting bad press scares people off for good. Ezra Kleinclaimed yesterday that, even though O-Care will now almost certainly miss its target of seven million enrollments next year, that’s no biggie; it’s the mix of enrollments, young/healthy versus poor/sick, that will determine if the program can go forward. And that’s true, sort of: If you’re building a boat, it’s more important to build one that can float than to build one that’s really big. In this case, though, those two features aren’t independent. If the White House falls way short of its target number, it’ll likely be because too few “young healthies” are enrolling, not too few poor and sick. They may very well hit their target for the latter group but badly miss the former. That boat won’t float. And now here’s the White House admitting, due to its technological self-sabotage, that it can’t take aggressive action to minimize the risk of missing its young/healthy target next month. If I were a Democrat whose seat is up next year, the “significantly different user experience” Sebelius is promising next week wouldn’t suffice.

Meanwhile, how’s all of this playing with the public? CNN has a poll out this morning that’s only mostly, not entirely, bad news for ObamaCare. Fifty-eight percent oppose the law, nearly 40 percent have already decided that it’s a failure, and 45 percent think its problems are too profound to be fixed. But there’s an important footnote on the support/oppose question. Here’s what you get when you ask people whether they favor the law, oppose it because it’s too liberal, or oppose it because it’s not liberal enough (the fourth row represents “don’t know” and the fifth is the margin of error for the subsample):

In every category except whites, a majority either supports the law as-is or wishes it weremore liberal. (Among O’s 18-34 fan base, that majority is 60 percent.) I wish CNN had added some historical data so that we could see the trend on that. It stands to reason that the more headaches O-Care creates for Obama, the more we’ll see Democrats peeling out of the “favor” column and landing in the “not liberal enough” one. Has that phenomenon already begun? Only the historical numbers can tell us. On the other hand, maybe we shouldn’t read too much into the “not liberal enough” metric. Here’s more data from the same Q&A as above:

Thirteen percent of Republicans and 15 percent of self-identified conservatives wish ObamaCare was more liberal than it is? That seems … unlikely. But maybe not impossible: Medicare consistently polls well even among GOP voters, which is why lefties increasingly eschew terms like “single-payer” (or, lord knows, “socialized medicine”) in describing their health-care ambitions and choose ones like “Medicare for all” instead. Maybe some segment of Republicans/conservatives thinks Medicare for everyone would be nifty. Or maybe they have something totally different in mind about what it would mean to make O-Care “more liberal.” But what?

Needless to say, as any good liberal will be quick to remind you, all of the numbers above are dynamic. If the website starts working, some of the people who are convinced that the law’s a failure and its problems can’t be solved will quickly become unconvinced. But of course, that works both ways: The more stories the public hears about the site not working, about coverage being dropped, about provider networks shrinking, and about premiums skyrocketing — and they’ll hear plenty more next year once small-business coverage is in the mix — the more sour those numbers could become. Which way are you betting? Exit quotation: “So the unavoidable truth is that Obamacare will hurt millions of Americans; the only question is how many.”

Monday, November 25, 2013

ObamaCare updates November 25 , 2013 - Who knew Desperation i

s a Destination ? Congressional Dems ready to flip the white house

and turn on Obama IF the Healthcare.gov website is still a dud come

December 1 , 2013 ? Besides isn't the website just a symptom for the

worsening condition of the whole of ObamaCare ?

So what did we glean today ?

http://hotair.com/archives/2013/11/26/white-house-website-wont-be-fixed-by-december-1/

( I know , what a shocker..... )

White House: Website won’t be fixed by December 1

POSTED AT 10:41 AM ON NOVEMBER 26, 2013 BY ED MORRISSEY

Old and busted: Healthcare.gov will be fully operational by November 30th. New hotness:Healthcare.gov will, er, work better than it did by December 1!

Brought to you by the same people who insisted that if you liked your insurance plan, you could keep it:

Obama administration officials said Monday that some visitors to HealthCare.gov will experience outages, slow response times or try-again-later messages in December.

The Centers for Medicare and Medicaid Services (CMS) delivered the message in the latest attempt to downplay expectations for Nov. 30, the administration’s self-imposed deadline for fixing ObamaCare’s federal enrollment site.

CMS spokeswoman Julie Bataille said errors that persist past this weekend would be “intermittent” and, in line with a promise made by the White House, would not affect the vast majority of the site’s users.

But Bataille acknowledged that some would still experience “periods of suboptimal performance” by the system due to either heavy traffic or technical issues that are still being addressed.

“The system will not work perfectly on Dec. 1, but it will work much better than it did in October,” Bataille said.

Speaking of suboptimal performance …

The comments came after HealthCare.gov experienced an unscheduled outage on Monday for one hour. The CMS had recently touted the site for not randomly crashing. Bataille said the problem was remedied quickly by the site’s tech team.

Let’s recall that the pledge last month was specifically that Healthcare.gov would be “fully functional” by December 1. That date was not an accident. In order to have coverage by January 1, enrollees have to complete their enrollment by mid-December, although the administration is trying to get insurers to wait until December 23rd rather than the 15th as the cutoff. If the web portal still can’t handle the enrollments properly and fully by that time — and the 834s to the insurers seem to still be a big problem in that regard:

Behind the scenes, when an individual selects a plan, the federal system transmits a file, known as an “834,” with all of the relevant information about that individual and his or her plan selection.

These files have been plagued by errors, from spouses and children being mixed up to enrollments being duplicated or inadvertently cancelled. According to HHS, they have “completed fixes for two-thirds of the high-priority bugs that our tech team working with issuers identified as being responsible for the issues with 834 transactions and other issuer priorities.”

But according to an insurance industry source, though the 834 problems are getting better, there is still a long way to go. Insurers still haven’t reached the point where they can feel confident that the data is reliable.

As a result, though they have been able to process some payments from individuals, they’ve only been able to do so on piecemeal basis in cases where they are fully confident in the data, often because it’s been verified by hand.

That’s another problem. If the front end starts working better, the deluge of last-minute enrollments to comply with the individual mandate will flood insurers with bad data, which will be impossible to fix by hand in that level of throughput. Let’s also not forget that the subsidy-payment system doesn’t exist yet, either. This announcement only relates to theconsumer experience of Healthcare.gov, not the full functionality. Without the subsidy payments to the insurers, there’s still a large question as to whether those subsidy-qualifying enrollees will actually have coverage on January 1 if insurers don’t get the full premiums in hand by December 31st, a deadline which now looks impossible to meet.

Democrats pinned their hopes of competing in the 2014 midterms on the Obama administration’s ability to deliver on this pledge. Now they’re beginning to realize that they’ve hitched their wagons to a failing star:

For Democrats, the politics of the health care law are creating a death spiral of their own. For the White House to protect its signature initiative, it needs to maintain a Democratic Senate majority past 2015. But to do so, Majority Leader Harry Reid needs to insulate vulnerable battleground-state Democrats, who are all too eager to propose their own fixes to the law that may be politically satisfying, but could undermine the fundamentals of the law.

Race-by-race polling conducted over the last month has painted a grim picture of the difficult environment Senate Democrats are facing next year. In Louisiana, a new state survey showed Landrieu’s approval rating is now underwater; she tallied only 41 percent of the vote against her GOP opposition. In Arkansas, where advertising on the health care law began early, Sen. Mark Pryor’s approval sank to 33 percent, a drop of 18 points since last year. A new Quinnipiac survey showed Sen. Mark Udall of Colorado, who looked like a lock for reelection last month, in a dead heat against little-known GOP opponents. Even a Democratic automated poll from Public Policy Polling showed Sen. Kay Hagan of North Carolina running neck-and-neck against Republican opposition, with her job disapproval spiking over the last two months. These are the types of numbers that wave elections are made of.

The big picture isn’t any better: The president’s approval rating, which historically correlates with his party’s midterm performance, has dipped below 40 percent in several national surveys. Democrats saw their nine-point lead on the generic ballot in the Quinnipiac survey evaporate in a month, and a CNN/ORC poll released today shows Republicans now holding a two-point lead.

“You want to prevent your race from being about Obamacare. If you enable your race to be about Obamacare, you’re making a mistake,” said Democratic pollster Mark Mellman, who’s working for Landrieu. “You need to explain what you’re trying to fix, and you better be trying to fix something. If there’s nothing you want to fix, there’s something wrong with you. At this point, it’s hard to defend the benefits, but you can say we’re not going back to the evils of the old system.”

In the old system, 85% of Americans had health insurance, and 87% were satisfied with their health care. Good luck trying to run on the “evils” of that system, especially after getting an up-close-and-personal look at DemocratCare.

http://hotair.com/archives/2013/11/26/payoff-feds-to-increase-risk-payments-to-insurers-in-return-for-un-canceling-plans/

Payoff: Feds to increase “risk payments” to insurers in return for un-canceling plans

POSTED AT 2:51 PM ON NOVEMBER 26, 2013 BY ALLAHPUNDIT

We all know about the “risk corridor” at this point, yes? Designed to spread the risk of budget overruns among insurers, it could end up as a mechanism for a federal bailout of the industryif the ObamaCare exchange risk pool ends up being much older and sicker than everyone expects. When King Barack declared that he’d allow insurers to un-cancel old plans, notwithstanding what the ObamaCare statute has to say about it, he increased the odds of that bailout being necessary by allowing healthy people to leave the exchange risk pool (temporarily) and revert to their old, cheaper coverage. That means less revenue for insurers, which of course makes budget overruns for the exchange plans more likely. How could O possibly make it up to them?

You know how. A day after Obama announced his “fix” that doesn’t actually fix anything, CMS sent a letter to insurers reassuring them that the agency would “explore ways to modify the risk corridor program final rules to provide additional assistance.” Translation: The feds are going to shovel a little extra taxpayer money their way to cover the extra cost imposed by O’s buck-passing, ass-covering, eleventh-hour attempt to keep his “if you like your plan” promise after all. And now, here it is:

The U.S. government has issued a proposal that would likely increase risk payments in 2014 to health insurers offering plans on the Obamacare exchanges after the companies complained a recent policy change allowing people to keep their insurance policies had changed the financial equation.

The rule, published on Monday in the Federal Register, lowered the threshold at which risk payments kick in for the sickest health plan members. The government proposed paying insurers 80 percent of claims greater than $45,000 in 2014. Previously the lower limit was $60,000…

In addition, the government has proposed a state-specific adjustment for risk payments based on how many people in the state extend their current polices, Citibank analyst Carl McDonald explained in a research note.

Insurers thought they’d have enough profit flowing in from healthy people who’d been forced onto the exchanges that they wouldn’t need federal help in paying off claims below 60 grand. Thanks to Obama’s need to protect himself and his party politically, that calculation has now changed — and your money will make up the difference. If you’re one of the lucky few million who’s received a cancellation notice this year, that means you’re one of the law’s “losers” twice over. Happy Thanksgiving.

Oh, almost forgot: The feds don’t have a way of transmitting these individual risk payments to insurers yet because … that part of the ObamaCare website hasn’t been built yet:

Beyond the troubles with enrollment forms, which have been evident since the marketplace opened on Oct. 1, insurers are anticipating problems if IT workers from the government and outside contractors cannot soon build other parts of the online system that are running behind schedule.

For instance, starting in mid-December, the government and each participating insurance company are supposed to perform a monthly “reconciliation,” to make sure that each side has the same list of new customers, the benefits chosen by the consumers and the government subsidies for which they qualify. That feature of the online system, however, has not been built, according to people close to the industry and government officials.

Nor can the system handle another feature, scheduled to be ready when health plans take effect on Jan. 1, in which insurers are to be paid extra government money, through a method known as “risk corridors,” if their new customers are old and require expensive medical care. “It’s not built, let alone tested,” the industry official said.

Other parts of Healthcare.gov still aren’t working — uploaded ID documents have been known to disappear into the ether, as have “orphaned” enrollment records — but at least there’s some sort of infrastructure in place for those. The back end, where insurers receive data and money from the feds, represents the 30-40 percent of the exchange that still needs to be built from scratch. Show of hands: Who’s not-so-secretly enjoying watching the insurance industry learn what it means to partner with Barack Obama?

http://talkingpointsmemo.com/dc/obamacare-website-fix-gradual-return

White House Privately Asks For Gradual Return To HealthCare.gov

AP Photo

DYLAN SCOTT – NOVEMBER 25, 2013, 6:44 PM EST6286

The Obama administration is quietly asking health care advocacy groups not to send a flood of consumers to HealthCare.gov next week, pushing instead for a more phased approach that won't overwhelm the website that the administration has pledged would be fully functional by Dec. 1.

The message is being communicated in private meetings, including one held Monday, a senior administration official told TPM. Groups like Enroll America and Planned Parenthood, which are among the leading organizations that are helping people sign up for coverage under Obamacare, are some of those to be targeted.

"We want to make sure that those who are reaching consumers at scale know that this isn't like you flip the switch and everyone can come back on the first day," the official said.

The plan would serve two purposes. First, it would lighten the load on HealthCare.gov next week, the first after the administration's self-imposed Dec. 1 deadline to get it fully functioning. Limiting the number of people who are coming to the site should help prevent any embarrassing outages. And second, preventing outages would ensure that people who are returning to the site after being frustrated by its early problems will have a better experience.

Julie Bataille, spokeswoman for the Centers for Medicare and Medicaid Services, which oversees the site's operations, told reporters Monday that the website's capacity would be doubled from 25,000 users at a time to 50,000 by next week. At that level, the site will be able to handle the load and perform well, she said. But above that level, there will presumably be a higher risk of crashes.

The fear of too much traffic is real for the White House. According to the senior administration official, the site sometimes saw as many as 250,000 people at the same time in October. Plus, the administration has very publicly pledged to have the site working by the end of November, and there is an expectation that traffic could spike as people come back following the Thanksgiving holiday after having a chance to talk about health insurance with their families. Those two factors could combine to send people in droves to the site starting Monday.

By contacting these influential enrollment groups and asking them to take a gradual approach, the administration is aiming to mitigate some of that risk. If volume is heavy, the site will be better equipped to handle it, the senior official said, with a better queueing system for users who have to wait than existed last month.

"It's a different world from what it was before," the official said. But avoiding any traffic problems would be preferable after the site's disastrous launch last month.

Though the official said the two weren't linked, the administration has also given advocates more time to sign people up for coverage that starts on Jan. 1. CMS extended that deadline last week from Dec. 15 to Dec. 23. So if those groups do take the phased approach that the White House is requesting, they will have that extra week to enroll people without having to wait for their coverage to begin

http://www.nytimes.com/2013/11/26/business/new-pitch-for-health-initiative-mind-your-mom-get-insured.html?hp&_r=0

New Pitch for Health Initiative: Mind Your Mom. Get Insured.

By KATIE THOMAS

Published: November 25, 2013 467 Comments

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As the Obama administration’s health overhaul sputters in its opening weeks, insurers and advocacy groups are pursuing a new strategy in the quest to get millions of young people to sign up for health insurance: They’re appealing to their mothers.

Enlarge This Image

Heather Ainsworth for The New York Times

Lynne Jackier, 56, left, says it’s her responsibility to push her daughter, Rosie Simon, 24, to obtain her own health insurance.

Share Your Experience With Health Insurance Exchanges(September 30, 2013)

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A maternal memo to adult children: Buy health coverage.

In one cheeky campaign, AARP is urging mothers to send e-cards to their children reminding them to sign up. One e-card reads, “As a reward for signing up for health insurance, I’ll defriend you on Facebook.” Another group, Organizing for Action, is seeking to steer holiday conversations toward health care by encouraging parents to have “the talk” with their adult children. And a Colorado group is promoting an adfeaturing a hapless young man who calls his mother from the golf course: “Yo, Mom, do I got insurance?”

Recruiting enough young people is a major goal of the Obama administration because insurers need healthy customers to offset the cost of caring for those with expensive medical needs.

The goal carries even more urgency now that insurers are considering a proposal by President Obama to let people, many of them healthy, stay on their existing policies for another year. If fewer of those people buy insurance in the new marketplaces, signing up young people without insurance will be even more crucial. Young people also account for a major chunk of the uninsured. About 40 percent of the estimated 41 million uninsured people nationwide who are eligible for coverage are between the ages of 18 and 35, according to the administration.

Even as supporters are enlisting mothers in the effort to sign up their adult children, critics have mounted an equally aggressive and well-funded campaign urging young people to “opt out” of coverage. Opponents use many of the same marketing tools as the law’s supporters, reaching out to young people on social media and through web videos.

Advocacy groups and insurers are expected to make a major marketing push beginning in early December, when the Obama administration has said it expects the malfunctioning federal health care website to be working better. They have their targets set on two major deadlines: Dec. 23, when insurance must be purchased for coverage beginning on Jan. 1, and March 31, when the open enrollment period will end.

Beneath the marketing campaigns’ playful language is a deeper truth: When it comes to making major life decisions, many people — especially young adults — still turn to their mothers for help. More broadly, women make about 80 percent of the health care decisions for their families, according to the federal Labor Department.

“It’s the cutest phenomenon ever,” said Lynn Quincy, a senior health policy analyst at Consumers Union, who stumbled on the significance of mothers while conducting a focus group of men and women last year about how well people understood the language in their insurance policies. When asked who they turned to for advice about health care, the overwhelming answer was their mothers. “These people could have husbands, they could have fathers, they may have a nurse who lives next door, but they’re all going to their moms,” she said.

FOR DISCUSSION

Are you a young person considering signing up for health insurance? What factors influence your decision?

Share your thoughts below.»

Of course, the administration and advocacy groups are also reaching out directly to young people themselves, collaborating with outlets like the comedy website Funny or Die, initiating social media campaigns, handing out fliers at concerts and sponsoring a video contest aimed at getting young people to sign up.

“People need to have heard about it a couple of times, and frankly from a couple of different sources,” said Jon Carson, the executive director of Organizing for Action, the nonprofit group that grew out of President Obama’s 2012 campaign organization. He said mothers represented just one avenue that they hoped would help persuade a young person to enroll. The recently posted video is part of a campaign, called Healthcare for the Holidays, that seeks to arm parents with talking points when they see their children at family get-togethers.

This approach may resonate especially well with the so-called millennial generation, which came of age in a recession and may still financially depend on their parents, say some experts.

“Millennials love their parents and they count on them for advice,” said Morley Winograd, the co-author of three books on the millennial generation. He noted that this might sound surprising to baby boomers, who famously rebelled against their parents’ generation. But millennials “assume that their parents have more worldly experience, and know about things like money and health insurance,” he said.

Mary Babich, the mother of two children in their 20s without insurance, said she had been pestering both of them to sign up. “They look at it as just government bureaucracy — as almost akin to filling out their taxes,” said Ms. Babich, who lives in Wisconsin. She paused, and added, “The sad thing is, I’ve always done both of their taxes.”

The mother-knows-best strategy isn’t entirely new. In 2007, when Massachusetts introduced its health care law, officials mailed greeting cards, timed for Mother’s Day, to the parents of young men between the ages of 18 and 26. Market research had shown this group was among the most resistant to buying insurance. “The idea was to trigger a phone call from the parent to the child to say, ‘Hey, by the way, do you have insurance?’ ” said Kevin J. Counihan, who served as chief marketing officer for Massachusetts’s health insurance marketplace at the time. “We made the hypothesis that we could best reach the young men through their mothers.”

The effort, Mr. Counihan said, was a moderate success: Many parents decided to pick up the bill for their sons’ health insurance. And more often than not, “we found they bought the most expensive plan because apparently nothing was too good for Johnny.” Mr. Counihan is now chief executive of Connecticut’s state marketplace and said he was still targeting the mothers of young men by focusing on churches and community groups where they are likely to be members.

Insurers are also taking note of this influence. Shaun Greene, the chief operating officer atArches Health Plan, a health care co-op in Utah, said he was surprised during a recent televised call-in when he fielded several calls from parents who quickly handed the phone to their children. “At least three of them had their kid by the ear,” he said, explaining: “My son or daughter needs insurance. Talk to them.”

A certain level of concern is just part of being a parent, said Nicole Duritz, who helped develop the AARP campaign. “I’m a mom and I’m constantly worried about my kids, and making sure they’re making good decisions,” she said. “And health insurance falls into that category.”

That’s certainly true for Lynne Jackier, of Ithaca, N.Y., who has been helping her 24-year-old daughter look into buying health insurance on the state marketplace. She also has a 26-year-old son who recently moved to California and is also uninsured.

“I feel like, as parents, it’s our responsibility to get them to look at this now,” Ms. Jackier said.

Her daughter, Rosie Simon, works as a nanny in Westchester County and said she had been uninsured since graduating from college a few years ago. Although Ms. Simon said that she had heard about the changes coming under the health care law, she added that her mother had been persistent in making sure she signed up. Last weekend, during a visit home, the two sat down at the computer and took the initial steps of completing an application on New York’s marketplace.

Without insurance, Ms. Simon said she often delayed going to the doctor when sick, or leaned on her parents for help. Ms. Jackier, who is on Medicaid and so can’t cover her daughter through private insurance, said she had become accustomed to the frustrating conversations. “She’ll get sick and I’ll say, ‘You have go to the doctor,’ ” Ms. Jackier said. “And she’ll say, ‘Well, I don’t have insurance.’ ”

The family had a scare when Ms. Simon recently developed a serious kidney infection. Her parents paid the bill, which cost a few hundred dollars. It wasn’t ideal, Ms. Simon said, but “I’m still their baby.”

Catharsis Ours

Tuesday, November 26, 2013