Saturday, November 30, 2013

ObamaCare Updates November 30 , 2013 - Another extended shutdown of Healthcare.gov , another indication that bolt-on fixes on the fly aren't going to cut it....Will the self- imposed deadline from the White house pass the smell test of functionality ? Whether or not the Rube Goldberg contraption works sufficiently not to crash once traffic comes back in volume , the more interesting question will be whether too many consumers have been turned off to care ? Technical problems still lurk beneath superficial improvements and major concerns surrounding security , verification of user identifications , transmission of accurate information to insurers remain and of course the payment processing aspect has not even been built yet ! Ironically , does Obamacare even provide increased access to medical care - NY Times says not so regarding Medicade ...

I love the smell of hubris in the morning.......Healthcare.gov will be working really well  by .... wait for it .... 2017 ?  Saying 2017 now is like moving the goalposts to a Stadium in another State , right ?


CNN Tests "Fixed" Obamacare Website And... It Crashes

Tyler Durden's picture





 'If you think health care is expensive now, wait until you see what it costs when it's free.'
       -  P.J. O'Rourke
If CNN was doing its best this morning to prove that the second coming of healthcare.gov is fixed, it... failed.
Transcript:
GEORGE HOWELL, HOST: We know the first thing you have to do when you go to this website you have to select your state. Is that working?

ALISON KOSIK, CNN BUSINESS CORRESPONDENT: And what's funny is I was talking with Matt, and, yeah, that seemed to work, right, when you logged on. But then came the road blocks. So tell me about what happened, because we're getting another error message here, and it's supposed to be running smoothly. We’re just not seeing that.

MATT SLOANE, CNN MEDICAL PRODUCER: Yeah, so, you know, we've been trying to get into the site since October 1 on and off again. I have to say it did work a lot more smoothly this morning. I got through. I picked my state. I put in all of my information and I got through the whole process in eight minutes. And then it said my status was in progress. So I went to refresh it and I got the error message.
But fear not. According to David Plouffe, 2008 campaign manager for Barack Obama, Obamacare "will work reall well"... by 2017. To wit:
This program was designed to be implemented by the states. And in most of the states it is going quite well. You talked about Medicaid expansion. I think it's just a fact, and it may take until 2017 when this president leaves office, you're going to see almost every state in this country running their own exchanges eventually and expanding Medicaid. And I think it'll work really well, then.




Video: Relaunch of most embarrassing gov’t website ever going about as well as you’d think

POSTED AT 3:31 PM ON DECEMBER 1, 2013 BY ED MORRISSEY

 
According to Fox News Sunday, the new Healthcare.gov site has not quite achieved the promised “fully functional” status by the November 30th deadline.  In fact, the site still can’t verify identities for potential enrollees, which means that consumers can’t be sure they’re seeing the right information for coverage options.  After forty-two months of development and nine weeks of futility and failure, this isn’t exactly a confidence-builder (via The Weekly Standard):
“Federal officials promised that healthcare.gov would work smoothly for a vast majority of users starting today. But that has not been the case so far because this morning the critical verification system is unavailable. That’s the system that confirms identities and makes sure people are receiving proper coverage information.
“And applications cannot be submitted without this ant step. The site says this particular problem should be solved within 24 hours. And there is another error much earlier in the process as well. When the site asks if an insurance agent or navigator is assisting you with your application. Ater clicking none of these people are offering any guidance, the next screen incorrectly displays a message declaring the opposite. The banner says, you told us another person is helping you.
“Furthermore, an address associated with healthcare.gov has sent several erroneous e-mails this morning with an alert suggesting that logging in at the website will reveal a new message, however no message ever appeared. Officials have said November 30th was not a magical relaunch date for healthcare.gov, and that like any site, they predict there will be times moving forward when it does not perform optimally.”
A “magical relaunch date”? That was the administration’s initial promise — that all of the bugs would be worked out by December 1, a deadline that is more than just an arbitrary date on the calendar. In order to meet their January 1 deadline for the individual mandate, the site has to be able to enroll millions of people no later than December 23rd — and then the back-end issues have to be fixed, and an entire subsidy payment system launched to ensure that the coverage actually takes effect for those enrolled through Healthcare.gov.
If they still can’t get the front end to verify an enrollee’s identity, just imagine the status of the 834 transmission and subsidy payment infrastructure.  And this is after a month-long push to fix these very problems.






Obama Administration Admits "There Is More Work To Be Done" As Healthcare.gov Relaunches

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While even the most naive private sector cyber-experts knew well in advance that an effective rewrite of Obamacare's 500 million lines of code would take a "little longer" than the month promised by the government in advance of the November 30 fix deadline, the Obama administration went ahead with its much touted healthcare.gov relaunch anyway. The results have been mixed.
The WSJ quotes Obama administration officials who said Sunday there has been "dramatic progress" in fixing HealthCare.gov but acknowledged "there is more work to be done" in improving the site and its underlying technology and that technicians for the site said they will not be able to fix all the glitches by the deadline.
Centers for Medicare and Medicaid Services officials released an eight-page report Sunday morning offering a few details of progress in fixing the site, which crashed shortly after its launch Oct. 1.
The site now allows 50,000 people to use it at the same time, according to the report, and wait times for Internet pages to load have dropped from 8 seconds to less than a second. More than 400 fixes have been made to the site.

"The bottom line, HealthCare.gov on Dec. 1 is night and day from where it was on Oct. 1," said Jeffrey Zients, the Obama aide tasked with fixing the technical mess, in a call with reporters.
Ironically, if Obamacare ends up being the success Obama has portrayed it as since day one, and traffic to the website surges (as is needed for Obamacare to become financially viable as opposed to just stop showing 404 screens), it is likely that it will crash once again. CMS representative Julie Bataille cautioned, “If there are extraordinary high spikes in traffic, which exceed the site’s capacity, consumers will be put in a new advance queuing system that will give them an expected wait time, or allow them to be notified via email when they can return to the site." Aka: F5.
That said, assuming the website is indeed finally fixed, it is clear who should be thanked: Google and Oracle. "Contractors and outside engineers from Google Inc. and Oracle Corp. brought in by Obama administration officialshave been working overtime over the past five weeks to try to fix the site and its underlying technology, including systems that send information and payments to insurers. Administration officials say they installed fixes this weekend to address erroneous customer data that have been sent to insurers. They won't know if that issue has been fixed until more consumers get through the enrollment process and more customer data is sent to insurers, said Julie Bataille, a CMS spokeswoman."
In other words, you have to sign up for Obamacare, to find out not only what's in it and what your premiums will be, but if it has even been fixed.
Finally, those still confused about the enrollment process, will get some much needed clarity from the flowchart below.


http://dailycaller.com/2013/12/01/officials-claim-partial-repair-of-obamacare-website-fail-to-meet-user-success-target/


President Barack Obama’s deputies are claiming they have successfully reincarnated the Obamacare network’s website.
“Twenty-four hours a day, we have rapid effectives response to any problems the instant they appear,” Jeff Zients, a top Obama advisor, told reporters during a Sunday morning press conference. “The site is now stable and operating at its intended capacity.”
But the stage-managed focus on the website drags the media’s attention away from the actual impact of Obamacare. So far, Obama’s centrally-planned healthcare system has cancelled insurance policies needed by at least 4 million Americans, and is imposing heavy health-care taxes on many Americans, companies, unions and hospitals.


The claims of technical success are also questionable.

Zients declined to answer some awkward questions during the Sunday morning press conference. For example, he declined to compare the website’s error rate to the error rate of commercial websites, such as Amazon.com.

Julie Bataille, a spokeswoman for the Centers for Medicare and Medicaid Services, declined to say they have met the administration’s November goal of allowing four out of five visitors to enroll on the site. “We’re more in the zone of about 80 percent,” for people “with information in hand” she said in in the press conference. That measure excludes people who have gathered the personal data demanded by the website, such as income estimates and tax records, she said.
Zients didn’t mention growing concern about the danger that hackers could steal Americans’ private data as it is process by the Obamacare website, and he downplayed managers’ failure to develop vital software that links website transactions to the databases and billing systems operated by health insurance companies.
He also downplayed his central role in the rejuvenation effort, fueling expectations that he will leave in January. Prior to October, Obama announced Zients would become the director of the National Economic Council in January. “My head is down. I’m focused on the project 24/7,” Zients told reporters.

The officials also declined to identity the website as the “Obamacare” website, reflecting the administration’s post-October effort to distance the president’s name from the unpopular system.
The failed website is proving to be a PR and a technical headache for Obama, who had hoped prior to October that he could enroll at least 7 million people into his network by March.
Several million Americans whose policies have been cancelled must enroll during the next 23 days, or else begin 2014 without insurance. (RELATED: Health insurance cancellation notices soar above Obamacare enrollment rates)
The system only enrolled 106,000 people in October, partly because of the failed website, but also because of the network’s high prices.
The new enrollees are also skewing older and sicker than needed, according to leaks from industry officials and to statements from state officials. That’s problematic, because prices will spike again for Obamacare’s customers in late 2014 if too few young people refuse to join the Obamacare network, despite the threat of large federal fines.
Obama’s effort to redesign the nation’s healthcare system has prompted a backlash from many influential middle class voters, driving his approval ratings down from roughly 50 percent to 40 percent, and threatening many Democratic legislators with defeat in the 2014 midterm elections. (RELATED: Obama schedules five fundraisers on West Coast as approval rate plummets)
The administration’s claims of success were showcased in a Dec. 1 report, titled “Healthcare.gov Progress and Performance Report.”
The graphics-filled report claims that software experts have repaired 400 software glitches, added much increased hardware, and allow visitors to click through to their next webpage after less than one second, compared to eight seconds per click in early October.
The website is operational 90 percent of the day, compared to 42 percent in early November, the report states.
Users spend an average 25 minutes per visit, allowing 50,000 people to use the site simultaneously, claims the report.
“We believe we have met the goal of having a system that will work smoothly for the vast majority of users,” the report concludes.
That vague and  goal was set in November, when Obama’s deputies ramped up their technical repair efforts and their PR campaign.
In recent days, officials have have arranged closed briefings for favored reporters and industry experts, and showcased their command center at an office building in northern Virginia. (RELATED: White House holds Obamacare background briefing with liberal reporters)
They’ve also deployed new P.R. phrases and terms during the last few weeks. “The language that we have used to describe the circumstance that we’re expecting is that the website will be functioning smoothly for the vast majority of users,” Josh Earnest, the president’s deputy press secretary said Nov. 21.
To help the website’s rejuvenation efforts, Obama has postponed once-critical functions, such as the creation of website for the owners of small business, and a Spanish-language site intended to enroll Democratic-leaning Latino voters.
Prior to October, he dropped enforcement of large section of the law, including a requirement that large private-sector employers buy Obamacare compliant healthcare plans for their employees before 2014.
His deputies are also showcasing isolated individuals who gain from the Obamacare system, which imposes heavy taxes on middle-income and younger people to subsidize insurance for Democratic-leaning constituencies, including poor people, Latinos and African Americans.










http://twitchy.com/2013/11/30/this-revamped-healthcare-gov-homepage-is-hilarious-photoshop/



View image on Twitter
Obamacare website puts on new face for repair deadline day.














New plan on Healthcare.gov: Declare victory … and fix it later

POSTED AT 12:31 PM ON NOVEMBER 30, 2013 BY ED MORRISSEY


Well, I guess it beats explaining why the Obama administration failed to meet yet another of its deadlines in getting a 42-month web-portal project to work.  According to the Washington Post, the White House will announce tomorrow that the Healthcare.gov site has been fixed, even though the site won’t actually be fixed — not even by the administration’s own metrics:
Administration officials are preparing to announce Sunday that they have met their Saturday deadline for improving HealthCare.gov, according to government officials, in part by expanding the site’s capacity so that it can handle 50,000 users at once. But they have yet to meet all their internal goals for repairing the federal health-care site, and it will not become clear how many consumers it can accommodate until more people try to use it.
As of Friday night, federal officials and contractors had achieved two goals, according to government officials who spoke on the condition of anonymity in order to discuss ongoing operations. They had increased the system’s capacity and reduced errors. On the other hand, the site’s pages do not load as fast as they want, officials said, and they are working to ensure that large numbers of consumers can enter the site.
An official at the Centers for Medicare and Medicaid Services, the agency overseeing the federal health insurance exchange, said the site’s true capacity is somewhat murky because workers need to see how it performs under “weekday traffic volumes” when demand is at its peak.
What exactly constitutes success?  Jeffrey Zients declared a month ago that the web portal would be “fully functional” by tomorrow.  This past week, though, Kathleen Sebelius moved the goalposts about 80 yards by promising only that consumers would “have a significantly different user experience by the end of this month.” The Post splits the difference, although noting that the White House has been slippery on what exactly constitutes success:
Administration officials have said for several weeks they define success as having “the vast majority of users” be able to navigate the site and sign up for insurance. While they initially did not define what that meant, White House press secretary Jay Carney said earlier this month that the administration’s aim was to have 80 percent of users enroll through the site. Those working on the project have set speed and error rates as a way of measuring that goal.
Industry observers are less than impressed with the new metrics for success:
However, problems continue to plague the system, and technology experts question if the fixes being deployed by a team of government workers, outside contractors and specialists can get it functioning smoothly as soon as Saturday.
Luke Chung, president of Virginia-based software developer FMS Inc., called the administration’s prediction that HealthCare.gov would work at 80% capacity on or around November 30 an impractical threshold in the software world.
“I don’t know how to build something that’s only 80% complete,” Chung told CNN. “I don’t even understand how that works.” …
Meanwhile, insurance industry insiders told CNN on condition of not being identified that problems continue with the transmission of data submitted by people signing up for coverage through HealthCare.gov.
“There’s no part of us that thinks all of this will be fixed in three days from now,” an industry official said, referring to the November 30 date for the site to run smoothly for most users.
In other words, we’re about to see the second beta release of Healthcare.gov.  Don’t you justlove it when software companies use a release as testing for failure thresholds?  I guess you can’t find out what’s in Healthcare.gov until you release it … just like a couple of months ago, it seems.
You couldn’t find out overnight, though, because the system was down:
The entire ObamaCare Web site was suddenly taken down for 11 hours — from Friday night into Saturday morning — just before its long-awaited ­relaunch.
Officials said the extended shutdown, which began 9 p.m. Friday, was required to get the site ready to accept double the number of applicants starting Saturday.
“We have more upgrades that require more time,” said Aaron Albright, a spokesman for the Centers for Medicare and Medicaid Services, which oversees the problem-plagued portal.
The site has been taken down before, but usually only for four hours between 1 and 5 a.m.
Even before the unexpected move, health-industry experts were skeptical that the fix that’s supposed to produce a “new and improved” site Saturday would be the game-changer President Obama has promised.
And just how confident is HHS in the fixes? This confident:
“There are 23 shopping days in December [until the deadline for coverage that starts Jan. 1]. No need to rush,” Sebelius advised in an attempt to avoid a panicked rush of the uninsured on Saturday.
Don’t forget that all of this is just to get the front end working.  Does the subsidy payment system on the back end even exist yet?  If not, then the 23 shopping days are meaningless, because insurers might not provide coverage without full premium payments.
Maybe the White House should declare victory and depart the field altogether.






This Is A Crucial Weekend For The Obamacare Website — And It's Already Going Poorly

Barack Obama Iran
REUTERS/Joshua Roberts
WASHINGTON (Reuters) - A crucial weekend for the troubled website that is the backbone of President Barack Obama's healthcare overhaul appears to be off to a shaky start, as the U.S. government took the HealthCare.gov site offline for an unusually long maintenance period into Saturday morning.
Just hours before the Obama administration's self-imposed deadline to get the insurance shopping website working for the "vast majority" of its users by Saturday, the Centers for Medicare and Medicaid Services (CMS) announced that it was taking down the website for an 11-hour period that would end at 8 a.m. EST on Saturday.
It was unclear whether the extended shutdown of the website - about seven hours longer than on typical day - represented a major setback to the Obama administration's high-stakes scramble to fix the portal that it hopes eventually will enroll about 7 million uninsured and under-insured Americans under the Patient Protection and Affordable Care Act, also known as Obamacare.
At the very least, the shutdown suggested that nine weeks after the website's disastrous launch on October 1 prevented most applicants from enrolling in coverage and ignited one of the biggest crises of Obama's administration, U.S. officials are nervous over whether Americans will see enough progress in the website to be satisfied.
For the administration and its Democratic allies, the stakes are enormous.
The healthcare overhaul is Obama's signature domestic achievement, a program designed to extend coverage to millions of Americans and reduce healthcare costs. To work, the program must enroll millions of young, healthy consumers whose participation in the new insurance exchanges is key to keeping costs in check.
After weeks of round-the-clock upgrades of software and hardware, Obama officials said they were poised to successfully double its capacity by this weekend, to be able to handle 50,000 insurance shoppers at one time.
But if the website does not work for the "vast majority" of visitors this weekend as the administration has promised, uninsured Americans from 36 states could face problems getting coverage by an initial December 23 deadline.
It also could create ripples that extend to the 2014 elections when control of the U.S. House of Representatives (now controlled by Republicans) and the Senate (now led by Democrats) will be up for grabs.
Obama's fellow Democrats who are up for re-election in Congress already have shown signs of distancing themselves from the president and his healthcare program. If the website does not show significant improvement soon, some Democrats - particularly the dozen U.S. senators who are from states led by conservative Republicans and who are up for re-election next year - might call for extending Obamacare's final March 31 enrollment deadline for 2014.
That would delay the fines that are mandated by the law for those who do not have insurance by that date, a scenario that insurers say would destabilize the market. It also would fuel Republicans' arguments that Obamacare, and its website, are fatally flawed and should be scrapped.
In broader political terms, the website's immediate success has become vital to Obama's credibility, which polls indicate has been tarnished by the site's problems as well as Obama's admission that he overreached in promising that everyone who liked their healthcare plan would be able to keep it under the new law.
Obama has been forced to apologize for oversimplying how the law would affect certain Americans, and has acknowledged being embarrassed and frustrated by the website's failures. Recent polls have shown that Obama's approval ratings are at the lowest point of his presidency.
"It is a lot harder to reboot public trust than it is to reboot software," said David Brailer, chief executive of the Health Evolution Partners private equity firm and a former health official in George W. Bush's administration.
"But the good thing about when you're down is that usually, you got nowhere to go but up," Obama said in an interview that aired on Friday on ABC.

IS IT FIXED? HARD TO TELL

Several technology specialists told Reuters that it will be difficult to independently assess on Saturday whether the HealthCare.gov site has met the administration's goals of functioning for most users most of the time, including handling 50,000 users at once.
"There won't be anything you can tell from the outside," said Jonathan Wu, an information technology expert and co-founder of the consumer financial website ValuePenguin.
When the site opened for enrollment on October 1, many users found that they could not complete the simple task of creating an account. Now, the website is functioning better but any remaining problems lie much deeper within the site, Wu said in an interview.
Eleventh-hour checks were not encouraging, said Matthew Hancock, an independent expert in software design who said he could tell within hours of the site's launch that its problems were the results of poor system design and bugs, rather than the heavy traffic that the administration blamed initially.
"I have tested the site every several days trying to buy a health insurance plan, but haven't been able to," Hancock said.
"I think the issues the site faces now are more complex to diagnose from the front end, whereas before the site was immediately failing and returning error details," he said.
Questions also remain about the website's ability to direct payments to private insurance companies when consumers enroll in their plans. Portions of the system handling those functions are still being built, officials say.
"The real tests are: Were my premium payment and subsidy accurately calculated? Am I getting the coverage I signed up for? If my income situation changes, will the reconciliation occur in a timely fashion?" said Rick Howard, a research director at technology consultant Gartner.

A DATE AND A NUMBER

Heading into this weekend, administration officials tasked with rescuing Obamacare showed signs of confidence that the series of fixes by tech specialists would work.
The officials gave a "virtual tour" of what they had branded the "tech surge" to a group of White House reporters.
The White House also invited a group of IT specialists to tour the website's "command center," where an engineer on unpaid leave from Google Inc directs disparate contractors and monitors their progress.
It was a convincing show that the team had the crisis under control, said John Engates, chief technology officer at Rackspace, a web hosting firm in San Antonio, who participated.
Engates, who had been publicly critical of the launch, said he felt it was likely the website would be able to handle 50,000 concurrent users on Saturday, although he did not know for sure.
"Whenever you have a date and a number, you need to be pretty sure that you can hit that date and that number," Engates told Reuters.
"It's just another loss of confidence if you don't make it."

















Health Site Is Improving But Likely to Miss Saturday Deadline

Updated Nov. 30, 2013 12:07 a.m. ET








Wendy Bounds and Louise Radnofsky discuss the deadline for the HealthCare.gov website, and Charles Passy looks at gourmet food deals for the holiday season.
Despite recent progress at HealthCare.gov, a raft of problems will remain beyond the Obama administration's Saturday deadline to make the troubled federal insurance website work.
The news isn't all bad: Users say the site looks better, pages load faster, and more people are getting through to sign up for health plans.
But technical problems still affect HealthCare.gov's ability to verify users' identities and transmit accurate enrollment data to insurers, officials say. The data center that supports the site faces continuing challenges, and tools for processing payments to insurers haven't been built.
Technical staff in Washington have been racing up to the end-of-November deadline. In their last public pronouncement on the effort, three days before the deadline, officials said they had much to do to get the site into a condition where it functions smoothly for a majority of users.
The success of the White House's signature domestic initiative is riding on the technicians' ability to fix the site, as well as the rest of the federal technology supporting enrollment. Across the nation, that effort is being eyed hopefully by supporters of the law, since the site is the centerpiece of the effort to overhaul American health care and extend coverage to millions of people.
Those hopes were deflated by a series of blows for the administration right up until Nov. 30, and the site continued to experience outages, both planned and unplanned, in the week leading up to the deadline.
The Wall Street Journal reported on Wednesday that the administration was planning to change its Web-hosting provider from Verizon Communications Inc.VZ -0.62% subsidiary Terremark to Hewlett-Packard Co. in the spring, a complex transition that could introduce new challenges and take months; and the same day, the administration said it was shelving for a year any attempts to operate an online exchange for small businesses. On Wednesday, Verizon declined to comment on its clients.
Officials mixed optimism with caution. "November 30th does not represent a relaunch ofHealthCare.gov," said Julie Bataille, a spokeswoman for the government's Centers for Medicare and Medicaid Services, which operates the site. "It is not a magical date. There will be times after November 30th when the site, like any website, does not perform optimally."

Find Your State's Health-Insurance Exchange

For the fix-it drive that began in late October, the administration tapped former White House adviser Jeff Zients and QSSI, a unit of UnitedHealth Group, to act as the new lead contractor, establishing a 24-hour "war room" operations center to coordinate contractors who previously weren't working well together. Since then, officials have focused on fixing the kinds of wrinkles that were most obvious to users.
They have reported success in speeding up the response time of the system, lowering it from an average of eight seconds at launch to less than one second for most users. They say they have eliminated a host of glitches in the software so that pages now load incorrectly less than 1% of the time. And they say they have added "visual cues" to help users navigate the system more easily.
Technicians have been racing to add new computer server, storage and database capacity to the website, hoping to get the site ready to withstand 50,000 simultaneous users by Sunday, as was originally intended, said people familiar with the work. "I think we are close," said one.
Some people involved with enrollment say they have seen a notable uptick in recent weeks. Maine Community Health Options, a nonprofit plan based in Lewiston, Maine, now is getting "hundreds of enrollments" a day, rather than the dozens it saw trickling in earlier this month, said Chief Executive Kevin Lewis.
But problems with the performance of the site's databases, storage and servers and their interaction with each other continue to slow the site or make it unavailable for short periods, according to government officials and contractors working on the project.

The Health Law Rollout

Explore how America's health-care overhaul will affect you on this first-person adventure. CLICK THE IMAGE to start interactive experience.
Karen Egozi, CEO of the Epilepsy Foundation of Florida, which has trained nearly 50 people to help others enroll, said the performance of the website has improved in recent weeks but suffers from unpredictable glitches. On Nov. 19, Secretary of Health and Human ServicesKathleen Sebelius visited a medical center in Miami and watched a member of Ms. Egozi's staff help a couple fill out an application. The website failed, in front of a local TV camera crew.
On the weekend of Nov. 23 and 24, Ms. Egozi said her navigators were able to sign up a few people. But on Nov. 25, she said the site was down for a little while. "Sometimes, similar to when the secretary was here, the site does not let us through to the next section," she said. "It was not working today, but yesterday it worked well."
One source of early problems: The government had bought web-hosting services from Terremark subsidiary that initially gave it a highly virtualized system of servers shared by other groups within the Medicare center, rather than a dedicated group of computer servers for HealthCare.gov. Plans are in place to replace the Verizon unit with H-P this spring.
HHS also didn't initially contract for a backup website or monitoring tools like those used by sophisticated consumer sites, according to people familiar with the matter.
The website still has no separate backup copy, but it did replace the virtual database with dedicated hardware, and bought and installed monitoring software.
Meanwhile, the site has a backlog of users who encountered problems in its first weeks of operation. Some appear to be locked out from the early stages unless they can get their account deleted. Others are stuck at the next big stage, persuading the federal government of their identity and their income so their application for tax credits can be processed.
Yannette Castellano waits to talk to a navigator about health-care options available under the Affordable Care Act, at the North Shore Medical Center, on Nov. 19 in Miami. AP
Guy Dicharry of Los Lunas, N.M., said he had been in limbo at the identity-verification stage since Oct. 5, despite giving the site personal information several times so it can confirm his income. He hasn't heard back about a paper application submitted Nov. 1.
"This has been botched and is not getting fixed. If it's not fixed, I'll be ringing in 2014 as a newly uninsured person. I suspect that is the opposite of what the ACA was supposed to achieve," said Mr. Dicharry, who described himself as a supporter of theAffordable Care Act. Because of their age and income, Mr. Dicharry and his wife stand to gain valuable subsidies toward the cost of coverage, but only if he buys it through the website.
Ronald Gallagher of Paradise Valley, Ariz., said he had been helping his daughter shop for coverage. After 16 hours over four days starting Oct. 1, they were told her identity was verified and she could pick a plan. But when they logged in to the website, it said her application was "In Progress."
After failing to get help from a call center, father and daughter filled out an application over the phone in early November, but they still haven't received a letter telling what insurance plans she qualifies for. "So far, nothing the government has done has worked," Mr. Gallagher said.
Even when people successfully enroll, insurers say they sometimes get incorrect data. Ms. Bataille, the government spokeswoman, said officials have seen "marked improvements" in the information transmitted to insurers but "we know there are still issues that remain." An HHS official also said that there had been improvements in identity verification, but that the agency knew it wasn't fully fixed.
Mr. Lewis of Maine Community Health Options also worried about a larger volume of applicants, especially since insurers have now been told to find ways to process applications that come in from people as late as Dec. 23 in time for their coverage to begin Jan. 1, rather than a previous Dec. 15 deadline.
If "there's an avalanche on that last date, I don't know if the system will be able to support all that," he said.
















Video: Health insurance company advertises by goofing on Obamacare

POSTED AT 7:01 PM ON NOVEMBER 29, 2013 BY MARY KATHARINE HAM


Say you’re a health insurer who decided not to jump into the exchanges fearing that the colossal Charlie Foxtrot about to visit itself upon the U.S. might not jibe with your branding as a company with the ability to offer a service with a modicum of competence. Say your decision turned out to be quite prescient as the federal exchange (and, to a lesser extent, state exchanges) began to implode before your eyes. Then, say you wanted to produce an ad to attract customers with a nod to your own prescience and competence as compared with the federal exchange.
Behold, the insurance schadenfreude ad, produced by Wellmark, a part of Blue Cross Blue Shield that opted out of exchanges.
“There’s More Than One Place to Buy Health Insurance”
I’m always a fan of an ad that highlights a company’s hesitance to collude with the government. It allows me to dream that perhaps, perhaps!, the idea of operating independently of the feds, without bailouts or preferential treatment or being in bed with them on regulation, might appeal to regular Americans. The moment that becomes a bonafide selling point, the market and the government will both be healthier. Ford made a commercial with a similar message in 2011 but it didn’t last long, getting pulled from rotation after the White House made a few calls. Ford maintains it was removed from the air for routine reasons.

Ed Haislmaier reads the tea leaves:
First off, the insurer, Wellmark, is the parent company of the Iowa and South Dakota Blue Cross plans. It is the largest insurer in both states. Wellmark currently accounts for 78 percent of the individual health-insurance market and 75 percent of the employer group market in Iowa. In South Dakota it has 73 percent of the individual market and 50 percent of the group market. So, this is not some marginal player, or an upstart trying to attract attention. Rather, this is an “establishment” company talking.
Second, of the 62 Blue Cross Blue Shield licensees, only three are not participating in the Obamacare exchanges in 2014, and Wellmark’s Iowa and South Dakota subsidiaries are two of those three. (The third company is Blue Cross Blue Shield of Mississippi.) Seasoned market analysts know that it is always a good idea to pay attention to what the “contrarians” are up to.
Back in mid August, an attendee at a conference of Iowa health-insurance agents told me that Wellmark had opted to stay out of the exchanges because the company did not expect—based on the way things were then going—that the exchanges would be “a positive customer experience.” Translation: Apparently Wellmark did not want to risk tarnishing its brand by associating with what was shaping up to be a disaster.
Haislmaier notes Wellmark still may get into exchanges in 2015, but is gauging its decision based on how the exchange winds blow. This ad says, “Hey, they may be trying to destroy the individual health care market with their idiocy, but we’re still here.” I wonder how many insurers might join them in the months to come.


NYT: So, turns out that all of this Medicaid expansion actually might not necessarily mean more access…


POSTED AT 3:01 PM ON NOVEMBER 29, 2013 BY ERIKA JOHNSEN





One wonders what the New York Times has been doing the past few years while conservativeswere very vociferously warning about the entirely predictable, pending phenomenon:

But now, as California’s Medicaid program is preparing for a major expansion under President Obama’s health care law, Dr. Mazer says he cannot accept additional patients under the government insurance program for a simple reason: It does not pay enough.
“It’s a bad situation that is likely to be made worse,” he said.
His view is shared by many doctors around the country. Medicaid for years has struggled with a shortage of doctors willing to accept its low reimbursement rates and red tape, forcing many patients to wait for care, particularly from specialists like Dr. Mazer.
Yet in just five weeks, millions of additional Americans will be covered by the program, many of them older people with an array of health problems. …
Community clinics, which typically provide primary but not specialty care, have expanded and hired more medical staff members to meet the anticipated wave of new patients. And managed-care companies are recruiting doctors, nurse practitioners and other professionals into their networks, sometimes offering higher pay if they improve care while keeping costs down. But it is far from clear that the demand can be met, experts say.

No kidding. Read on for the many discouraging ways in which increased Medicaid rolls are likely to result in reduced access, poor-quality healthcare, and added fuel to the fire of widespread doctor shortages — and yet the Obama administration is still adamantly pushingthe remaining resistant states to expand Medicaid as a miracle drug for expanding healthcare access.

Medicaid enrollment has been going much more smoothly than ObamaCare’s general rollout; the CBO has projected that a full nine million American will sign up through various states’ Medicaid expansions next year alone; and even some states not expanding Medicaid are already seeing a jump in enrollments, probably due to the increased ObamaCare-related publicity. None of this, however, means that the system is suddenly equipped to handle the onslaught or that doctors will even want to take more Medicaid patients and deal with the program’s already notoriously poor reimbursement rates (as they do still have that choice…for now). ObamaCare might mean some form of insurance for all, but that insurance might not be the automatic favor for all that the Obama administration is determined to believe it is.

Twitchy........


Health and Human Services Secretary Kathleen Sebelius posted a list of tips to finding insurance in a piece at the Huffington Post today, urging Americans to #GetCovered. The tips were also tweeted out by the official HHS account.




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