Surprise: Insurers extend deadline to pay first month of ObamaCare plan premiums until January 10th
POSTED AT 4:01 PM ON DECEMBER 18, 2013 BY ALLAHPUNDIT
The deadline was December 31st, but faced with the prospect of 50 percent or more of their new enrollees going uncovered in January due to nonpayment, some individual insurers had already begun granting grace periods. Then HHS announced that it was strongly urging (wink wink) insurers across the industry to extend their deadlines too. And now, inevitably, here comes the umbrella group America’s Health Insurance Plans to say that its members have done exactly that.
No matter how messy the White House’s mismanagement of O-Care’s rollout gets, the insurance industry has no choice now but to try to clean it up. You bought the ticket, guys. Enjoy the ride.
As a result of the change, individuals who pick plans by Dec. 23 will be considered covered as of Jan. 1 as long as they pay their first month’s premiums by Jan. 10. Previously, payment had been required by Dec. 31…In addition to asking insurers to allow consumers more time to process payments, HHS asked insurers to treat out-of-network providers as in-network, to continue to allow individuals to refill prescriptions that had been covered under previous plans and to accept partial payments for January premiums. AHIP did not address those requests in its statement.
It’s only the deadline for payment that’s changed, not the December 23rd deadline for enrollment, but we’ll see how that goes during the next few weeks. I’m sure the White House would love to extend the enrollment deadline into January too, with coverage retroactive to January 1st, but that’s more dangerous for insurers since in theory it would allow someone to sign up for insurance after they’ve already had an expensive accident. Maybe HHS could allow for retroactive enrollment with the caveat that claims over a certain amount won’t be covered? Or maybe they’ll just shovel some “risk corridor” money at insurers to cover any heavy losses from people who sign up to pay for pricey treatment that’s already been incurred. There are bound to be good-faith cases next month of people who really did try to sign up before this month’s deadline but were thwarted by lingering problems with Healthcare.gov or by the fact that the federal data hub still isn’t working well enough to let them enroll directly with insurers as a workaround. (At least one state exchange website has performed so terribly that some locals think they should switch to Healthcare.gov because it’s … more reliable.) Once you let those people enroll retroactively, why not let others whose attempt at enrollment in December wasn’t quite as diligent enroll too? All the better to pad HHS’s sign-up numbers.
But that raises a bigger question: Why would insurers further complicate their lives by bending over backwards this way for procrastinating consumers? Sure, they’d like to have some extra revenue in January by letting latecomers sneak in before January 10th, but insurers forgo revenue all the time by sticking to preset deadlines. Is this simply a little Christmas generosity on the industry’s part? No, silly: They were threatened by the federal government.
Health industry consultant Kip Piper said HHS doesn’t have the authority to enforce what he calls these “political requests” [for deadline extensions]. But HHS said it will consider insurers’ cooperation now when it decides which ones can participate on the insurance exchanges next year.“They are simultaneously asking insurers to assume the cost and risk of non-payment, taking public credit for it, and threatening insurers with loss of business if they don’t comply,” said Piper, a former government and insurance industry official.
Avik Roy made the same point a few days ago, pointing to the “menacing language” used by HHS in its new regulations urging insurers to comply with its extension “requests.” That should be illegal, says Roy, but is there any insurer bold enough to sue the feds over it, knowing that they might retaliate by booting them from the exchanges just as millions of new consumers are being forced onto them? This is why you don’t do business with the mafia: When they “ask” you for something, there’s no way to say no.
By the way, via Guy Benson, Ezra Klein’s Wonkblog has gone from arguing that the enrollment numbers are far less important than the demographic make-up of the exchange risk pools to arguing that it’s less important than you think that the risk pools contain lots of “young invincibles.” That’s the best evidence yet that HHS is lagging badly in signing up young adults.
Breaking: Microsoft exec to take over Healthcare.gov rescue
POSTED AT 12:01 PM ON DECEMBER 17, 2013 BY ED MORRISSEY
Everyone who loves Internet Explorer and Windows 8 will rejoice at the latest appointmentfrom the White House to rescue its core policy from incompetence. The rest of us will just marvel at the irony:
The White House is tapping the private sector for its next point man to fix the troubled Obamacare website.The administration is set to announce that Kurt DelBene, an executive at Microsoft, will succeed Jeff Zients in leading the overhaul of the embattled HealthCare.gov, according to four sources with knowledge of the decision.
But DelBene isn’t just a Microsoft executive. He’s also the husband of a Congresswoman. Guess which party?
DelBene is currently the president of the Microsoft Office Division and has been with the company since 1992. He is also the husband of freshman Rep. Suzan DelBene (D-Wash.).
Other than being the husband of a Democratic Representative, DelBene doesn’t dabble much in checkbook politics, according to Open Secrets. Over three election cycles, he’s donated $16,540 to Democratic candidates, with a little over half of that coming in the 2014 cycle. His bio shows why he’s at least more qualified than Zients to take charge of a web-portal disaster:
As president of the Microsoft Office Division, Kurt DelBene is responsible for driving Microsoft’s global productivity strategy for information workers. DelBene oversees the engineering and marketing functions for a wide range of productivity products and services, including Office, Office 365, Exchange, SharePoint, Lync, Project, and Visio.Previously, he served as the senior vice president for the Microsoft Business Division, responsible for the development of client and server software that collectively delivers to organizations and individuals a holistic productivity experience, including authoring, collaboration, communications, information sharing, and project management. In this role, he oversaw development teams in the Office engineering organization including Office desktop applications, Office Web Applications, Microsoft SharePoint, Microsoft Exchange Server, Microsoft Office Communications Server and Office Labs.
This frees up Zients to take his appointed position as director of Obama’s National Economics Council as planned on January 1. In his brief tenure as fixer, the promises of a revamped Healthcare.gov went from “fully functional” to “a significantly different user experience,” and the December 1 delivery didn’t even really produce that significant a change. DelBene at least has the experience needed to assess a bad system and determine what it takes to fix it, a process that Microsoft has used on more than a few occasions for its own products at the expense of their consumers.
The problem is this — what it will take to fix the system and its gaping security holes is months of off-line development to make up for the failures in the 42 months HHS had to develop it in the first place. Without that option, DelBene will probably only be incrementally more successful than Zients, and consumers will continue to put their private data at considerable risk just to discover that the system isn’t enrolling them in insurance reliably.
Update: How could I have forgotten Clippy?
( Photo op time... )
During a White House meeting called to brief America's largest tech companies today about government overreach in electronic surveillance, President Barack Obama changed the subject – angering some meeting participants by shifting gears to address the failed launch of healthcare.gov.
'That wasn't what we came for,' a vice-president of a company whose CEO attended told MailOnline. 'We really didn't care for a PR pitch about how the administration is trying to salvage its internal health care tech nightmare.'
One executive said that meeting participants were dead-set against straying from the principal focus of the meeting – the uncomfortable and legally untenable position they are in when the National Security Agency demands access to their digital records.
The White House said in advance that the meeting would include a discussion of healthcare.gov, but the company executive said the only subject that mattered to the participants was the NSA.
'He basically hijacked the meeting,' the executive said. 'We all told the White House that we were only there to talk about what the NSA was up to and how it affects us.'
All smiles: Obama joked with tech executives before focusing on Obamacare and relegating the companies' NSA concerns to second-tier status
Yet Obama, according to insiders, repeatedly peppered the discussion with reassuring words about how the Affordable Care Act's marquee website was well on its way to becoming functional.
The change was so noticeable that an AFP/Getty photographer assigned to cover the event noted in a photo caption only that Obama was there to 'meet with executives from leading tech companies to discuss progress with healthcare.gov.'
One executive of a company represented at the meeting told The Guardian that a change of focus 'is not going to happen. We are there to talk about the NSA.'
Another said issues other than intelligence agencies' snooping are 'peripheral.'
The unnamed business leader told the paper that 'there's only one subject that people really want to discuss right now.'
The 15 companies, including Google, Yahoo!, Microsoft, Netflix, Twitter, Apple and Etsy, issued a one-line joint statement after the 150-minute marathon meeting in the White House's Roosevelt Room, saying that they 'appreciated the opportunity to share directly with the president our principles on government surveillance that we released last week and we urge him to move aggressively on reform.'
There was no mention in the statement of healthcare.gov.
Hands on the table, Joe: Vice President Biden was seated next to one of the meeting's few female participants, Yahoo! CEO Marissa Mayer. Biden made headlines yesterday for his roving paws at a holiday party
A serious matter: Reporters on Tuesday put White House press secretary Jay Carney on the spot about about a federal judge who declared that the NSA's bulk collection of millions of Americans' telephone records is unconstitutional
But in its statement to reporters about the meeting, the White House played up the significance of focusing portions of the get-together on how to fix the government's disastrous health insurance website.
Obama and the executives 'discussed a number of issues ... including the progress being made to improve performance and capacity issues with heathcare.gov,' the statement began.
After announcing a changing of the guard in the push to repair the site, the White House noted that '[f]inally, the group discussed the national security and economic impacts of unauthorized intelligence disclosures.'
A group of eight tech companies, including some in attendance on Tuesday, asked Obama last week for an overhaul of the surveillance laws that govern the NSA.
'The balance in many countries has tipped too far in favor of the state and away from the rights of the individual – rights that are enshrined in our Constitution," they wrote in an open letter to the president.
Distraction: Obama took time out from the supposedly NSA-focused meeting to announce that Jeff Zients (L) would be replaced as his healthcare website czar
A federal judge ruled Monday that their concerns about government spy programs are well-founded.
U.S. District Court Judge Richard Leon declared that the NSA's broad seizures of telecommunications companies' call records violate the Fourth Amendment to the U.S. Constitution. That provision protects Americans from unreasonable searches.
The ruling is already being seen as partial validation for the exiled leaker Edward Snowden, who exposed details of the NSA's huge data collection program to the public this year.
'I have significant doubts about the efficacy of the metadata collection program as a means of conducting time-sensitive investigations in cases involving imminent threats of terrorism,' the judge wrote in his ruling.
'I cannot imagine a more ‘indiscriminate’ and ‘arbitrary invasion’ than this systematic and high-tech collection and retention of personal data on virtually every single citizen for purposes of querying it and analyzing it without judicial approval.'
In Tuesday's meeting, Yahoo! CEO Marissa Meyer was seated next to Vice President Joe Biden, whose wandering hands were the subject of nationwide jokes on Monday.
The vice president was photographed at a recent holiday party posing with a reporter, who was pictured apparently making sure his grasp didn't stray north of her waist.
Fine print: State can seize your assets to pay for care after you’re forced into Medicaid by Obamacare
POSTED AT 9:41 PM ON DECEMBER 16, 2013 BY MARY KATHARINE HAM
My, this is an unpleasant consequence of Obamacare. I’m not going to call it unintended because in its current form, it potentially earns a bunch of money for states, so I’m pretty sure that’s intentional. What I think is unintentional is anyone noticing this is what they’re up to.
It wasn’t the moonlight, holiday-season euphoria or family pressure that made Sophia Prins and Gary Balhorn, both 62, suddenly decide to get married.It was the fine print.As fine print is wont to do, it had buried itself in a long form — Balhorn’s application for free health insurance through the expanded state Medicaid program. As the paperwork lay on the dining-room table in Port Townsend, Prins began reading.She was shocked: If you’re 55 or over, Medicaid can come back after you’re dead and bill your estate for ordinary health-care expenses.The way Prins saw it, that meant health insurance via Medicaid is hardly “free” for Washington residents 55 or older. It’s a loan, one whose payback requirements aren’t well advertised. And it penalizes people who, despite having a low income, have managed to keep a home or some savings they hope to pass to heirs, Prins said.
So, here’s the deal. There used to be a provision whereby the state could recuperate funds spent on a Medicaid patient post-55 years old from whatever assets he owned. So, a low-income individual in nursing home care after age 55 might pass away and his kids would find out the family home or car of whatever he had to his name had to be bought back from the state if they wanted it. It’s called estate recovery, and sounds pretty shady if it’s not boldly advertised as the terms for Medicaid enrollment, which is most definitely is not.
Before the Affordable Care Act’s Medicaid expansion, there weren’t that many people in Medicaid who had much in the way of assets for seizing. But now that Medicaid enrollment requirements have been relaxed, more people with assets but low income are joining the program or being forced into it. For instance, a couple in their 50s who, say, retired early after losing jobs in the bad economy may have assets but show a very low income. Under Obamacare, if their income is low enough to qualify for Medicaid, they must enroll in Medicaid unless they want to buy totally unsubsidized coverage in the now-inflated individual market. As teh Times notes, this is no small difference:
People cannot receive a tax credit to subsidize their purchase of a private health plan if their income qualifies them for Medicaid, said Bethany Frey, spokeswoman for the Washington Health Benefit Exchange.But they could buy a health plan without a tax credit, she added.For someone age 55 to 64 at the Medicaid-income level — below $15,856 a year — it’s quite a jump from free Medicaid health insurance to an unsubsidized individual plan. Premiums in King County for an age 60 non-tobacco user for the most modest plan run from $451 to $859 per month.
The couple in the Times story was able to marry, combine their incomes, and get out of the Medicaid trap. Others will not be so lucky, and may not even read the fine print:
Prins, an artist, and Balhorn, a retired fisherman-turned-tango instructor, separately qualified for health insurance through Medicaid based on their sole incomes.But if they were married, they calculated, they could “just squeak by” with enough income to qualify for a subsidized health plan — and avoid any encumbrance on the home they hope to leave to Prins’ two sons.
For no one else in the world is it a-okay to give low-income people a loan that might endanger their family’s assets and not even clearly inform them they’re getting a loan.
This Daily Kos diarist has a nice write-up (I know) on the toll this could take on lower and middle-class people looking for relief and getting what amounts to a surprise predatory loan instead:
We haven’t had lots of people younger than 65 on Medicaid, because in most states simply earning less than the Federal Poverty Level did not qualify one for Medicaid.And we haven’t had many people with lots of assets on Medicaid, because in most places you have to have less than around $2400 to your name before Medicaid will cover you. You can keep your house and your car, but Medicaid reserves the right to put liens on them and take them when you die.But now we have the Affordable Care Act, and its expectation that everyone in the lower tier of income will end up in the Medicaid system. To accomplish this, they have dropped the asset test. So now we will have lots of people ages 55-64, who have assets but not a lot of income right now, for whatever reason, on Medicaid.The kicker of it is, if you make the right amount to qualify for a subsidized health insurance plan, your costs are going to be shared and subsidized by the government. But if you go on Medicaid, you owe the entire amount that Medicaid spends on you from the day you turn 55…How will this play out? No one knows, as far as I can tell. But it is easy to see how this could become a real problem. If someone is low income and goes on Medicaid, will Medicaid put a lien on their house? If they need to sell their house and move, will they then lose all their equity in paying off the lien? Will people get hit with bills and liens for many thousands of dollars, even if they were healthy and hardly ever went to the doctor?
The fact that this is being treated with seriousness at Kos is an indication of how large a liability it could be for this government program. Washington is scrambling to change the law. No doubt other states will start looking at their implementation of this part of Obamacare. But there will be people caught unaware that their houses effectively belong to the government because the government forced them into Medicaid coverage. You’re welcome!
Weekend items - but first the prior post !
Fixes they say ? Well , Fixes is not exactly the same as fixed......
WSJ: About those Healthcare.gov fixes …
POSTED AT 2:01 PM ON DECEMBER 14, 2013 BY ED MORRISSEY
The Obama administration insisted that they would have a working web portal for ObamaCare by October 1st, but they couldn’t even get people within a dozen clicks of determining their eligibility. Kathleen Sebelius tried pretending that all was well more than once in live events, only to have the website crash in her presence. After that, the White House appointed Jeff Zients as an interim grand poobah for all things related to HealthCare.gov, and promised a “fully functional” web portal by December 1. That promise, however, got whittled down to delivering a “significantly different user experience” by Sebelius as the deadline approached.
Did Sebelius manage to deliver even that much? Not really, the Wall Street Journal reports this morning, and it’s going to get a lot worse when people who think they have coverage try using it in January:
Insurers and federal officials sifting through insurance applications under the health-care law have identified a raft of errors, including missing customers and inaccurate eligibility determinations that mean people may be enrolled in the wrong coverage. …In some cases described by a state official with knowledge of the matter, legal immigrants who aren’t yet eligible for Medicaid in Illinois—it takes five years of residence to join the state-run programs for low-income people—were nevertheless told they would be enrolled.The risk that consumers could remain in limbo as the health law’s coverage expansion begins in January has been a continual political threat to the Obama administration, which has addressed flaws—ranging from a malfunctioning website to the cancellation of health policies that don’t meet the law’s requirements—with a patchwork of last-minute fixes.
The White House wants insurers to establish a grace period after January 1 for payments of premiums. Insurers aren’t too keen on the idea, and point out that premium payments aren’t really the big issue anyway:
But insurance-industry executives warn that some of these data problems will only emerge once customers begin seeking care in January at physicians’ offices, pharmacies and hospitals. The result could be bureaucratic chaos as doctors and patients storm insurers’ phone banks and federal officials work to clean up the inaccuracies.There will be “eligibles lost in the ether,” said Mark Bertolini, chief executive of Aetna Inc.,in an interview. In some cases, children who are meant to be enrolled in their parents plans aren’t listed there, he said.
The Healthcare.gov web portal apparently chokes on family coverage, despite that being a decades-long industry practice. A “glitch” in the system somehow splits them off from their parents’ households and treats them like adults with no income, pushing them into Medicaid.
The news is just as bad if you were an early adopter. You may not know it until you try to use your benefits, but you have to delete your account and start over if you enrolled before December 1:
Administration officials urged customers to contact the companies they believe will cover them to verify their enrollment, or call state Medicaid agencies to confirm that they are in fact eligible for those programs. People who believe they have received inaccurate eligibility determinations can appeal the decisions, HHS officials have said.To correct inaccuracies, some people may have to delete accounts and start over now that some glitches have been repaired, people familiar with the matter said.
Sebelius promised us “a significantly different user experience.” Sounds like deja vu all over again instead.
Will people pay their first premium or will we see a neverending series of Patches from the White House - a different version of extend and pretend ?
Obamacare's Next Hurdle: Getting People To Pay
Submitted by Tyler Durden on 12/14/2013 15:12 -0500http://www.kgw.com/news/Enrollees-report-erroneous-debits-by-WA-Healthplanfinder-235244701.html
Healthcare.gov may or may not be fixed, depending on who one listens to (and if one reads the WSJ's, "Errors Continue to Plague Government Health Site" this morning, there is much more fixing left despite the administration's most sincere promises), but a greater issue is already looming: payment. "We have a bigger number of applicants than people who have paid," Aetna Chief Financial Officer Shawn Guertin said in an interview today in New York. "That’s a situation that I am a little bit worried about, that people will think they have completed the process but haven’t paid the premium yet." Whether Americans didn't realize there would be an actual payment involved in America's socialized healthcare system, or simply there is too much confusion over how the process is run, is irrelevant - the bottom line is that for whatever reason people are simply not paying their premiums.
As Bloomberg reports, the disjointed process of having customers shop through the government-run marketplace and then pay insurers separately has created a risk that people who have chosen a plan won’t actually be covered Jan. 1. And if people don’t pay by Dec. 31, insurers may end up stuck with a disproportionate number of sicker and costlier customers.
“You have to remember that many times we are dealing with low-income people,” Robert Laszewski, an Alexandria, Virginia-based consultant to carriers, said in a telephone interview last week. “They signed up and they certainly want the insurance, but do they have the money or have they changed their mind by Dec. 31? Nobody’s done this before.”
And while the government has been touting the surge in sign up numbers, with the CMMS announcing yesterday that some 365,000 people have signed up for a private plan through November, what the government has not said is how many of these people have already paid their premium. Judging by the Aetna CFO remarks there is a major, gaping discrepancy between the two. And even if people do expect to get completely free healthcare, that is not what Obamacare is about, at least not yet. So suddenly Obama may have a situation where he has millions signed up for the ACA, and only a fraction has actually paid. Recall that Obama has a goal of 7 million sign ups by the March 31 end of open enrollment.
In the meantime, while it remains to be seen if the new plans will be feasible, the old healthcare plans have already been largely scrapped.
Aetna, based in Hartford, Connecticut, also said it faces too many administrative hurdles to reinstate policies that it’s terminating next year because they don’t meet the new standards set by the health law. Hundreds of thousands of people around the country have gotten cancellation notices from insurers this year, prompting a political firestorm for President Barack Obama.Obama responded last month by giving insurers and state regulators the option of extending the policies by an extra year. Aetna decided it would be too difficult to do in time for Jan. 1, Guertin said. Some customers were able to renew their policies early before the termination notices arrived. Guertin declined to say how many.“It gets them a plan frankly that we’re ready to service,” he said. “It would just be too administratively burdensome to try to get everything ready to restore all the old plans.”
Well, nobody said central planning works everywhere. The good news that for now, at least, the fourth - monetary - branch of government is offsetting any and all other disappointments created by the legislative and executive. Because no matter how vast the shock, or how acute the disappointment, one can always point to an S&P that is just shy of all time highs. And all is well if the "markets" say it is...