( Now they tell us this one ? )
Obama paves the path to removing Obamacare
POSTED AT 4:01 PM ON DECEMBER 7, 2013 BY JAZZ SHAW
Philip Klein has some interesting observations on the long term effects of Barack Obama’s handling of the, shall we say, shortcomings of the Obamacare roll out. He cites an earlier analysis of his – one from the previous election – where he opined that a hypothetical President Romney would have a hard time actually exempting all of the states from Obamacare until at least 2017.. if it could be done at all. But the recent actions of President Obama may have demonstrated a path by which a truly robust chief executive could cut a few corners and get the job done quick like a bunny.
Though I still believe I was right about what the statute said, as it turns out, I was being old-fashioned by taking the letter of the law so literally.Having watched President Obama and Secretary of Health and Human Services Kathleen Sebelius over the past several months unilaterally alter or outright ignore major portions of the law, I now believe that a future Republican president would have greater latitude to gut Obamacare than I once thought possible.The changes instituted by the Obama administration in response to implementation snags have ranged from perfectly legal areas of administrative discretion stemming from the vast regulatory powers granted to the HHS secretary under Obamacare, to more creative interpretations of that discretion, to Obama simply choosing to ignore parts of the law that became inconvenient.Obama has turned his signature legislative accomplishment into a constantly evolving wikilaw, with editing privileges restricted to himself and a few administration officials.He’s largely been able to get away with it due to the difficulties posed by gaining standing in court for legal challenges.
The President delayed some portions of the bill. He claimed that he wouldn’t enforce others imposed on the health insurance companies. HHS is now proposing to make new changes to alter a provision of Obamacare known as the “risk corridors” program, channeling more money to insurers who no longer think they can pull a rabbit out of this particular hat. And all of these actions are making changes – either directly or in de facto enforcement – to a piece of legislation passed through Congress and signed by his own hand.
In the old days, you needed to go back to the well and make changes through the legislative process. By Klein’s reckoning, those days are past. Getting the bill through once is sufficient, and after that the Executive Office can just tailor things as needed. Such tailoring could obviously include directing the appropriate offices and functions to simply ignore the whole thing, no? It sort of takes the idea of presidential signing statements to a whole new level. And who would have guessed that Barack Obama would solve this puzzle himself ?
Covered California gave consumers' contact info to agents
California's health exchange has provided insurance agents with names and contact information for tens of thousands of people who went online to check out coverage but didn't ask to be contacted.
Covered California Executive Director Peter Lee acknowledged that consumers did not ask to be contacted by the state or its certified insurance agents. But he said the outreach program complies with privacy laws. (Max Whittaker / Getty Images / November 13, 2013)
Raising concerns about consumer privacy, California's health exchange has given insurance agents the names and contact information for tens of thousands of people who went online to check out coverage but didn't ask to be contacted.
The Covered California exchange said it started handing out this consumer information this week as part of a pilot program to help people enroll ahead of a Dec. 23 deadline to have health insurance in place by Jan. 1.
State officials said they are only trying to help potential customers find insurance and sign up in time. But some insurance brokers and consumers who were contacted said they were astonished by the state's move.
"I'm shocked and dumbfounded," said Sam Smith, an Encino insurance broker and president of the California Assn. of Health Underwriters, an industry group.
Smith said he was under the impression from the exchange that these consumers had requested assistance. He received the names of two consumers this week but has not yet contacted them.
"These people would have a legitimate complaint," Smith said.
The names provided include people who started an insurance application on the Covered California website since enrollment launched Oct. 1, but for whatever reason never picked a health plan or completed the sign-up process.
The state said it provided information on tens of thousands of people who logged into the state's website, but it didn't know the exact number.
The exchange said agents were given names, addresses, phone numbers and email addresses if available.
No other information on the application, such as Social Security numbers, income and other personal details, was shared, according to the exchange.
Peter Lee, executive director of Covered California, acknowledged that these consumers did not ask to be contacted by the state or its certified insurance agents. But he said the outreach program still complies with privacy laws and it was reviewed by the exchange's legal counsel.
"I can imagine some people may be upset," Lee said in an interview Friday. "But I can see a lot of people will be comforted and relieved at getting the help they need to navigate a confusing process."
Robert Blatt, a technology consultant in Ventura County, said he didn't appreciate receiving an email Thursday from a local agent asking him about his unfinished application with Covered California.
He said it violates his privacy, and he wondered what other details on his application were shared with the agent.
"You can't do this," Blatt said. "For a government agency to release this information to an outside person is a major issue."
In the email Blatt received, the local agent said, "your contact information was provided to me by Covered California since your application is not yet finalized, however, you have been determined as eligible by Covered California."
Blatt said he wasn't interested in getting coverage through the exchange anymore after determining he had a better deal with his existing insurance policy.
Through mid-November, Covered California signed up nearly 80,000 people in private health plans and an additional 140,000 people qualified for Medi-Cal, the state's Medicaid program.
But the state has been struggling to deal with a surge of applicants ahead of the Dec. 23 deadline, with many people expressing frustration with long wait times and website problems. Open enrollment continues through March 31.
In light of those concerns, Lee said, the state wanted to offer more assistance to people through its network of 7,700 insurance agents who are trained and certified to enroll people.
Lee said those certified agents cannot use this consumer information for any other purposes or to try to sell other products.
Covered California shared the consumer data with four major insurance agencies that are coordinating enrollment efforts by agents statewide. Those agencies then asked the state's certified agents whether they wanted to receive any of these names.
An official at Warner Pacific Insurance Services in Westlake Village, one of the four agencies, said he hadn't received any negative feedback.
"We haven't heard any complaints yet," said Neil Crosby, director of sales at Warner Pacific. "But I can see how someone would be upset by this."
70% Of Calfornia's Doctors Expected To Boycott Obamacare
Submitted by Tyler Durden on 12/07/2013 14:33 -0500
“We need some recognition that we’re doing a service to the community. But we can’t do it for free. And we can’t do it at a loss. No other business would do that,” exclaims the president of the California Medical Association, as The Washington Examiner reports, independent insurance brokers estimate 70% of California's 104,000 licensed doctors are boycotting the exchange. “The Covered California board says we have plenty of doctors, and they allege they have 85 percent of doctors participating, but they’ve shown no numbers," and if a large number of doctors either balk at participating in the exchange or retire, the state’s medical system could be overwhelmed. “Enrollment doesn’t mean access, because there aren’t enough doctors to take the low rates of Medicaid,” warns one health director. “There aren’t enough primary care physicians, period.”
An estimated seven out of every 10 physicians in deep-blue California are rebelling against the state's Obamacare health insurance exchange and won't participate, the head of the state's largest medical association said.“It doesn't surprise me that there's a high rate of nonparticipation,” said Dr. Richard Thorp, president of the California Medical Association....California offers one of the lowest government reimbursement rates in the country -- 30 percent lower than federal Medicare payments. And reimbursement rates for some procedures are even lower....“Some physicians have been put in the network and they were included basically without their permission,” Lisa Folberg said. She is a CMA’s vice president of medical and regulatory Policy.“They may be listed as actually participating, but not of their own volition,”...“This is a dirty little secret that is not really talked about as they promote Covered California,” Waters said. He called theexchange's doctors list a “shell game” because “the vast majority” of his doctors are not participating...“The Covered California board says we have plenty of doctors, and they allege they have 85 percent of doctors participating," notes Mazer. "But they’ve shown no numbers."...“Enrollment doesn’t mean access,because there aren’t enough doctors to take the low rates of Medicaid,” he said. “There aren’t enough primary care physicians, period.”...Briscoe professed not to be surprised by the refusal of doctors to participate in Covered California. “It rings true. I’ve been kind of wondering in my head, ‘How are they offering such low premiums?’ ”
( Now they tell us this one ? )
Feds: On second thought, maybe you shouldn’t use paper applications to sign up for ObamaCare either
POSTED AT 2:02 PM ON DECEMBER 7, 2013 BY ALLAHPUNDIT
If the website doesn’t work (much) and paper applications don’t work (they take too long to process), what’s left? What possible medium could they use at this point to get people who are desperate for coverage enrolled before December 23rd? Our only hope now, my friends, might be … the noble floppy disk. Don’t laugh — the last office in America that still uses them lies, of course, within the federal government.
Is this good news or bad news for Obama and HHS?
Federal health officials, after encouraging alternate sign-up methods amid the fumbled rollout of their online insurance website, began quietly urging counselors around the country this week to stop using paper applications to enroll people in health insurance because of concerns those applications would not be processed in time…After a conference call earlier this week with federal health officials, Illinois health officials sent a memo Thursday to their roughly 1,600 navigators saying there is no way to complete marketplace enrollment through a paper application. The memo, which Claffey said was based on guidance from federal officials, said paper applications should be used only if other means aren’t available…That contradicts what federal health officials told reporters during a national media call this week, during which they said there were no problems with paper applications…In early November, President Barack Obama himself encouraged paper applications as one of several alternatives to the federal website.
The good news: I assume it’s only because the website really is working better that they feel comfortable nudging people back towards using Healthcare.gov and away from paper applications. The paper option was always more of a political fallback than a technical one anyway. The info on your paper form gets entered into the same system that serves the website; if the latter doesn’t work, the former won’t either. By discouraging paper now, HHS is doing what it can to free up some agency and insurance industry manpower for the nightmarish logistical challenges to come later this month. The bad news: One advantage that the paper form has over the website is that you can trust that the information on it is correct. That’s no small thing when the feds are still reporting a website “834 error rate” of 10 percent. Will insurers save more time waiting for people to enroll on Healthcare.gov and then painstakingly correcting the errors in their files or processing and inputting paper forms themselves? Beyond that, the more people decide to skip paper enrollment and stick with the website, the greater the risk that the site will be overwhelmed by traffic and crash down the stretch. Not a huge risk right now, but what about next weekend when there are less than 10 days left before the enrollment deadline?
Regardless, this raises a new question: How heavy is the backlog of paper forms that the feds now feel they have no choice but to cry “no mas”? You would think they’d want to keep all methods of applying open in December even if the website’s functioning better than before.John Ekdahl theorized on Wednesday that maybe the much-hyped surge of 29,000 enrollments in the first two days of December wasn’t a product of people flooding into the site after all but merely the feds clearing a backlog of enrollments that had been caught temporarily in limbo while Healthcare.gov was being repaired in November. (A commenter later gave some credence to the theory.) If that’s true, then no one outside HHS itself knows whether there really has been a new surge of enrollments this month. And if it’s not true, how come HHS isn’t giving us daily updates on the alleged big flood of sign-ups? Clearly Sebeliusis receiving daily numbers or else they couldn’t have given us the figures for December 1st and 2nd. Where are the numbers for the 3rd through today? Why not share them?
By the way, in case you missed it in Headlines, the administrator of Maryland’s state ObamaCare exchange, which was touted pre-launch as a model for others before crashing intoone technical brick wall after another, has now resigned. Maryland’s enrollment goal through next March is 150,000 people. Total so far as of yesterday: 3,758 and counting.
MEDIA TIRES OF WHITE HOUSE SELECTIVE RELEASE OF OBAMACARE DATA
Apparently the media is growing tired of the White House selectively releasing ObamaCare data that gets to the heart of nothing but makes the program look like it is much more popular than it likely is. For instance, today the White House informed the media that between Sunday and Friday, Healthcare.gov enjoyed 3.7 million visits.
WH CLAIMS OBAMA 'REGULARLY' MEETS WITH SEBELIUS OFF THE RECORD
On Friday, White House Press Secretary Jay Carney tried to dismiss a shocking Government Accountability Institute (GAI) report that found President Barack Obama had only a single face-to-face meeting with Health and Human Services Secretary Kathleen Sebelius since Obamacare was signed over three years ago.
Congressional staffers get extension due to DC exchange failures
POSTED AT 1:51 PM ON DECEMBER 6, 2013 BY ED MORRISSEY
It’s only for a month, but that’s a month longer than anyone working outside of Capitol Hill will get. Staffers who enrolled in the Washington DC health exchange — or attempted to enroll — will have their current insurance extended until January 31st as the local exchange attempts to work through all of the bugs and errors generated in what is the smallest independent exchange in the country, Audrey Hudson reports for the Colorado Observer:
Members of Congress and their staff will be allowed to keep their health insurance past the end of the year deadline because of persistent problems plaguing the DC Health Link, The Colorado Observer has learned.A memo issued to House staffers Thursday night said that the Obama administration has been made aware of the “significant problems preventing members and staff in Washington, D.C. and in district offices from enrolling in a healthcare plan.”The memo from Chief Administrative Officer of the House Dan Strodel said that while they are awaiting a decision to keep the enrollment time open past Dec. 9, health insurance coverage would be extended through Jan. 31.
There are a couple of important points to note about the DC exchange. First, this is not Healthcare.gov, but a separate exchange called DC Health Link. It’s one of a handful of separate entities that supposedly work better than the federal website. In fact, that’s a particular sore spot for ObamaCare supporters, who claim that Republican governors “sabotaged” ObamaCare in part by refusing to create their own state-based exchanges. Oregon, though, still hasn’t enrolled a single person in its own state exchange, and Hawaii has only enrolled a few hundred. Ted Cruz speechwriter (and my friend) Amanda Carpenter spent the last week documenting on Twitter the absurd failures she experienced in attempting to enroll in DC Health Link.
Why absurd? First, like the federal government and the states that opened exchanged, DC had 42 months to ready a web portal. But DC belongs in a class by itself. In late September, the Washington Post reported that DC Health Link was going to work great, but that was hardly a major accomplishment, as I noted at the time:
Amusingly, however, the Post then spends the next nine paragraphs talking about what a success the District of Columbia exchange will be. It’s true that the Post serves that community with local news, but ObamaCare isn’t a local news story, nor was its lead local. Besides, if DC couldn’t launch the nation’s smallest ObamaCare exchange successfully (with an overall population of 632,000 in a city where over 90% of residents already have health insurance), that would be the story.
And now, that is the story. The federal exchange struggles to allow 50,000 concurrent connections for enrollees, but the DC Health Link should only need to allow 70,000 or so (including Congressional staffers who don’t live in DC) total to successfully enroll. It can’t even do that much, as Amanda reported as late as yesterday:
After refusing for weeks to detail the extent of back-end problems with healthcare.gov, the Obama administration on Friday said a technical bug affected approximately 25 percent of enrollments on the federal exchanges in October and November.
Those technical bugs, separate from the troubles consumers had experienced accessing information on the website during the first two months, are posing a significant new problem for those who signed up and are expecting insurance coverage come Jan. 1.
One in four of those applications either did not get transferred to insurers, were transferred in duplicate form, or had major errors in information shared.
Insurers are supposed to receive the 834 Forms from healthcare.gov. The forms, meant to be read by computers, provide insurers with information on enrollees and what plan they have chosen. Without the information, insurers have no way of knowing who has signed up on the Obamacare exchanges and what coverage they need.
A spokesman for the Centers for Medicare and Medicaid Services on Friday suggested that the only way those who enrolled in October and November can be sure they will be covered in January is by paying their insurance bill and contacting their insurer to confirm their standing.
“I would certainly encourage any consumer that has a question of their insurance choice to contact the insurance company of their choice to get additional information,” CMS spokeswoman Julie Bataille told reporters Friday.
Bataille said CMS, along with the outside firm QSSI, is working furiously to fix the back-end problems, and has succeeded in reducing the number of erroneous 834 Form communications to insurers to 10 percent of all applications.
That error rate could still be affecting a significant amount of applications, especially considering that healthcare.gov is operating much more smoothly this week and has seen its traffic spike.
“To be clear, we do not have precise numbers [of those affected] at this time,” she said.
Bataille said more than 3.7 million consumers had visited healthcare.gov over the past five days since the administration’s self-imposed Dec. 1 to stabilize the website and provide a smoother user experience for the vast majority of visitors.
“This week the site remains stable and experienced no unscheduled down times ... and page response averaged well under one second,” Bataille said.
Those running healthcare.gov set up a queuing system that allows users to submit their email address and receive alerts about different times to enroll when the website is operating better. Bataille said officials offered that system once on Monday morning during a high-traffic time and another time on Tuesday afternoon.
She said all of those users contacted were invited to return on the same day and more than 93 percent actually did return to the website.
Total number of one-on-one meetings between Obama and Sebelius since ObamaCare was passed: One
POSTED AT 10:31 AM ON DECEMBER 6, 2013 BY ALLAHPUNDIT
Actually, says Peter Schweizer, the number is zero, but he’s crediting O for having once met with Sebelius and a single other cabinet member. More than three and a half years ago.
Remember, this is the same guy who said recently of the website, “We’re evaluating why it is exactly that I didn’t know soon enough that it wasn’t going to work the way it needed to.” A possible clue:
A new Government Accountability Institute (GAI) analysis finds that from July 12, 2010, to Nov. 30, 2013, the president’s public schedule records zero one-on-one meetings between Obama and Sebelius. Equally shocking, over the same period, the president’s calendar lists 277 private meetings with his other Cabinet secretaries (excluding full Cabinet meetings).Given these startling findings, and the fact that the White House calendar did not reflect meetings prior to July 12, 2010, GAI researchers then performed a second analysis using another respected recorder of presidential activity, the POLITICO presidential calendar. The results: Just one April 21, 2010 entry was found listing a White House meeting between Obama and Sebelius—and even that was a joint meeting with then Treasury Secretary Timothy Geithner…To be sure, presidents exchange emails and phone calls that are not recorded on White House calendars. Still, why would the White House calendar list by name one-on-one meetings with 16 other Cabinet secretaries but omit Sebelius if other meetings with her occurred? Wouldn’t Obama want to catalog for all to see his personal devotion to the law that bears his name?
Schweizer wonders whether O and his deputies deliberately kept Sebelius away just in case the project went to hell, so that Obama could plead ignorance later as a defense to the charge of gross incomptence. That was my first hunch too, but why would they have taken that approach so soon after the law was passed? If they were trying to quarantine Sebelius, I would assume they’d have done it once the first signs of development problems started showing, not a month after he signed the bill. There had to be some period, certainly longer than a month, where he was optimistic that this rocket could get off the launch pad.
Regardless, the irony of Schweizer’s piece is that it’ll ultimately prove more useful to the left than to the right. Liberals will sneer at him for it today, dismissing the lack of personal interaction between O and S as irrelevant and typical of how modern bureaucracies work. Obama’s their guy for the next three years so they’ll do what it takes to defend him. Three years from now, though, assuming O-Care’s still on the books and groggily stumbling along, they’ll point back to this piece as evidence that the real problem isn’t the law, it was Obama’s odd passivity and disengagement. A more proactive executive — like, say, Hillary Clinton — would have made time for Sebelius every day. Watch and see.
Via RCP, here’s video of the one pitch that Matthews threw him in yesterday’s interview that had a little heat on it. Simple question: Do you have “strong top-down authority”? What is it about your management system that would allow the website problem to snowball? Key bit from O’s reply:
Generally speaking, my theory has been, number one, that yes, I’ve got a strong Chief of Staff but I’m holding every cabinet member accountable and I want to have strong interactions with them, directly. Number two, is I have an open door policy where I want people bringing me bad news on time so that we can fix things. And, you know, the challenge, I think, that we have going forward is not so much my personal management style or particular issues around White House organization. It actually has to do with what I referred to earlier which is we had these big agencies, some of which are outdated.
He’s a hands-on manager saddled with a bloated bureaucracy who craves direct problem-solving interaction with his subordinates. And also, he met alone with his quarterback on ObamaCare once in three and a half years. What?