Monday, December 9, 2013

ObamaCare updates - December 9 - 13 , 2013 - top items of note......"No Way To Tell How Many People Who Have Signed Up For Obamacare Actually Have" ....... NYT: My, many of these ObamaCare premiums aren’t really as low as they seem, are they ? ......... Mutliple State Exchanges Vulnerable to Wi-Fi Attack ....... If you want to keep your Doctor , pay more ( say Zeke Emanuel ) ...... Apart from not keeping your Doctor unless you pay more - seems that you will lose top hospitals also ( unless you will pay more or all of the costs ) ...... Additional collateral damages !

For the next ObamaCare speech perhaps ......

WSJ: About those fixes …


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, 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 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.

December 13th.......

Report: Insurers fear they’ll have a net loss in enrollments for the year on December 31


A week ago, Politico called this the worst-case scenario for ObamaCare. The odds were slim, they assured us, but not quite zero that the magical combo of millions of cancellations, endless exchange “glitches,” and panicky half-assed logistical complications designed to “fix” the problem would mean fewer insured Americans at the end of 2013 than existed at the start of the year. It was unlikely, claimed Politico, because the four or five million whose plans have been canceled had alternate routes to enrollment that didn’t involve They could enroll directly with their current insurer in a new plan (although not if they wanted a subsidy, which are available exclusively on the exchanges) or they might even be automatically enrolled in a plan by their insurer in the interest of preventing a lapse of coverage. But it was, in fact, possible that the first week of January would bring news that ObamaCare had actually made the problem it purported to solve worse. That’s the worst-case scenario. It’d be a PR catastrophe.
Via John McCormack, Bob Laszewski says it’s not so unlikely anymore.
Insurers privately tell Bob Laszewski that they think more people will have lost insurance by January 1 than the number who have signed up for Obamacare by January 1.
“I was out making some client calls this week with a number of different carriers and they know exactly how many policies they canceled and how many who reupped. And they know how many people have come in through the exchange,” says Laszewski. “And I didn’t find one of them who thought they were going to be net ahead on January 1. They all think they’re going to net behind on January 1. That’s where it’s trending so far.”
So far, at least 4.8 million Americans have received insurance cancellations notices, but Laszewski predicts that the total Obamacare enrollment will be less than half that number on January 1.
“My guess is that we’ll have somewhere around a million and a half people signed up for Obamacare on January 1 in the states and in,” he says. The big question then, he adds, is “why have we gone through this whole dislocation of the American health insurance system if only a million and a half to two million buy health insurance?”

Good question. Another question, via Guy Benson: How many people will be neither enrolled nor not enrolled come January 1? What I mean is, how many of them will be stuck in some sort of limbo where they tried to sign up but either got trapped in the Twilight Zone or tangled up in the endless red tape HHS has created for insurers? WaPo claims that the federal O-Care exchange is already looking at a backlog of 50-60,000 paper applications with the final 10-day enrollment crunch still to come. And that’s not all:
She and the other individual familiar with the system said that some of the 50,000 to 60,000 applications have not been completed because consumers did not provide all the required information, and workers from the outside company, Serco, have been unable to reach them by phone to fill in the blanks.
In other instances, paper applications were placed on hold until last week because parts of the online system needed to answer eligibility questions were not working well enough.
In still other cases, Serco workers ran into one of various computer errors when they tried to process a paper application, and that error has not been corrected.
Besides the applications in the backlog, there are roughly 100,000 paper applications that have been processed, but the consumer was not told of the results until recently. The applicants are supposed to be mailed notification letters, but none went out until recently and the vast majority still have not.

So, to sum up: Not only is some significant portion of the backlog destined to go unprocessed due to uncorrectable errors, but even the status of the ones that have been processed are still a mystery to most of the consumers who filled them out. Some of these people expecting to receive a “you’re enrolled” letter are going to get a letter instead notifying them that their application’s incomplete or that there’s some outstanding issue. How many will get that in time to correct the error before December 23? How much extra work will that mean for already overwhelmed insurers before January 1?
As a gloss on all this, go read this Peter Suderman piece at Reason. Per this week’s WSJ/NBC poll, support for ObamaCare is now running at 24/50 — among the uninsured. Go figure that HHS is suddenly in jeopardy of having more people lose coverage this year than sign up for it.

Chaos: HHS “asks” insurers to extend multiple ObamaCare deadlines


The December 23rd enrollment deadline? Time to move that to next month. The deadline to pay your first month of premiums? Let’s go ahead and move that back too. Emergency treatment needed from an out-of-network provider? It’d be swell if that was covered the same way in-network treatments are. And what if your coverage is temporarily screwed up in January when you desperately need your prescriptions refilled? HHS “strongly encourages” insurers to pick up the slack.
In other words, they’re finally realizing that lots of people who had planned to have coverage next month won’t have it, whether because of their own procrastination, HHS’s technological incompetence, or the mind-boggling logistical problems that have been forced on insurers by Obama’s screw-ups and ass-covering political “fixes.” So now they’re going to pile another bunch of “fixes” on them — mere suggestions, wink-wink — and hope for the best, and if chaos ensues anyway in January, it’ll be insurers who are scapegoated.
Phil Klein’s right: It’s panic time in the White House. Let’s let this be the end of the “things are working better now” propaganda.
Among the guidance the HHS announced:
– It is requiring insurers to accept payments until Dec. 31 for coverage starting on Jan. 1. It is also “urging” insurers to give individuals more time beyond that to pay for coverage. In other words, if somebody pays for coverage in the middle of January, HHS is asking insurers to retroactively make that person’s coverage effective as of Jan. 1. HHS is also asking insurers to cover individuals who offer a “down payment,” even if that payment only covers part of the first month’s premiums.
– In a press release, HHS said it was also “strongly encouraging insurers to treat out-of-network providers as in-network to ensure continuity of care for acute episodes or if the provider was listed in their plan’s provider directory as of the date of an enrollee’s enrollment.”
– HHS is also “strongly encouraging insurers to refill prescriptions covered under previous plans during January.”…
Of course, for insurers who have spent years designing plans to comply with the law, this would present huge and unreasonable logistical hurdles.

To put it slightly differently:

At this point HHS may as well ask insurers to simply declare everybody in America covered 

December 12th....

Surprise: Insurers begin granting grace periods to pay first month of premiums on new ObamaCare plans


When you’re staring at 95 percent nonpayment in some cases and an unholy clusterfark in January of people not realizing that their coverage hasn’t taken effect yet, you’re going to do everything you can to mitigate the problem.
And this will mitigate it. A little.
As a deadline approaches for people to sign up for medical insurance under President Barack Obama’s healthcare law, some insurers and state-run online marketplaces are giving shoppers an extra week to pay their first premiums.
The shift to early January from the end of December provides a short grace period for insurers and shoppers to work through any errors in the new policies caused by technology problems dogging enrollment since it opened on October 1…
Aetna Inc, which is selling health insurance on exchanges, or marketplaces, in more than a dozen states, will allow consumers to pay premiums as late as January 8. The Connecticut exchange, Access Health CT, said some shoppers can pay as late as January 7. The Vermont exchange and Covered California have announced similar extensions while Maryland requires payment by January 15.
Cristine Vogel, a Navigant Consulting associate director who has health insurers and providers as clients, said that the grace period is a way for insurers to keep their members at a time when confusion about coverage is expected.
That’ll avert lapses in coverage for people who see the doctor early next month, not realizing that their first payment was already due by New Year’s Eve. Remember, though, according to one expert who spoke to Charles Ornstein about this, insurers can probably expect only half of their customers to have paid up by the December 31st deadline. Even if another 25 percent manage to make payment during the grace period, you’re still looking at thousands of people whose coverage will lapse in January. That’s a political disaster for HHS in the making. Uncle Sam will have to do something about it. But what?
Bob Laszewski says insurers are telling him that only about 20 percent of “enrollees” have made their payments so far. And that’s not all:
As of this week, the 834 transaction error rates (enrollments sent from the government to the health plans) are better than they were in October and early November but are still running in the 5% to 10% range––a place they have been for a number of weeks now.
The Obama administration has still not built the reconciliation computer system needed to clean up the remaining enrollment data issues between and the health plans. The health plans have been told to expect an electronic file in the next few days, containing what the feds think are the health plan’s enrollments through November. The plans will then have to figure out how to reconcile the two lists and then fix the problems. Many plans will have thousands of enrollments to reconcile. There will be another such file coming in January for the December enrollments with likely tens of thousands of more names to reconcile.That means that any December errors will have to be fixed before people can be covered, thereby creating additional customer service issues until the files can be cleaned up.
We know there’s already a backlog of tens of thousands of applications in some of the state exchanges, but we don’t know — as usual — how bad it is at the federal level. That’s another incentive for insurers to grant a grace period for people who miss their payments: If their enrollment is voided due to nonpayment and they’re forced to re-enroll, not only is there a chance they’ll sign up with a different insurer, it’s more paperwork for their current insurer even if they decide to stick with them. And thanks to President Bumblefark’s botched website and delayed deadline for enrollment, more paperwork in late December/early January is something insurers simply can’t afford.
Exit question: Is it possible that some people out there don’t yet understand that they’re expected to pay at all? I’m tempted to say no: When you shop on the exchange, the premiums are listed right there in front of you. If anything, the greater risk is that people are paying too much attention to the pricetag and overlooking the fact that their new deductibles might be higher than expected and their provider network smaller than expected. On the other hand, if I’ve learned one thing from blogging polls over the years, it’s that you should never underestimate the stupidity of the very low-information voter. Could it be that there’s someone out there who’s so stupid that he/she thinks insurance in the age of Obama Claus is free? Exit answer: Yes.

CoveredCalifornia would like young people to drop it like it’s hot. Wait, wha…?


ObamaCare officials and advocates have always blithely claimed that the evident lack of young people signing up for health insurance through the exchanges at the program’s outset would be no immediate cause for panic, despite the absolute necessity of making sure that young people comprise a healthy portion of ObamaCare’s demographic mix — the better to the help pay for the costs of older, sicker participants with more expensive healthcare needs. Young people are procrastinators, after all, ObamaCare’s supporters insist, and they’ll probably wait until the last minute to sign up for new-and-improved, practically free ObamaCare plans — but they seem to be hoping that just the right PR approach will help to make damn sure that that nonchalant prediction actually comes to fruition.
The Obama administration has been trying for months now to get celebrities, actors, comedians, and athletes more involved in their outreach to young people, and a bunch of state exchanges led by Covered California in concert with healthcare advocacy group Enroll America are re-upping that approach with an extended social media campaign: “Tell a friend — get covered!” Via the LA Times:
Thursday’s launch of the “Tell a friend — Get covered” campaign marks a new phase of the effort that is being led by Covered California, the state’s thriving Obamacare exchange which enrolled more than 100,000 peoplethrough November (accounting for nearly a third of signups nationwide).
The new campaign, with its daily missives from celebrities, aims to reach 100 million people by encouraging friends to speak to friends about the benefits of health insurance. The message bearers will include actors Tatyana Ali of “The Fresh Prince of Bel-Air,” Wilmer Valderrama of “That ’70s Show” and Fran Drescher of “The Nanny.” On Thursday, the campaign released a video featuring Obama impersonator Iman Crosson (who performs as “Alphacat”) rapping about the new law.
“One of the key reasons we’re doing this campaign is that those under 30 live and breathe social media — they live Twitter, they live Facebook,” said Peter Lee, executive director of Covered California. Research has shown strong demand for health insurance within that age group, he noted: “Young people are not young and invincible, rather they’re the young convincibles. Again and again, if you look at the surveys, if you put before young people what insurance costs them, what they get — they want to buy.”
And the aforementioned video: “Drop it like it’s hot.” Hawt? Hot.
I must say, I find the usage of “drop it like it’s hot” to be a bit of an eyebrow-raiser. I know it’s just supposed to be an earwormy spoof, but the possibilities for adverse interpretation here are endless. “Drop your entire budget on expensive premiums designed to pay for the program’s redistributive nature, like it’s hot.” “Get dropped from your insurance plan, like it’s hot, because it didn’t include all of the extra ‘benefits’ we decided you needed and wasn’t expensive enough.” And so forth.
I suppose the cherry on top of this celeb-tastic PR sundae is supposed to be that the “Sexiest Man Alive” (…certainly not in the humble opinion of this twentysomething, I can assure you) is going to be in on campaign.
Pop singer Adam Levine, who won the designation from People magazine last month, is among the celebrities who’ll be promoting enrollment in online health insurance exchanges as part of a social media campaign kicking off tomorrow.
With enrollment totals behind administration projections after the botched start-up of the federal exchange, 17 state exchanges joined by an advocacy group are drawing on Obama administration allies in entertainment and sports to promote sign-ups, using social media such as Facebook and Twitter.
The effort is evidently really banking on young people being more social-media sheep than rationally-self interested individuals. We’ll see how that works out for them.

Obama Admin Pressures Insurers to Provide Coverage Before Getting Paid

HHS "urging issuers to give consumers additional time to pay their first month’s premium and still have coverage beginning January 1, 2014."

On Thursday, Lauren Aronson, Director of the Office of Legislation for the Centers for Medicare and Medicaid Services, announced a set of policies designed to pressure insurance companies to take measures to fill the gaps left by Obamacare.
More specifically, the Department of Health and Human Services will now pressure health insurers to retroactively accept payment for coverage that was supposed to begin on January 1, even if no payments have been made and no coverage has been formally granted. Furthermore, HHS wants insurers to pay out-of-network providers as though they were in-network “to ensure continuity of care for acute episodes,” and to pay for refill prescriptions under previous plans.”
In other words, if you applied for Obamacare, have not been enrolled, have not paid a dime, and get sick on January 1, the Obama administration now wants insurance companies to pay for your care before you ever pay a dime. Furthermore, they want you to get care for which you will not be approved under your insurance plan.
Rory Cooper, communications director for House Majority Leader Eric Cantor, stated, “It’s clear the administration knows Obamacare’s problems are only going to get worse, and patients will be the ones who suffer. What’s not clear is whether they understand the confusion and chaos they continue to cause.”

December 11th......

Capitol Hill Staffers Warned "Do Not Rely" On Obamacare Website

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On a day when Sebelius faces more music, but small golf-claps are heard around Democrat offices at the sign-up rates for Obamacare, The Hill reports - rather dishearteningly, Capitol Hill staffers who signed up for ObamaCare through the Washington, D.C. healthcare exchange are being told to confirm their enrollments in person, and not to rely on data provided by the website... "Do not rely on your 'My Account' page or other correspondence from DCHL... do not assume you are covered."

The Hill obtained an email sent to staffers on Wednesday warning them, “it is essential that you confirm your coverage in DCHL through the Disbursing Office.”

“Do not rely on your ‘My Account’ page or other correspondence from DCHL,” the email reads.

“Please do not assume you are covered unless you have seen the confirmation letter from the Disbursing Office,” the email continues.

Capitol Hill workers had until Monday to sign up for healthcare in D.C., where members and their staffs are eligible for a generous employer healthcare subsidy from the government.


After weeks of pressure from journalists, the Centers for Medicare and Medicaid Services (CMS) said that as much as 25 percent of enrollment transmissions sent from the federal portal to insurers were either garbled or contained bad data.

Based on HHS’s enrollment figures,upwards of 30,000 applications might need to be re-evaluated before the end of the year.

Bob Laszewski: The demographic mix in some ObamaCare risk pools right now is “very, very bad”


I wish he had been more specific about what “very, very bad” means and how many plans are in trouble because of this, but his previous criticisms of O-Care and have been accurate so there’s little reason to doubt that this one is too. On the contrary, this is consistent with the dog that didn’t bark in the HHS enrollment data released this morning. If the composition of the risk pools looked good, with oodles of “young invincibles” signing up to subsidize people with preexisting conditions, Obama and Sebelius would be shouting it from the mountaintops. The progressive goalposts, always capable of quickly shifting, would move instantly from “how many people have signed up?” to “how’s the demographic mix of the risk pools?”. That’s what’s really important, don’tcha know.
The answer to each question in turn: Not enough people have signed up, and per Laszewski, not enough of the ones who have are the healthy youngsters insurers desperately need.
Older clients, aged above 40, comprise 60 percent of the new Obamacare customers at one of his client health-care companies, Laszewski told The Daily Caller.
The skew is “very, very bad,” said Laszewski, who is president of Health Policy and Strategy Associates, Inc…
Precise predictions are impossible because the Obamacare system is so new, and executives do expect a surge of people to join in the next two weeks, Laszewski said.
But the apparent lack of young people “is a very poor omen,” Laszewski said.
Not the first time we’ve heard that the risk pools are older and grayer than HHS hoped. The October data for some plans showed the average age of enrollees climbing above 50. In Connecticut and Kentucky, the biggest segment of enrollees came from the 55+ group; in California, which operates the largest state exchange, 56 percent of October enrollees wereolder than 45 and, of that group, a majority were over age 55. Just 23 percent came from the coveted 18-34 demographic. But all of that was expected: It stands to reason that the first rush of sign-ups after the exchanges launched would come from older, sicker people who are desperate to get coverage. The significance of Laszewski’s comments today is that he seems to believe that the skew has persisted, at least in some segments, well into December. Again, though, I wish he’d given us numbers. According to HHS, the exchanges will be fine if 40 percent of enrollees are young and healthy. Laszewski told the Daily Caller that 60 percent of new enrollees in some plans are older than 40. That … doesn’t sound terribly skewed, frankly. And since it’s the lazy and/or distracted youngsters who are expected to finally sign up in the last enrollment crunch before Christmas, there’s reason to think that the risk pools might be even more balanced by New Year’s. It would, presumably, be very easy for HHS to clue us in on all this, but as I say, they’re keeping their mouths shut. Which almost certainly means it’s bad news, i.e. Laszewski’s right.
It’s not just the age mix that’s confounded predictions. Patrick Brennan notes a curious trend in the HHS data released today:
About one-fourth of the people who have entered their income information on their applications were deemed eligible for subsidies on the exchanges (about 900,000 out of about 3.6 million), which is lower than the number we saw in October alone and remains really far from what was projected. The CBO projected that just 1 million out of the 7 million people to enroll in the exchanges in the first year would be ineligible for subsidies,so the ratio is way off from what was expected (15–75 vs. 75–25). I had some thoughts on that surprising fact a month ago, and I’ll add a couple now: Unsubsidized customers (basically, those above the national median income) are generally savvier and more likely to have the resources to enroll and make their payments ahead of time, so maybe this is understandable and doesn’t say anything about who will eventually enroll. On the other hand, it may demonstrate that the people to whom insurance was supposed to be expanded — the uninsured, who tend to be low-income and not well educated — aren’t getting to the exchanges at all, and covering them will be a much longer term project.
CBO made a rational assumption: If you expand coverage to people irrespective of preexisting conditions and subsidize those with smaller incomes to make their premiums more affordable, it stands to reason that lower-income people who’d been priced out before will leap at the chance to buy insurance once it’s available in October. Right? They’re the “winners” from the law. Uncle Sam’s helping them out with a little welfare towards their health insurance. Why not avail themselves? What we’re seeing instead is higher-income people who don’t qualify for subsidies enrolling. Maybe that’s because they, more so than lower-income folks, used to have insurance and were recently canceled, making them desperate to get new coverage before January 1st. If you’re poor and have spent years without insurance, you might be so used to it that you don’t bother to hurry when the exchanges open. Or maybe the premiums are so high even after you discount them for subsidies that some poorer consumers still can’t afford them and are holding out for the time being. Or maybe the subsidy problem is a function of the poor demographic mix right now: The “young invincibles” who are just starting out in the labor market (if they’re lucky enough to find a job) are, I’d guess, way more likely than older middle-class people to need a little help paying their premiums. If they’re not signing up yet, then naturally the risk pool will be older andwealthier. Good news for taxpayers at the moment, in that the subsidies are flowing relatively slowly from the tap, but bad news later if the skewed risk pool persists and HHS has to bail out insurers from their adverse selection problem.
Anyway. Senate Democrats have decided that Obama’s fixes to the law aren’t nearly enough and so they’re working on their own fixes, pretty much of all which will only make the adverse selection problem worse and a bailout more likely. They’re the Smart Party, remember.

Uh oh: Only 5-15% of enrollees have paid their first month of premiums in some ObamaCare plans


A good way to tell whether a media outlet is serious about ObamaCare reporting is to see if they cover this bombshell as a corollary to the new enrollment data. If 365,000 have “signed up” but only one-tenth of them, say, have paid their first month of premiums to activate their new coverage, how many people are really “enrolled” in ObamaCare plans right now?

Last week an insurer in Indiana told CNN that one of their plans had received payment fromonly 20 percent of people who signed up so far. According to Charles Ornstein’s sources, that insurer was doing relatively well.
“There is also a lot of worrying going on over people making payments,” industry consultant Robert Laszewski wrote in an email. “One client reports only 15% have paid so far. It is still too early to know for sure what this means but we should expect some enrollment slippage come the payment due date.”
Another consultant Kip Piper, agreed. “So far I’m hearing from health plans that around 5% and 10% of consumers who have made it through the data transfer gauntlet have paid first month’s premium and therefore truly enrolled,” he wrote me…
Blue Shield of California said it has sent out thousands of payment request letters…
While saying it is difficult to guess what will happen, Piper said he believes “a plan will be lucky if half of applicants pay first month’s premium on time for January coverage start but that perhaps three-quarters will pay in time for coverage start by February or March.”
My pal Karl pointed out on Twitter that Ezra Klein’s blog is describing the 365,000 sign-ups announced by HHS today as people who “have purchased private insurance.” Simply not true, and it’s no minor detail that it isn’t. Remember, per the CNN article last week, failing to pay by the deadline this month doesn’t necessarily mean that your coverage will take effect next month as soon as you finally pony up with your first premium. In some states, your enrollment is void if you don’t complete the purchase on time. That means you’ll have to re-enroll in January, which might be an easy process or might not be depending upon whether can handle the growing traffic load and whether insurers are buried under a mountain of backlogged applications, some of them with errors that require correction.
I’m frankly surprised that HHS hasn’t started ringing alarm bells about the nonpayment problem in order to try to mitigate it. I can only assume, as with so much else, that that’s a political decision made at the expense of a policy one. The more they start screaming about paying on time, the more the media will start focusing on this as the next landmine to detonate, replete with another look at how pricey some of America’s new “affordable” coverage is. Better to keep quiet, let people not pay, and then seek some form of “fix” next month in which HHS covers the first month of payments for new enrollees in return for repayment at a later date. Or maybe the easier fix would be for the King to proclaim that no enrollments will be voided in the event of nonpayment. They’ll simply be suspended until payment is tendered. That would reduce the logistical complexity of all this — a little — but I don’t know how insurers will replace the missing revenue in January from all those delayed premiums. Maybe that’s where Uncle Sam and “risk corridors” come in.
Elsewhere in ObamaCare chaos news, go read this USA Today report from Monday about how the new and allegedly improved is telling some people who make $80,000 a year that they qualify for Medicaid. When those people call the O-Care hotline, the operators tell them that whatever the website says must be correct. Will those poor saps be sprung from limbo in time to enroll before the deadline? Stay tuned.
Update: Sebelius was asked about this at today’s House hearing. Quote:
Burgess: What if that patient doesn’t make the premium payment? You said they’re covered Dec. 23, but they never write the check. They never make the payment.
Sebelius: Then they’re not covered. They are not enrolled, and at every point along the way, on the website they are told until they make the payment—

"No Way To Tell How Many People Who Have Signed Up For Obamacare Actually Have"

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The Obamacare enrollment portal is the gift that keeps on giving endless examples of government incompetence. The latest comes from Bloomberg which informs us that "there’s no way to tell how many people who think they’ve signed up for health insurance through the U.S. exchange actually have, after about 1 in 4 enrollments sent to insurers from the federal website had garbled included incomplete information." Still that particular glitch was not enough to prevent Obama from taking full credit for a "fixed" website after somehow the White House managed to calculate that sign ups soared to 100,000 people, and have taken off since the "fix."
[T]he acknowledgment suggests consumers need to be vigilant about their health plan purchases. Letters from insurers confirming coverage can take a week or more, and the Obama administration now says people should call their companies if they aren’t contacted within that time.

With repairs to the front end of leading to a spurt of 29,000 new enrollments in the first two days of December, U.S. officials are now focusing on what happens after customers select a plan on the website. Enrollment isn’t complete until consumers make their first payment, which is due Dec. 31 for insurance coverage that will begin on Jan. 1.

It’s time for people to move toward locking in coverage and paying for it,” said Joel Ario, a consultant with Manatt Health Solutions, in a telephone interview. Insurers will face “a tall challenge” trying to resolve enrollment errors as the time shortens before coverage begins Jan. 1, he said.

The Centers For Medicaid & Medicare Services, which runs the federal health website, doesn’t have “precise numbers” on how many of the enrollment forms called 834s have been sent to insurers or how many have errors, Julie Bataille, an agency spokeswoman, said during a Dec. 6 conference call.
One aspect where Obamacare is working, is where the government decided to bypass the 500 million lines of code monstrocity entirely and allow consumers to enroll directly with state insurance companies.
A project the government began two weeks ago with 16 insurance companies in three states -- Texas,Florida and Ohio - - to allow them to enroll people directly into health plans, bypassing, has improved the working relationship among the government’s technicians and those at the companies, said a person familiar with the work who asked not to be identified because the information is private. The new cooperation has helped to resolve issues with the data transfers, the person said.
Alas, the bulk of the enrollment problems remain when using the central portal:
“In general our 834 files have been pretty good,” said Kathleen Oestreich, CEO of Meritus, a Tempe, Arizona, startup insurer funded by government loans. The company has seen only one “orphan” member, she said -- a person who called and said they hadn’t received an enrollment notice even though they had picked Meritus as their insurer.

More troubling are “ghosts” -- people whose files never reach their insurers, Robert Laszewski, an insurance industry consultant, said. It’s unclear how many people may fall into that category or how companies will identify or reach them.

“If they enroll 500,000 people and 25,000 of them walk into the doctor’s office and nobody knows who they are, that’s a problem,” he said in a phone interview.
It is indeed. And it is just the start, because while the enrollment process of Obamacare will (one hopes) eventually be fixed, that will merely unleash all new, and far more disturbing problems. Such as the deductible sticker shock that is about to be unleashed upon Americans in need of medical aid, especially those who choose the cheaper "bronze" plan. The WSJ reports:
As enrollment picks up on the website, many people with modest incomes are encountering a troubling element of the federal health law: deductibles so steep they may not be able to afford the portion of medical expenses that insurance doesn't cover. The average individual deductible for what is called a bronze plan on the exchange—the lowest-priced coverage—is $5,081 a year, according to a new report on insurance offerings in 34 of the 36 states that rely on the federally run online marketplace.

That is 42% higher than the average deductible of $3,589 for an individually purchased plan in 2013 before much of the federal law took effect, according to HealthPocket Inc., a company that compares health-insurance plans for consumers. A deductible is the annual amount people must spend on health care before their insurer starts making payments.

The health law makes tax credits available to help cover insurance premiums for people with annual income up to four times the poverty level, or $45,960 for an individual. In addition, "cost-sharing" subsidies to help pay deductibles are available to people who earn up to 2.5 times the poverty level, or about $28,725 for an individual, in the exchange's silver policies. As enrollment picks up on, many people with modest incomes are encountering a troubling element: deductibles so steep they may not be able to afford the portion of medical expenses that insurance doesn't cover. 

But those limits will leave hundreds of thousands or more people with a difficult trade-off: They can pay significantly higher premiums for the exchange's silver, gold and platinum policies, which have lower deductibles, or gamble they won't need much health care and choose a cheaper bronze plan. Moreover, the cost-sharing subsidies for deductibles don't apply to the bronze policies.

That means some sick or injured people may avoid treatment so they don't rack up high bills their insurance won't cover, according to consumer activists, insurance brokers and public-policy analysts—subverting one of the health law's goals, which is to ensure more people receive needed health care. Hospitals, meantime, are bracing for a rise in unpaid bills from bronze-plan policyholders, said industry officials and public-policy analysts.
Ah: central planning, also known in the now-defunct USSR as the where "whatever can go wrong, will." As Obama (and soon the Fed) are learning first hand...

NYT: My, many of these ObamaCare premiums aren’t really as low as they seem, are they?


In the latest in the Paper of Record’s recent series on their gradually creeping realization that There Is No Such Thing as a Free Lunch: ObamaCare Edition, the NYT has a story out this morning that hones in on the Obama administration’s desire to tout premiums that sound as gloriously low as is humanly possible — even if that means deliberately obfuscating the ways in which insurance companies are now looking to make up the increased costs of the overhaul in other, less immediately obvious areas.
The Obama administration will herald what appear to be “affordable” premiums available to so many lucky Americans through ObamaCare all day long, “but as consumers” [and, evidently, the NYT] “dig into the details, they are finding that the deductibles and other out-of-pocket costs are often much higher than what is typical in employer-sponsored health plans.” There’s plenty of cushion on behalf of ObamaCare in the piece, but the overriding message I’m reading is that ObamaCare is not the wondrous and automatic cost-saving measure officials are touting it as, and that a lot of people, if they’re ineligible for ObamaCare’s more blatantly redistributive effects, are going to have to pay for all of the added “benefits” they now have no choice but to include in their plans somehow:
Until now, it was almost impossible for people using the federal health care website to see the deductible amounts, which consumers pay before coverage kicks in. But federal officials finally relented last week and added a “window shopping” feature that displays data on deductibles.
For policies offered in the federal exchange, as in many states, the annual deductible often tops $5,000 for an individual and $10,000 for a couple. …
Mark A. York, a 60-year-old freelance writer in Hailey, Idaho, said he began shopping after he received a letter saying that his current insurance policy would be canceled because it did not meet the requirements of the health care law. In the exchange, he said, he found policies with premiums similar to what he is now paying, $440 a month, but “the deductibles were so high — $4,000 to $6,000 a year — that it defeats the purpose of having insurance.” …
Federal officials often point to premiums as evidence that the health care law has made insurance affordable. “Nearly six in 10 uninsured Americans can pay less than $100 a month for coverage in the health insurance marketplace,” Kathleen Sebelius, the secretary of health and human services, has said.
Except that those miraculously low premiums aren’t really much of a favor if they’re accompanied by much higher deductibles, co-payments, and drastically limited provider networks, are they? There’s been a sizable and obviously deliberate lack of straightforwardness going on with this law, and those aren’t the only hidden and/or “unexpected” costs that consumers might now find themselves facing, as the WSJ reported the other day:
Americans with chronic illnesses—who are expected to be among the biggest beneficiaries of the health law—face widely varying out-of-pocket drug costs that could be obscured on the new insurance exchanges.
Under the law, patients can’t be denied coverage due to existing conditions or charged higher rates than healthier peers. The law also sets an annual out-of-pocket maximum of up to $6,350 for individuals and $12,700 for families, after which insurers pay the full tab.
But depending on the coverage they select, some patients on expensive drug regimens could reach that level fast. Some medications for conditions including hepatitis, rheumatoid arthritis, HIV and cancer can retail for thousands of dollars a month, and some plans require patients to pay as much as 50% of the cost.

Mutliple State Exchanges Vulnerable to Wi-Fi Attack


Multiple state-run health-care exchanges are vulnerable to a type of Wi-Fi attack that can allow hackers to intercept usernames and passwords, KSTP, a Minnesota ABC affiliate, reports.
According to Mark Lanterman, the CEO and chief technology officer of Computer Forensic Services who ran the simulated attack for KSTP, state-run exchanges in Minnesota, Hawaii, Nevada, Colorado, New Mexico, New York, Maryland, and the District of Columbia are vulnerable to it.
Lanterman tested at least a dozen of the state-run exchanges to determine if they had the vulnerability. Kentucky, Rhode Island, Vermont, Massachusetts, and California did not., the federal exchange, also is not vulnerable to the attack.
MNsure, Minnesota’s exchange, insists that its website does not have a problem.
KSTP also reports that during the period that was hosted by servers owned by Google, the tech giant appeared to be capturing MAC addresses—reporter Nick Winkler characterizes them as “computer fingerprints”—which can identify individual computers.
“It seems weird to me,” Lanterman told KSTP. “I’m a little bit troubled by it. It’s not something that would ordinarily be collected, so someone had to make a decision to collect it.”
Google has been unwilling to speak with KSTP about the collection of MAC addresses.

Zeke Emanuel: If you want to pay more to keep your doctor, “you can do that. It’s a matter of choice.”


Is it a matter of “choice,” Mr. Emanuel? Is it?

Wallace: President Obama famously promised, ‘if you like your doctor, you can keep your doctor.’ Doesn’t that turn out to be just as false, just as misleading, as his promise about ‘if you like your plan, you can keep your plan’? Isn’t a fact, sir, that a number, most in fact, of the ObamaCare health plans that are being offered on the exchanges exclude a number of doctors and hospitals to lower costs?
Emanuel: The president never said you were going to have unlimited choice of any doctor in the country you want… But look, if you want to pay more for an insurance company that covers your doctor, you can do that. It’s a matter of choice. … The issue isn’t the selective networks… People are going to have a choice of whether they want to pay a certain amount for a selective network, or pay more for a broader network. They get that choice.
Yes, which isn’t much comfort if you are now precluded from seeing your same doctor unless you start paying more more, is it? How odd that they mysteriously neglected to mention that little caveat when they were making grandiose promises while simultaneously designing a system that would try to prevent premiums from skyrocketing by deliberately, systematically, and drastically limiting provider networks and reducing consumer choice, no?