Monday, December 30, 2013

ObamaCare Updates for December 30 , 2013 - January 2, 2014 ( Open thread to be updated as warranted ) .....News dump: CMS official in charge of HealthCare.gov ( Michelle Snyder ) retiring ........ 2,016,387 people have enrolled nationally in private insurance plans sold through federal and state-run health exchanges as of Monday - but how many folks have paid that first month's premium to formally be enrolled ? Is that number less than 77,000 - as per CNBC's Larry Kudlow on December 30 , 2013 ?

http://www.zerohedge.com/news/2014-01-03/how-obamacare-rollout-really-being-experienced

( I'll try clusterfarks for 200,  alex..... )


How The Obamacare Rollout Is Really Being Experienced

Tyler Durden's picture





 
As the New Year brings the actual implementation of Obamacare, it appears in reality things are not as great as many were promised. A recent Gallup survey found thatonly 7% called their Obamacare experience "very positive" with a stunning 29% seeing it "very negative." But as The Daily Mail found, from Northern Virginia hospitals turning away sick people because they can't determine whether their Obamacare insurance plans are in effect to high deductibles and long waits for authorizations; as many as one-third of the administration's claimed 2.1 million enrollees remain unsure of their coverage.The 'lie of the year' in 2013 may be even bigger in 2014.

No one knows if they are covered...
Hospital staff in Northern Virginia are turning away sick people on a frigid Thursday morning because they can't determine whether their Obamacare insurance plans are in effect.

Patients in a close-in DC suburb who think they've signed up for new insurance plans are struggling to show their December enrollments are in force, and health care administrators aren't taking their word for it.

In place of quick service and painless billing, these Virginians are now facing the threat of sticker-shock that comes with bills they can't afford.

'They had no idea if my insurance was active or not!' a coughing Maria Galvez told MailOnline outside the Inova Healthplex facility in the town of Springfield.

She was leaving the building without getting a needed chest x-ray.


'The people in there told me that since I didn't have an insurance card, I would be billed for the whole cost of the x-ray,' Galvez said, her young daughter in tow. 'It's not fair – you know, I signed up last week like I was supposed to.'
The x-ray's cost, she was told, would likely be more than $500.

And no one knows for sure of those who signed up - how many have actually paid?
Galvez said she enrolled in a Carefirst Blue Cross bronze plan at a cost of about $450 per month through healthcare.gov, three days before Christmas.

'No one has sent me a bill,' she said.

Health and Human Services Secretary Kathleen Sebelius testified... 'Some may have paid, some may have not,'

The government's advice?...
"We're telling consumers if they're not sure if they're enrolled they should call the insurer directly," White House Press Secretary Jay Carney old reporters on December 2.

But the insurers are overwhelmed by the numbers...
The Washington Post reported that day that because of computer glitches in the 'back end' of healthcare.gov, enrollment records for as many as one-third of new insurance customers were corrupted or otherwise contain errors.

Given the Obama administration's latest claim that 2.1 million have signed up nationwide, that means as many as 700,000 Americans might falsely believe they have a current health insurance policy.

Mary and others like her, who took the time to enroll but may not follow the daily flood of news about Obamacare, likely don't know one way or the other.

'Why is this so complicated?' she asked. 'I had my own private insurance last year, but they cancelled me in November. I'm not sure which end is up.'

Private industry estimates put thenumber of policy cancellations as high as 4.7 million in the last quarter of 2013, mostly involving health care plans that didn't meet the Affordable Care Act's strict minimum standards.

How Life Changes Affect Your Care?

How Long Will Doctors Keep Providing Service For Free?
President Obama has attracted widespread criticism, and a 'lie of the year' award from one newspaper's fact-checker, for promising that Americans who liked their health plans would be allowed to keep them.

Dr. John Venetos, a Chicago gastroenterologist, told the Associated Press on Thursday that he is seeing 'tremendous uncertainty and anxiety' among his patients who signed up for Obamacare plans but don't have insurance cards.

'They’re not sure if they have coverage,' Venetos said. 'It puts the heavy work on the physician.'

'At some point, every practice is going to make a decision about how long can they continue to see these patients for free if they are not getting paid.'

But even then... people have apparently been misled into believing Obamacare is 'affordable' - it appears not...
Her Carefirst plan, identified on the Obamacare website as BlueChoice Plus Bronze, carries a $5,500 per-person deductible for 2014 – an amount she would have to pay out-of-pocket before her coverage would apply to medical expenses.

...

similar situation frustrated Mary, an African-American woman small businesswoman who asked MailOnline not to publish her last name. She was leaving the Inova Alexandria Hospital in Alexandria, Virginia with two family members.

'I had chest pains last night, and they took me in the emergency room,' Mary said. 'They told me they were going to admit me, but when I told them I hadn't heard from my insurance company since I signed up, they changed their tune.'

She told MailOnline that a nurse advised her that her bill would go up by at least $3,000 if she were admitted for a day, and her doctor told her the decision was up to her.
As Gallup found:
Fifty-nine percent of Americans told Gallup pollsters that they have had negative experiences with the Affordable Care Act, according to the public opinion giant's latest survey.














http://hotair.com/archives/2014/01/03/eleven-state-ags-protest-obamacare-fixes-as-flatly-illegal/



Eleven state AGs protest ObamaCare “fixes” as “flatly illegal”

POSTED AT 8:31 AM ON JANUARY 3, 2014 BY ED MORRISSEY

 
Alternate headline: Hot Air readers get results! In our year-end poll, readers chose as the most underreported story of 2013 the lawlessness of the Obama administration in its handling of ObamaCare. Eleven state Attorneys General share that opinion — and started off the year attempting to correct it. Led by Patrick Morrisey of West Virginia (no relation), the consortium of AGs protested the changes in a letter to Kathleen Sebelius (via Instapundit):
The attorneys general specifically criticize President Obama’s executive action that allowed insurance companies to keep offering health plans that had been canceled for not meeting ObamaCare’s more rigorous standards.
We support allowing citizens to keep their health insurance coverage, but the only way to fix this problem-ridden law is to enact changes lawfully: through Congressional action,” the attorneys general wrote in a letter to Health and Human Services (HHS) Secretary Kathleen Sebelius. “The illegal actions by this administration must stop.”
They say the healthcare fix was “flatly illegal under federal constitutional and statutory law.”
Congress wrote the law in a manner that transfers much of its authority to HHS. The bill is chock-full of the phrase, “The Secretary shall determine …” in areas where Congress should have provided much more specific direction, which allows the executive branch wide latitude in a number of areas. However, the bill does have some specificity, especially on deadline dates for enforcement. HHS does not have the statutory flexibility that it has arrogated to itself for these “fixes,” nor does it have the constitutional power to change statute.
Morrisey and his colleagues are correct in their accusations. The question will be whether any of them will challenge those decisions in court. One would have to think they have standing to do so, especially as it relates to the impact on insurers in their states.  Congress also would have standing to bring a complaint to the federal court, and one has to wonder whether John Boehner and the House is considering such an action. If “the illegal actions by this administration must stop,” they have to know that a letter to Sebelius isn’t going to be the fulcrum of that change.
In other ObamaCare news, the confusion over sign-ups versus actual enrollments is keeping people from getting care:
Hospital staff in Northern Virginia are turning away sick people on a frigid Thursday morning because they can’t determine whether their Obamacare insurance plans are in effect.
Patients in a close-in DC suburb who think they’ve signed up for new insurance plans are struggling to show their December enrollments are in force, and health care administrators aren’t taking their word for it.
In place of quick service and painless billing, these Virginians are now facing the threat of sticker-shock that comes with bills they can’t afford.
‘They had no idea if my insurance was active or not!’ a coughing Maria Galvez told MailOnline outside the Inova Healthplex facility in the town of Springfield.
She was leaving the building without getting a needed chest x-ray.
‘The people in there told me that since I didn’t have an insurance card, I would be billed for the whole cost of the x-ray,’ Galvez said, her young daughter in tow. ‘It’s not fair – you know, I signed up last week like I was supposed to.’
The x-ray’s cost, she was told, would likely be more than $500.
She chose a plan that cost $450 a month but hasn’t received a bill yet, the Daily Mail reports, but she also has a $5500 deductible — which means she’d be paying for that chest X-ray anyway. There are plenty of more anecdotes from the front lines of the ObamaCare rollout in the article, so be sure to read it all.



http://hotair.com/archives/2014/01/02/study-medicaid-patients-use-emergency-room-more-not-less/




Study: Medicaid patients use emergency room more, not less

POSTED AT 7:01 PM ON JANUARY 2, 2014 BY MARY KATHARINE HAM

 
A new study of Medicaid beneficiaries in Oregon makes a strong version of this case. The study, published today in the journal Science, finds that adult Medicaid beneficiaries rely on emergency rooms about 40 percent more than similar uninsured adults.
“When you cover the uninsured, emergency room use goes up by a large magnitude,” said Amy Finkelstein, a health economist at the Massachusetts Institute of Technology who served as a lead investigator on the study, in an MIT press statement accompanying the study.
There were no exceptions to the trend. “In no case were we able to find any subpopulations, or type of conditions, for which Medicaid caused a significant decrease in emergency department use,” said Finkelstein.
We’ve seen real-world evidence that Medicaid increases emergency room utilization before, in states like California. But the Oregon study should settle any lingering debate.
These results, reported by Peter Suderman at Reason, were reported in the journal Science and are based on the Medicaid study in Oregon that made news in May for showing Medicaid patients had no material health improvements over the uninsured.
The Oregon study is important because it’s a randomized controlled trial— the research gold standard we’ve reported on before in studies like the Tennessee Pre-K study and theWashington, D.C. Opportunity Scholarship study. Washington state held a lottery for access to Medicaid and then studied the both the cohort that got Medicaid and the cohort that did not. This means the cohorts were randomly selected within a group of people with similar motivations, economic situations, etc., making them more accurately comparable.
Suderman notes that Medicaid recipients are less likely to experience ” feel better after they are covered, and they are much less likely to be subject to large, health-related financial shocks,” making it largely a “financial buffer” instead of a health program. If our friends on the Left were as pro-science as they purport to be, they’d acknowledge it’s worth discussing whether we’re accomplishing what we want to accomplish with these very expensive programs. Research shows we’re not helping people as advertised. If we’d like to actually help people instead of just patting ourselves on the back for saying we’re helping them, we’ve got to rethink these programs instead of expanding them. If anything, the Oregon study offers a pretty decent argument for Republican governors that skipping Medicaid expansion wasn’t just the right fiscal decision, but the right one for general health outcomes and emergency room crowding.






http://thehill.com/blogs/healthwatch/health-reform-implementation/194316-obamacares-use-expected-to-spike-beginning


The number of people seeking to use their new ObamaCare coverage for the first time is expected to spike next week.
Representatives from healthcare companies, trade groups, and the Obama administration told The Hill that many who obtained new coverage under the law are using this week to learn about their plans and set up preliminary appointments.
They’re expected to turn out in force at the nation’s clinics and hospitals as early as next Monday.
“We are anticipating a surge in activity beginning next week,” said Markeisha Marshall, a spokesperson for Walgreens, the country’s largest pharmacy.
“We haven’t seen many issues, but it’s early,” said Kevin Schweers of the National Community Pharmacists Association.
“We’re predicting Monday will be a better arbiter [for how the law is holding up], so that’s something we’re keeping an eye on,” Schweers added. “We’ve asked our members to let us know about their experiences.”
The administration and healthcare groups have been bracing for the latest test of the law after enrollment deadline delays and processing errors at HealthCare.Gov created an administrative nightmare for insurers.
Two worries are paramount.
The first is that a sizable number of consumers who show up at the doctor’s office will discover that they don’t have the insurance they thought they purchased.
A second is that people have enrolled in ObamaCare, but have to make a payment. Some will discover they don’t have the insurance they thought they purchased as a result .
A spokesperson from the American Medical Association said “it may take some time” before the full picture comes into view, while some interest group representatives cautioned not to attribute everything that happens over the next week to the new healthcare law.
The administration has received a great deal of help from the private sector in an attempt to make this year’s transition a smooth one.
Some big insurers are allowing consumers to pay their first premium by Jan. 10 and still be insured on Jan. 1.
In addition, Walgreens, CVS Pharmacies, Kroger and WalMart announced this week that they’d provide up to a month of no-cost medications to consumers who haven’t received their ObamaCare ID cards yet, but can prove they enrolled.
Marshall said Walgreens has so far serviced only a “moderate” number of those who needed to take advantage of the added flexibility the pharmacies are offering. All of the major chains said it was too early to provide totals at this time.
Keith Dailey, a spokesperson for Kroger, said early January is always a complicated time for the industry because they historically see a “surge of customers with new insurance the first month of every year.”
White House senior adviser David Simas made the same argument on a Thursday conference call with reporters.
“Like any transition, such as occurs every year, when people move from one type of plan to another, it requires a lot of coordination between pharmacies, insurance companies, hospitals, doctors and providers,” he said. “That type of coordination is ongoing and will continue to ramp up over the course of the next week.”
The botched ObamaCare rollout has left the administration vulnerable to criticism.
The administration is adamant that most of the back-end issues with the HealthCare.Gov website have been resolved, but the nation’s largest insurance trade group described the problems as “ongoing.”
“Health plans are working around the clock to process the high volume of enrollments that they have received from the exchanges,” said America’s Health Insurance Plans spokesman Robert Zirkelbach.
“While there are still some ongoing challenges with the back-end systems, including so-called 'orphan records,' where the enrollment files are never received, health plans are working with CMS to resolve those issues as quickly as possible so that consumers' coverage can begin in January,” he said.
In the interim, the political debate surrounding the law rages.
The administration has embarked on a public relations blitz to highlight positive ObamaCare stories.
Health and Human Services secretary Kathleen Sebelius uploaded a YouTube video and circulated an op-ed on Thursday touting the benefits of the law, and Simas’s conference call focused on the rollout in Georgia. It included a woman who told gave personal testimony about her experience in gaining affordable coverage for the first time.


Republicans aren’t letting up either.
On Thursday, Speaker John Boehner (R-Ohio) said in a blog post that the law was “unworkable and unaffordable,” and solicited personal stories from citizens that have been adversely affected.
And the Koch-brothers backed Americans For Prosperity launched a seven-figure ad buy against three Democratic senators it believes are vulnerable because of their support for the law.






http://www.dailymail.co.uk/news/article-2532869/They-no-idea-insurance-active-not-At-Virginia-hospitals-Obamacare-confusion-reigns-frustrated-patients-walk-out.html

(  Looks like the expected are popping up basically from  day 1 ... )


'They had no idea if my insurance was active or not!': Obamacare confusion reigns as frustrated patients walk out of hospitals without treatment


  • MailOnline spoke with patients who were told they would have to pay their bills in full if they couldn't prove they had insurance

  • One was faced with a $3,000 hospital room charge and opted to leave the hospital after experiencing chest pains

  • 'Should I be in the hospital? Probably,' she said

  • Another, coughing in the cold, walked out without receiving a needed chest x-ray

  • Consumers face sticker-shock from medical costs under the new Obamacare system, made worse if they can't prove they're insured

  • As many as one-third of new enrollees' applications have seen problems when the government transmits them to insurance companies


Hospital staff in Northern Virginia are turning away sick people on a frigid Thursday morning because they can't determine whether their Obamacare insurance plans are in effect.

Patients in a close-in DC suburb who think they've signed up for new insurance plans are struggling to show their December enrollments are in force, and health care administrators aren't taking their word for it.
In place of quick service and painless billing, these Virginians are now facing the threat of sticker-shock that comes with bills they can't afford. 

'They had no idea if my insurance was active or not!' a coughing Maria Galvez told MailOnline outside the Inova Healthplex facility in the town of Springfield.

She was leaving the building without getting a needed chest x-ray. 

'The people in there told me that since I didn't have an insurance card, I would be billed for the whole cost of the x-ray,' Galvez said, her young daughter in tow. 'It's not fair – you know, I signed up last week like I was supposed to.'
The x-ray's cost, she was told, would likely be more than $500.



SCROLL DOWN FOR VIDEO
Going home: One patient left the hospital without being admitted for chest pains after she was warned she might have to pay full-price. She asked MailOnline not to publish a photograph of her face
Going home: One patient left the hospital without being admitted for chest pains after she was warned she might have to pay full-price. She asked MailOnline not to publish a photograph of her face


MailOnline spoke to patients outside hospitals in Virginia's Washington, D.C. suburbs, many of them confused about the state of their insurance coverage
MailOnline spoke to patients outside hospitals in Virginia's Washington, D.C. suburbs, many of them confused about the state of their insurance coverage

Galvez said she enrolled in a Carefirst Blue Cross bronze plan at a cost of about $450 per month through healthcare.gov, three days before Christmas.

'No one has sent me a bill,' she said.

Health and Human Services Secretary Kathleen Sebelius testified in a December 11 congressional hearing that the federal government can't say how many new enrollees have written checks for their first month's premiums.

'Some may have paid, some may have not,' she conceded.
It's unlikely that a valid insurance card would have changed Galvez' fortunes, however. 

GALLUP: MOST AMERICANS HAVE OBAMACARE HORROR STORIES

Fifty-nine percent of Americans told Gallup pollsters that they have had negative experiences with the Affordable Care Act, according to the public opinion giant's latest survey.
Just 39 per cent said their experiences were positive.
Only 7 per cent called their Obamacare journeys 'very positive,' but 29 per cent said their interaction with the new system has been 'very negative.'
Gallup interviewed 1,500 uninsured Americans in December, 450 of whom said they had visited health insurance exchange websites.
As dismal as those numbers are, they represent a slight improvement: In November, Gallup found that 63 per cent of uninsured Americans had negative experiences with the president's new health care overhaul.
Her Carefirst plan, identified on the Obamacare website as BlueChoice Plus Bronze, carries a $5,500 per-person deductible for 2014 – an amount she would have to pay out-of-pocket before her coverage would apply to medical expenses.

The Inova radiology department wouldn't speak with MailOnline, and Carefirst did not respond to a request for comment. 

A similar situation frustrated Mary, an African-American woman small businesswoman who asked MailOnline not to publish her last name. She was leaving the Inova Alexandria Hospital in Alexandria, Virginia with two family members.
'I had chest pains last night, and they took me in the emergency room,' Mary said. 'They told me they were going to admit me, but when I told them I hadn't heard from my insurance company since I signed up, they changed their tune.'

She told MailOnline that a nurse advised her that her bill would go up by at least $3,000 if she were admitted for a day, and her doctor told her the decision was up to her.
No x-ray for you: This patient left a Virginia medical facility without receiving a test her doctor recommended
No x-ray for you: This patient left a Virginia medical facility without receiving a test her doctor recommended

'Should I be in the hospital? Probably,' she said. 'Maybe it's one of those borderline cases. I have to think that if I were really in danger, they wouldn't give me the choice. But what if I think I'm covered and I'm really not ?'

'The emergency room bill is going to be bad enough.'
No card, no service: Hundreds of thousands of Americans are likely in health-insurance limbo with no proof of insurance as the new year begins
No card, no service: Hundreds of thousands of Americans are likely in health-insurance limbo with no proof of insurance as the new year begins
The Obamacare system has suffered from a long list of setbacks since its October 1 rollout, starting with an inoperable website and ending with rampant uncertainty about whether Americans who enrolled are actually covered.
"We're telling consumers if they're not sure if they're enrolled they should call the insurer directly," White House Press Secretary Jay Carney old reporters on December 2.

The Washington Post reported that day that because of computer glitches in the 'back end' of healthcare.gov, enrollment records for as many as one-third of new insurance customers were corrupted or otherwise contain errors.
Given the Obama administration's latest claim that 2.1 million have signed up nationwide, that means as many as 700,000 Americans might falsely believe they have a current health insurance policy.

Mary and others like her, who took the time to enroll but may not follow the daily flood of news about Obamacare, likely don't know one way or the other.

'Why is this so complicated?' she asked. 'I had my own private insurance last year, but they cancelled me in November. I'm not sure which end is up.'

Private industry estimates put the number of policy cancellations as high as 4.7 million in the last quarter of 2013, mostly involving health care plans that didn't meet the Affordable Care Act's strict minimum standards.

Democrats serving on the House Committee on Energy and Commerce dispute that number, saying in a new report that no more than 10,000 will wind up without affordable insurance options after losing their old policies.
The Inova Healthplex in Springfield, Virginia offers free valet parking, but if you want to see a doctor you'll need proof that you've paid your Obamacare premium
The Inova Healthplex in Springfield, Virginia offers free valet parking, but if you want to see a doctor you'll need proof that you've paid your Obamacare premium

Still working: Emergency services are still being provided at Northern Virginia hospitals, whether or not patients can prove they're covered -- but getting a bed in a hospital ward could come with a tremendous sticker-shock
Still working: Emergency services are still being provided at Northern Virginia hospitals, whether or not patients can prove they're covered -- but getting a bed in a hospital ward could come with a tremendous sticker-shock

President Obama has attracted widespread criticism, and a 'lie of the year' award from one newspaper's fact-checker, for promising that Americans who liked their health plans would be allowed to keep them.

Dr. John Venetos, a Chicago gastroenterologist, told the Associated Press on Thursday that he is seeing 'tremendous uncertainty and anxiety' among his patients who signed up for Obamacare plans but don't have insurance cards.

'They’re not sure if they have coverage,' Venetos said. 'It puts the heavy work on the physician.'

'At some point, every practice is going to make a decision about how long can they continue to see these patients for free if they are not getting paid.'






















http://www.infowars.com/obamacare-health-secretary-to-dictate-how-doctors-practice-medicine/


Obamacare: Health Secretary to Dictate How Doctors Practice Medicine

  •  The Alex Jones ChannelAlex Jones Show podcastPrison Planet TVInfowars.com TwitterAlex Jones' FacebookInfowars store
HHS Secretary Sebelius, a bureaucrat with no medical experience, can tell your doctor how to treat patients starting in 2015
Kit Daniels
Infowars.com
January 2, 2014
Despite President Obama’s claim that “you’re not going to have anybody getting in between you and your doctor,” a little known provision of Obamacare gives the health secretary broad authority to dictate how doctors practice medicine and treat their patients.
If she's still the health secretary in 2015, Kathleen Sebelius will tell doctors how to practice medicine even though she has absolutely no medical experience. Credit: United States Mission Geneva via Wiki
If she’s still the health secretary in 2015, Kathleen Sebelius will tell doctors how to practice medicine even though she has absolutely no medical experience. Credit: United States Mission Geneva via Wiki
Starting in 2015, Obamacare will grant the Secretary of Health and Human Services, an unelected bureaucrat with no medical experience, power to decide what treatments are available to patients and if the doctor can perform procedures.
“Beginning on January 1, 2015, a qualified health plan may contract with … a health care provider only if such provider implements such mechanisms to improve health care quality as the Secretary may by regulation require.”
In other words, insurance companies will be banned from doing business with doctors who do not comply with the regulations established by the health secretary – and there’s almost no limit on what these regulations may entail.
“Under President Obama’s health care law, should the HHS Secretary determine that performing mammograms on women younger than 50 violates a standard of care, the provider must comply, regardless of his or her concerns,” Rep. Phil Gingrey, M.D. (R-Ga.) said on the subject. “Failure to do so would allow the Secretary to shut down a medical practice.”
“The powers given to the Secretary are so broad, he or she could literally dictate how all physicians nationwide practice medicine.”
The lawmaker also added that the provision violates “the sanctity of the doctor-patient relationship, as physicians are trained to treat patients individually and not with a ‘one-size-fits-all’ approach.”
However, Dr. Donald Berwick, an administrator of the Centers for Medicare and Medicaid Services under Obama, deplored that the physician’s focus is “on the acute needs of individual patients” and not on “care for important subgroups” in the name of “social justice,” as reported by Betsy McCaughey.
Berwick’s statement serves as a microcosm of Section 1311(h)(1)(b) and for Obamacare as a whole: the pursuit of centralized planning and collectivism at the expense of the individual.
Rep. Gingrey, one of the few lawmakers who knew about the provision, introduced the Safeguarding Care of Patients Everywhere Act in both 2012 and 2013 to repeal Section 1311(h)(1)(b), but both bills never left the Subcommittee on Health.
Outside of Gingrey’s press release on his bills and a recent article in the New York Post, the provision has generated little media attention.
But by 2015, Americans will be demanding answers for the inevitable loss-of-life due to byzantine regulations and the destruction of the doctor-patient relationship.




http://hotair.com/archives/2014/01/02/video-healthcare-gov-contractor-forcing-hospital-to-miss-payroll-for-weeks/



Video: Healthcare.gov contractor forcing hospital to miss payroll — for weeks

POSTED AT 8:31 AM ON JANUARY 2, 2014 BY ED MORRISSEY


The Weekly Standard’s Jeryl Bier has spent the last few months reporting on the relationship between HHS and Novitas Solutions, a health-sector systems provider hired by the Obama administration on a no-bid contract to build the back-end payment systems of Healthcare.gov. Those would be the still missing back-end systems, but this report flagged by Jeryl from Houston suggests that it might not make much difference. Novitas, which provides the payment systems for Medicare, is so far behind in its payments to one Houston hospital that its employees have stopped getting paid. ABC’s local affiliate reports on the situation:
Dozens of employees at a hospital in northeast Houston have had to make it through the holidays without getting paid for weeks. The CEO of Saint Anthony’s Hospital on Little York is blaming a new Medicare payment contractor for his payroll problems.
Nearly 150 employees, ranging from doctors to nurses and administrators, haven’t been paid in nearly a month, and the CEO says it’s not his fault. …
The hospital is strapped for cash not because its not making money, but because Leday says a new Medicare payment facilitator named Novitas Solutions is taking too way long to pay out Medicare claims to the hospital.
Leday says he’s owed nearly $3 million in payments from Medicare and can’t make payroll.
It’s not the first time that problems have arisen in Novitas’ payment systems, Jeryl reminds us:
Novitas also runs the south-central region’s Medicare website which was launched just two days before the October 1 launch of Healthcare.gov.  As THE WEEKLY STANDARD reported on December 19, that site has experienced problems reminiscent of Healthcare.gov’s troubles, and the site will not be fully operational until well into 2014.
The White House keeps insisting that their ObamaCare system has just experienced “glitches,” which will all get smoothed out shortly. However, the Medicare system used to be able to pay providers until Novitas got involved, and it’s possible that the hospital might have to cease operations for lack of staff. They certainly might choose not to accept Medicare assignments in the future, and I doubt that the issue is limited to St. Anthony’s in Houston.
Just imagine what will happen when Novitas brings its payment-systems expertise to private insurers looking for subsidies to cover premiums for ObamaCare enrollees. Will insurers wait weeks and months to get those premiums — or will they dump their enrollees for non-payment? Stay tuned.

http://www.infowars.com/millions-of-young-americans-refusing-to-enroll-in-obamacare/

Millions of Young Americans Refusing to Enroll in Obamacare

  •  The Alex Jones ChannelAlex Jones Show podcastPrison Planet TVInfowars.com TwitterAlex Jones' FacebookInfowars store
Feds use social networks, Lady Gaga to sell unpopular healthcare program
Kurt Nimmo
Infowars.com
January 2, 2014
Poll after poll indicate young people are disillusioned with Obamacare. In early December, a Harvard University Institute of Politics poll found that 56% of Americans between the ages of 18 to 29 reject Obamacare, compared to a meager 39% who support the law. Moreover, so-called millennial respondents believe the law will degrade the quality of health care and significantly raise prices.
“We’re now seeing a sea change among this critical demographic,” Trey Grayson, the director of the institute, told Time magazine. “You’re seeing cracks in his base.”
The government says the failure of the young demographic to purchase “Brosurance” through federally run marketplaces will spell doom for the program.
In response to this dwindling support, the Obama administration is spending millions of tax payer dollars on “racy ads, social media campaigns and celebrity endorsements” including Lady Gaga to convince so-called “young invincibles” to sign-up, according to the Associated Press. Obama is even asking the mothers of young people to urge them to sign-up. “Moms can tell young people who think they’re invincible that they’re not and prod them to at least get information,” Obama recently told a group of mothers visiting the White House.
In the District of Columbia, officials recruited residents to convince young people to enroll in the problem-plagued program by showing up where they “party by night and shop by day,” according to Fox News. Officials went to two Footlocker stores where Nike’s exclusive Air Jordan 12 “Taxi” sneakers were on sale. “Get some health care to go along with them taxis, OK?” said DC Health Links representative Vanessa Brooks. Obamacare hucksters also visited two Denny’s restaurants, according to Fox.
In December, Caroline Baum, writing for Bloomberg, said the government needs to take a carrot and a stick approach. “Instead of outreach programs and sappy TV ads with parents imploring their kids to sign up for Obamacare, President Barack Obama needs to start thinking creatively if he wants his signature legislative achievement to be a success. What motivates kids? In fact, what motivates any of us?”
Her answer? Apple iPhones, iPads and bags of weed. “In states that have legalized marijuana for recreational use — Colorado and Washington — by all means, throw in a bag of cannabis,” she wrote last month. Baum also suggests that the penalty for not buying government mandated healthcare is not punitive enough. She writes that “if the point is to create an onrush of enrollees at the start, the penalty rate is cheaper for many young, healthy individuals than the premium cost of a health-care policy.”
Short of imposing excessive fines and imprisonment, the federal government will have a difficult time selling Obamacare. The government is once again ignoring a simple economic principle: minus punishment and physical violence, people will not buy products they do not want or need and believe will negatively affect them. In order to force compliance, the feds will have to activate the IRS or some other thuggish government agency and strike fear into the hearts of not only millennials, but all Americans regardless of age.


Obamacare debuts with more canceled plans than enrollments

  •  The Alex Jones ChannelAlex Jones Show podcastPrison Planet TVInfowars.com TwitterAlex Jones' FacebookInfowars store
Sarah Hurtubise
The Daily Caller
January 2, 2013
Obamacare may have promised health insurance for the masses. But on its first day, it’s left more Americans without coverage than before the law was passed.
More than 4.7 million Americans had their health insurance canceled as a result of any of the thousand-plus-page law’s new rules, the Associated Press reports, but the Department of Health and Human Services (HHS) confirmed Tuesday that between federal and state exchanges, just 2 million Americans have signed up for Obamacare coverage. (RELATED: Obama administration announces net loss of at least 3 million insurance plans)
The Obama administration has yet to announce the final tally of full enrollments, which are only confirmed once customers have made their first payment, but Cato Institute health policy expert Michael Cannon warns that not all those who signed up will complete their purchases, potentially leaving the White House with an even lower bottom line.







http://twitchy.com/2014/01/01/kathleen-sebelius-jubilantly-claims-that-today-there-are-millions-of-newly-insured-americans/



Yesterday, the Department of Health and Human Services announced that 2.1 million people have signed up for private health insurance plans through Obamacare. As Twitchy noted, however, HHS still is not saying how many of those people have paid their premiums. Under the administration’s “expanded definition” of enrollment, people are considered enrolled if they have simply placed a plan in their online shopping cart.
We have a feeling that some (most?) of the freshly-minted Obamacare “enrollees” have not paid premiums and have not been officially confirmed by any insurer.
Meanwhile, an estimated 4 to 5 million Americans in the individual market have received cancellation notices as a direct result of Obamacare.
None of which stopped HHS Secretary Kathleen Sebelius from bragging about “millions of newly insured Americans.”
Twitter users gave Sebelius a talking-to:


  1. Today, lifetime limits are gone, those with pre-existing conditions have protection, and there are millions of newly insured Americans!
@Sebelius - Millions minus one. Thanks to ACA, I can't afford the new insurance.
  1. Today, lifetime limits are gone, those with pre-existing conditions have protection, and there are millions of newly insured Americans!
@Sebelius yeah, and now that my ins rates have gone up because of this stupid law, I have to cut back on food because that has gone up to!😡

  1. Today, lifetime limits are gone, those with pre-existing conditions have protection, and there are millions of newly insured Americans!
@Sebelius @HHSGov Wow! What a bold statement. What about the other 3/4 that can't afford this "affordable" care Lets rename it OBAMADONTCARE

  1. Today, lifetime limits are gone, those with pre-existing conditions have protection, and there are millions of newly insured Americans!
@Sebelius Results, over 3 million people that used to have insurance but don't now.



  1. Today, lifetime limits are gone, those with pre-existing conditions have protection, and there are millions of newly insured Americans!
@Sebelius I get my health insurance through my employer GROUP plan. I was told my rates would go DOWN $2500. They went UP 30%. Thanks.










http://www.zerohedge.com/news/2014-01-01/obamacare-goes-live-today-here-next-big-problem



Obamacare Goes Live Today: Here Is The Next Big Problem

Tyler Durden's picture





Obamacare officially went live at midnight. This means that 2.1 million Americans (the latest enrollment number provided by the administration) will be given a chance to exercise their new plans at hospitals and clinics across the country (it was unclear what the latest number of Americans kicked off their existing plans was most recently: the tally was 4.0 million as of mid-November and it is fair to assume it has risen since then). And then the real glitches will begin.
We reported two weeks ago that navigating the healthcare.gov labyrinth successfully and "signing up" for Obamacare is one thing; actually activating coverage by making a payment is something totally different. We added that "if people don’t pay by Dec. 31, insurers may end up stuck with a disproportionate number of sicker and costlier customers."
It is this "shock" realization that one's Obamacare plan is not active until after the healthcare service has been rendered, that may hit as many as 50% of all enrollees, which means that of the 2+ million Americans who believe they have coverage, up to 1 million is about to be served with a bill which they can't afford. This also happens to be the main story across various media outlets today.
First, The Hill:
Enrollment deadline delays and processing errors at HealthCare.gov have been an administrative nightmare for insurers, and may leave some consumers discovering that they don’t have the insurance they thought they purchased when they show up at the doctor’s office. 

It’s also likely that some people think they have insurance under ObamaCare but do not because they have yet to make their first premium payment. Until they do, they aren’t actually insured. 

In Washington and Nevada, only about 50 percent of enrollees have made their first premium payments. Those are the only states that provide the breakdown.

The biggest risk now is people thinking that by picking a plan, that they’re insured, when in fact final step is paying the premium,” Larry Levitt, a senior vice president with the Kaiser Family Foundation, told The Hill. “I haven’t seen good numbers on how many people are paying premiums, so that to me is the uncertainty.”
Next, it's Reuters' turn:
"It will be difficult for us to actually verify coverage - that's my concern," said Dr. William Wulf, CEO of Central Ohio Primary Care, which has 250 primary care physicians.

The task could be made more difficult by decisions by the U.S. government and many states to push back enrollment deadlines toward the end of the year, and to allow some patients well into January to pay for coverage that is retroactive to the start of the year.

The late deadlines mean that many enrollees who seek care initially may lack insurance cards or other proof of coverage. Wulf said his physician offices will assume that an existing patient is covered if they claim to be when they come in for appointments and their coverage cannot be verified immediately. But if they require expensive tests, such as MRIs or heart-stress tests that can cost up to $700, the Ohio practice will check with insurers first to make sure the patient has coverage.

Similarly, Dr. Andy Chiou, CEO of Peoria Surgical Group Ltd in Illinois, said that if the practice finds a "significant minority" of its patients do not have coverage when they believe they do, it might delay elective surgeries for patients until their insurance is confirmed.

"For the protection of patients and us, we'll have to say, 'Sorry, you don't have insurance,'" Chiou said.
That means 1 million Americans, some of whom are very ill, are about to get a big new year's disappointment from their doctor.
To be sure, some stop gap measures have been implemented: the Hill reports that some big insurers "will allow consumers to pay their first premium by Jan. 10 and still be insured on Jan. 1. In addition, Walgreens and CVS Pharmacies announced this week that they will provide up to a month of no-cost medications to consumers that haven’t received their ObamaCare IDs yet, but can prove they enrolled." However, for those who expected Obamacare to be a deus ex with zero payment at all, which appears to have been the case at nearly a majority level, no temporary measures will fix the situation that there is still a payment to be made: a payment which millions simply can not afford.
Needless to say, with 2014 an election year, the stakes for the administration are huge:
For the Obama administration, the political stakes are high in ensuring a smooth transition period for coverage, particularly after the website's problems damaged the popularity of the Democratic president and the healthcare overhaul, his top domestic achievement.

Republicans who have called Obamacare a costly program that will rob many Americans of insurance choices have said they will make Obamacare's problems their top issue in the November 2014 elections, when control of Congress will be at stake.

White House health policy adviser Phil Schiliro said on Tuesday that because of the intense focus on Obamacare, "problems that have never gotten attention before will get some attention now."
The Hill adds:
There’s little doubt the success of the healthcare law will be a big factor in Democratic efforts to retain the Senate, where Republicans need to gain six seats to win back a majority.

Doing so would be a huge blow to Obama’s remaining years in office, virtually assuring him lame-duck status through the rest of his term.

So there’s a lot at stake for the administration to ensure things go smoothly, starting on New Year’s Day.
At this point, some opt out to fall back to a naive belief that things will be well:
John Holahan, a fellow at the non-partisan Urban Institute, said the idea that people will be blindsided is foolish. “If they don’t pay they don’t have insurance, that’s part of the deal, you’re not really enrolled,” he said. “But I assume anyone who goes through the trouble of enrolling will go ahead and pay.”
Actually, most who have the free time to go through the trouble of enrolling likely don't have a source of disposable income.
A more realistic conclusion comes from Joe Antos of the conservative American Enterprise Institute, who predicted the flood of applications would be too much for the administration and the insurers to handle before the newly covered head out to exercise their plans. “There’s no way the insurance industry could hire enough people to process all that paperwork if the data was coming in correctly, and it’s not,” he said. “I think most people who think they have coverage will find some difficulty early in January."
We will find out in the coming days if the next big embarrassment for the administration will unfold and if Obama's ratings will tumble to fresh record lows as a result.









http://twitchy.com/2013/12/31/hhs-still-not-saying-how-many-have-paid-for-health-insurance-plans/


Health and Human Services Secretary Kathleen Sebelius and the Centers for Medicare and Medicaid Services scheduled another conference call Tuesday afternoon to provide reporters an update on the progress of the HealthCare.gov website.

Judging from the tweets of the journalists on the ObamaCare update conference call, the Obama admin is once again lying its ass off.








http://hotair.com/archives/2013/12/31/report-only-half-of-new-obamacare-enrollees-in-17-states-have-paid-first-month-of-premiums/


Report: Only half of new ObamaCare enrollees in 17 states have paid first month of premiums

POSTED AT 11:31 AM ON DECEMBER 31, 2013 BY ALLAHPUNDIT


No way to know yet if the federal exchange is also seeing a 50 percent payment rate system-wide, but if it is, we’re looking at close to 500,000 people whose new coverage will begin tomorrow in some sort of limbo. Or maybe more, actually: At least one insurance company is seeing payment rates closer to 35 percent, and the Journal found one man who signed up in late November who still hasn’t been billed yet by his new insurer. That’s the fruit of chaos imposed on the industry by Obama and HHS in moving around deadlines haphazardly to protect themselves politically. They moved the sign-up deadline back nine days, to Christmas Eve, and then they “suggested” that the payment deadline be moved back to January 10th, all but forcing insurers to cover people retroactively. Expect a new “suggestion” for them to move the payment deadline back further into January, as some insurers have already done, if that 500,000 can’t get their acts together in time to pony up the 10th.
How chaotic is it right now? One insurance exec predicts that people will be bringing printouts from the exchange websites to the doctor in lieu of insurance cards because the industry simply can’t meet the logistical demands created by the White House to send everyone their card in time.
Normally, insurers require payment for coverage before the coverage begins. They count an enrollment as complete only when the first month’s premium has been received from a customer. As of Monday, however, only about half of enrollees billed for plans offered by more than 100 insurers in 17 states had paid their first month’s premium, said Mark Waterstraat, chief strategy officer at Benaissance, a third-party billing firm that works for those insurers…
After the federal government extended the deadline to sign up for coverage from Dec. 15 to Christmas Eve, most insurers in turn extended their deadlines for payment, some as late as Jan. 10 for coverage starting Jan. 1. Some, like Independence Blue Cross, a Philadelphia-area insurer, pushed the deadline as far back as Jan. 28. Humana Inc. said Monday that it would accept payments as late as Jan. 31.
Independence Blue Cross is pre-emptively sending insurance cards to consumers before they have paid, said Brian Lobley, a senior vice president. The insurer dispatched 20 workers over the weekend to create the plastic membership cards and ship them to presumptive enrollees. The plans won’t be “active” until the new customers actually pay Independence, but mailing the cards early will allow them to start using their plans right away once they have paid, Mr. Lobley said.
I’m guessing HHS will announce this weekend, while the media’s still in its holiday slumber, that they’re “suggesting” insurers follow Humana’s lead and extend their own payment deadlines from the 10th to the 31st. That’s the beauty of these White House “fixes”: There’s no limit to them, really, because insurers are in no position to resist even if what Obama wants doesn’t technically carry the force of law. HHS already threatened to exclude companies that don’t comply with its every ass-covering whim from the exchanges next year, a potentially terrible financial blow given how many millions more consumers will have been forced onto them by then. This is what a government takeover of health care looks like.
http://hotair.com/archives/2013/12/31/iowa-to-thousands-healthcare-gov-didnt-work-youre-uninsured-please-try-our-site/

Iowa to thousands: HealthCare.gov didn’t work, you’re uninsured, please try our site


POSTED AT 2:31 PM ON DECEMBER 31, 2013 BY MARY KATHARINE HAM





When we were coming up on the doldrums of the December news cycle, I knew we could count on Obamacare to keep breaking down in new and spectacular ways. This time, there are a bunch of Iowans who think they’re being processed by Iowa’s Medicaid system, but they’re not:

Nearly 16,000 Iowans who tried to apply for coverage via the trouble-plagued federal health-insurance website are being told to apply separately through the state Department of Human Services.
The Friday afternoon announcement is the latest bout of bad news about the website, which is a key part of the Affordable Care Act.
The announcement affects people who entered their information into healthcare.gov and received a notice that they might qualify for Medicaid.The federal computer system was supposed to transfer their applications to a state computer system, but that transfer has been complicated by technical problems. The timing is critical, because the new insurance coverage is supposed to take effect on New Year’s Day, which is Wednesday.

That’s 16,000 low-income Iowans who spent hours getting through the system, thought they were successful, got a notice that they might be Medicaid eligible and that their applications were being taken care of by Iowa. But their applications can’t get to Iowa, of course. Because FAIL.
Iowa made the announcement about this snafu Friday, Dec. 27, when so many people are thinking about their insurance applications and whether they went through after being told they would. They’re also attempting phone calls and e-mails. The state hopes to have this worked out by Jan. 31 and says coverage would be retroactive as of Jan. 1, but a) I never count on anyone telling me they’re going to cover me retroactively and b) Medicaid-eligible Iowans aren’t the segment of the population that can easily drop money on a doctor’s appointment until the state gets its act together or they wouldn’t be Medicaid-eligible.
But there’s a whole other set of people in this cohort who may have been told they were Medicaid eligible and their stuff had been sent to Iowa, when in fact they are neither Medicaid eligible nor had their stuff been sent to Iowa. Those people— are you ready for this?— are going to be told to go back to the federal exchange after Iowa determines they’re ineligible. How might that go for them?
Jesse Patton, a West Des Moines insurance agent who has helped numerous clients sign up for coverage on healthcare.gov, said he was not surprised by Friday’s announcement. “I’m not happy about it,” he said. “For a lot of these people, I spent three or four hours to get them through the process, and now they’re back in limbo.”
What’s the root of the problem with this data transfer?
Aaron Albright, a spokesman for the Centers for Medicare and Medicaid Services, which is implementing Obamacare, said his agency is working with states to get them the information they need to determine whether applicants are eligible for public programs. He said federal officials have been sending information to states in something called a “flat file,” but he said not all states are accepting those.

McCoy, the Iowa human-services spokeswoman, said the flat-file format is different from what Iowa was told to expect. She also said many of the files Iowa has received from the federal system are missing crucial information, such as Social Security numbers and income reports.
The Washington Post piece assumes the federal data hub itself will work perfectly, even though it’s meant to cull an incredible amount of data and pair it with an incredibly complex set of eligibility requirements. I think even that’s an open question, but here’s the bottom line: This is a giant tech undertaking which will need to serve many localities with different needs, link existing technologies and personnel with a new, giant federal hub, and somehow make sure all of them work together to smoothly to guide consumers who have no idea what to expect in subsidies or services through a brand new web portal for health insurance. They have less than a year to accomplish this. It seems there has been no pilot program, no training, and no beta testing. This thing is ORCA on steroids.
Oh, and there’s a 30-60 day public commenting period before HHS even finalizes the rules it proposed Tuesday. So, make it nine months to implementation. Here’s hoping.
Some 4 million people lost health coverage due to cancellation, according to Associated Press coverage. The Obama administration reversed course and said these substandard plans could exist for another year, but not all states and insurers agreed to this fix.
That means it’s possible the United States is entering the first year of Obamacare with a net loss of 2 million insured, according to the law’s critics.
But anyone worried about their insurance coverage can just call a number (nope) or visit someone in person (nope) or be assured that the federal website transferred your info (a thousand times nope), or be satisfied that Michelle Snyder is hanging out at the bar with Lois Lerner and the rest of Obama’s well-paid forced retirees in charge of national Charlie Foxtrots, and they all have insurance (yep).















Another rat jumps off sinking ship.....


http://hotair.com/archives/2013/12/30/news-dump-cms-official-in-charge-of-healthcare-gov-retiring/



News dump: CMS official in charge of HealthCare.gov retiring

POSTED AT 7:01 PM ON DECEMBER 30, 2013 BY MARY KATHARINE HAM


This is how you take your lumps in the Obama administration. Botch the roll-out of the president’s legacy law so badly that you end up with three million fewer insured people than when we started, and you get to retire, announce it over a holiday weekend, and grab that juicy pension for 41 years of mediocre-to-disastrous public service.
The person tasked with overseeing the development of HealthCare.gov is retiring, the administrator of the Centers for Medicare and Medicaid Services said Monday.
The departure of Michelle Snyder, the chief operating officer at CMS who’s been in public service for 41 years, comes a few months after the bungled launch of the federal health care insurance website.
Uh huh:
CMS administrator Marilyn Tavenner noted in an email that Snyder was set to leave CMS at the end of 2012 but stayed on at Tavenner’s request to help with “the challenges facing CMS in 2013.”
“While the agency is losing a key member of its leadership team, we should celebrate Michelle’s dedication to a mission that provides vital health care services to tens of millions of our fellow Americans through the Medicare and Medicaid programs,” Tavenner said.
Snyder is the second top CMS official to leave since the website’s rocky rollout. Tony Trenkle, who served as the agency’s chief information officer, retired in November.
Celebrate her. We should celebrate her work. Not politely overlook her career and move on. Not merely thank her for trying despite her massive failure. But celebrate. We should celebrate her. These people are warped.
Her official biography says that Ms. Snyder was responsible for “standing up new programs and activities required by the Affordable Care Act.”…
A former agency official who had predicted Ms. Snyder’s departure said Monday: “She had to go. She was responsible for the implementation of Obamacare. She controlled all the resources to get it done. She was in charge of information technology. She controlled personnel and budget.”
But, but there are more than 1 million people enrolled in Obamacare. And, estimates of 5 million who lost their coverage in 2013 because of Obamacare. If we’re generous, we can at least say there are millions fewer Americans with insurance thanks to Obama’s brilliant plan to expand insurance. 
Heckuva job.

Try a new lie when the old lies stop working  edition.....

Dem rep: Maybe people aren’t signing up for ObamaCare because they think it’s already been repealed

POSTED AT 4:01 PM ON DECEMBER 30, 2013 BY ALLAHPUNDIT


Via NRO, I’m torn. I want to mock her, but if there’s one thing I’ve learned from blogging polls over the years, it’s that you should never underestimate the stupidity of the low-information voter. She’s exaggerating the extent of this problem, no doubt, but there arepeople out there so ignorant of current events that they wouldn’t be able to tell you even now whether O-Care is good law or not.
And by “people,” I don’t mean one or two people. I mean … percentages. Here’s what Kaiser found when they polled this subject back in April:
k
Twenty-three percent had no idea and 19 percent were aggressively wrong. But surely those numbers changed over the summer, as we got closer to launch on October 1st and media coverage of the law’s rollout ramped up, right?
pe
The good news? The number who were aggressively wrong went down! The bad news? The number who have no idea went up, resulting in a slight increase overall in those who don’t realize that it’s still good law. Let that thought comfort you when you ponder the U.S.’s inevitable transition to a Chinese protectorate circa 2100. When future Americans are ignorant about the law, it won’t be due to their own lazy ignorance, it’ll be because their government’s, er … . actively concealing it from them.
There’s an obvious caveat here, of course. Both of those polls were taken before the exchanges launched and O-Care became a justifiable media obsession. Since October 1st, there’s been no escaping the fact that the law’s in effect simply because there’s also been no escaping the fact that the first two months were a historic clusterfark of implementation, replete with mopey Obama news conferences about how he and his team screwed up. For Holmes Norton’s theory to hold now would require a mind-boggling degree of almost willful idiocy among the population to keep themselves cocooned from what’s been going on in the news in their country every hour for the past three months. Which means at this point the “don’t know” contingent probably can’t reach much beyond — what? 20, 25 percent?
Exit question: Speaking of voter ignorance, how many people wrongly believe that their new insurance under ObamaCare will be totally free? Click the image to watch.

Sticker shock.......

Case study: Auto dealership workers cope with ObamaCare sticker shock after company plan is canceled

POSTED AT 11:31 AM ON DECEMBER 30, 2013 BY ALLAHPUNDIT


sneak peek at America 2014 from the Ghost of Christmas Future. It’s not the premiums that are killing these people, although those are higher in some cases too. It’s the out-of-pocket costs. The media coverage of O-Care has paid less attention to those for the simple reason that no one’s actually incurred them yet. That’ll change on Thursday.
Insurance broker Michael Harp said small businesses, part of what’s known in the industry as the “small group market,” are used to seeing health insurance premiums climb about 10 percent a year, but it’s never before been this dramatic. For Extreme Dodge to have kept deductibles and out-of-pocket costs at last year’s levels, he said, would have cost the dealership almost 50 percent more than last year.
Harp says what is happening at this dealership is representative of the other small businesses he deals with. Businesses with 50 or fewer employees currently provide health insurance to about 17 million U.S. workers, according to the National Association of Insurance Commissioners.
He said the biggest surprise to him in how the law impacts small business clients is “how many people are losers versus winners. … There are some people who do come out ahead, but I would say the overwhelming majority, they’re paying much higher rates and they have lower benefits.”
The dealership’s old policy didn’t comply with O-Care requirements so it was canceled. A new policy would have been too expensive for the company to sponsor, so instead they handed their employees $2,400 apiece and wished them luck on the exchanges. Will that pay for the premium hikes and the higher deductibles? Probably not (especially once the new ObamaCare excise tax on premiums takes effect), but that’s all the company says it can afford to give. The employees themselves can, of course, opt for cheaper plans on the exchange to keep their costs down, but that brings us to the other post-New-Year’s ObamaCare landmine — namely, shrinking provider networks. According to the Journal, some doctors have seen a huge crunch in December of patients scheduling tests and treatments before New Year’s because that doctor isn’t in the network for their new O-Care plan in January. I thought that was a problem limited to rural areas where there aren’t many doctors to begin with, but no, evidently this is systemic. And it doesn’t affect just the cheap “bronze” plans either:
Some 70% of new plans under the health law offer relatively narrow networks compared with many current plans, according to a recent McKinsey & Co. report…
The recognition by some consumers that their new plans won’t always cover the facilities or doctors they want is triggering the boomlet in last-minute procedures, say health-care providers.
UT Southwestern Medical Center in Dallas has seen requests for complicated imaging tests and colonoscopies rise in recent weeks, said Bruce Meyer, an executive vice president. Barnes-Jewish Hospital in St. Louis has seen “dozens” of patients push up elective orthopedic surgeries, a spokeswoman said. Cedars-Sinai Health System, a top teaching hospital excluded from most exchange plans in the Los Angeles market, said it has fielded thousands of calls from people concerned about losing access and wanting to schedule elective procedures before Dec. 31.
Per the WSJ, more than two-thirds of “silver” plans “sharply reduce” the number of hospitals available to consumers as compared to their current plans. So there’s the consolation prize for the dealership workers: Sure, they’re paying more than they used to, but they’re getting … less choice than they used to as well. It’s going to be a long year.

Enrollment numbers - who is signing up anyway and how many folks have actually paid their premiums ? 

  http://newsbusters.org/blogs/pj-gladnick/2013/12/30/sarah-kliff-skips-p-word-article-hailing-december-deluge-obamacare-enro

Sarah Kliff could barely contain her joy while exclaiming unto all the world in her Washington Post article about a supposed "December Deluge" in which "1.1 million have enrolled in healthcare.gov" since the beginning of October. However, a very important word is missing in her story. The P-Word as in "PAID." Yes, according to Sarah, over a million "enrollees" have deluged the federal exchange website but is it unreasonable to wonder how they could have paid their premiums since, as yet, that website has no payment system set up.
However, far be it for me to spoil her party mood so let us now join Sarah exuberantly celebrating her "deluge" statistics which very conveniently doesn't mention PAID enrollees:
More than 1.1 million people have enrolled for private health insurance through HealthCare.gov, the Obama administration announced early Sunday. More than 975,000 of them signed up this month, prior to the Dec. 24 deadline. In other words: Enrollment in the federal exchange was about nine times as high in December than all of October and November.
If you add in the state enrollment data that Charles Gaba has been keeping an eye on, you see enrollment growing from 90,000 in October to just about 2 million through late December.
Whether this is good news depends a bit on the context you put it in.....
Um, how about the context that your deluge stats don't mention PAID enrollees? Why? Perhaps because that would involve having to discuss the inconvenient "glitches" about how hard it is to actually pay the premium or the reluctance of sticker shock "enrollees" to pay it. A small hint of this difficulty is demonstrated in another article that Kliff wrote with Juliet Eilperin. Following the expected celebrations about the "deluge" numbers comes this downer about actual premium payment:
David and Karen Hart live in Santa Rosa Beach, Fla., and both are self-employed. Their existing Blue Cross Blue Shield policy was canceled in the fall and then reinstated, but they picked a new plan on HealthCare.gov and paid for it on Dec. 19.
When he noticed that their payment hadn’t been deducted from their bank account, David Hart called Florida Blue on Dec. 27; he was told that the government’s computer system had canceled their plan. His wife spent more than four hours on a federal hotline Saturday, at which point she was told the insurer had jettisoned their policy.
Such stories are not at all unusual. In fact we have the case of notorious DUer William Rivers Pitt of the Rindge, NH area who recently posted at the Democratic Underground about his "success" in signing up for ObamaCare...except for one not so tiny detail:
Well, I just had my first experience with the Healthcare.gov website...
Creating a user name and account: easy.
Plowing through all the questions: easy.
Yes, Will. All so "easy" until...
Alas, I logged out to track down some personal info, and when I tried to log back in, it said the system was currently down.
...but then, Ermahgerd! A phone number: 800-318-2596
And it's toll-free, too!
So I'll be calling in the morning to finish the process.
No. Big. Deal.
Thanks, Obama.
No. Big. Deal. Except did Will ever finish the process? Although over two weeks have passed since this posting, there has been only silence from Pitt on this matter. Perhaps Ms Kliff could check with Pitt on his "enrollment." It could be he is only waiting 24 business hours for his payment to go through.


http://www.forbes.com/sites/theapothecary/2013/12/30/how-many-healthy-people-are-signing-up-for-obamacare-the-white-house-wont-say/









PHARMA & HEALTHCARE 
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12/30/2013 @ 2:51AM |49,628 views

How Many Healthy People Are Signing Up For Obamacare? The White House Won't Say


Marilyn Tavenner, head of the Centers for Medicare and Medicaid Services, the branch of the government tasked with implementing the health insurance exchanges of the Affordable Care Act. (Photo: Wikipedia)
Marilyn Tavenner, head of the Centers for Medicare and Mediciad Services, the branch of the government tasked with implementing the health insurance exchanges of the Affordable Care Act. (Photo: Wikipedia)
On Sunday, the Obama administration announced that a total of 1.1 million Americans have signed up for health insurance coverage on Obamacare’s federally-run exchange at Healthcare.gov. While that number falls well short of the administration’s original expectations, it is a big step up; as of the end of November, only 137,204 individuals had “selected a marketplace plan” on the state and federal exchanges combined. But the Centers for Medicare and Medicaid Services continue to conceal critical data regarding actual enrollment in the exchanges—data that will tell us whether or not Obamacare’s insurance marketplaces will ever end up functioning as they were intended.
‘Sign-ups’ ≠ enrollments
First off, CMS won’t tell us how many people have actually enrolled in exchange-based coverage. As a reminder, you aren’t actually enrolled in a health plan unless the insurer has received your premium payment for the first month of coverage. Previously, we heard that only around 5 to 15 percent of SAMPs—people who have “selected a marketplace plan,” in CMS lingo—had actually enrolled in coverage.









In addition, in November, one of CMS’ top IT officials, Henry Chao, testified before Congress that the administration has yet to build the system needed to pay the insurers.
Healthy vs. unhealthy enrollments
The most important thing CMS won’t tell us is the proportion of healthy people, as opposed to sick people, who are signing up for exchange-based coverage. If too many sick people sign up, and not enough healthy people, the average health spend per enrollee will increase, leading to higher premiums that are increasingly unaffordable for average Americans.
Some Obamacare enthusiasts argue that this problem doesn’t matter, because the poor will be protected from rate hikes by taxpayer-funded subsidies. But over time, the subsidies will not be able to keep pace, if healthy people drop out and only sick people by Obamacare-based insurance plans.
And make no mistake: on average, sicker and older people will fare far better under Obamacare than healthy people will. According to an analysis I conducted with colleagues at the Manhattan Institute, older, sicker individuals will benefit most from Obamacare’s exchange subsidies. On the other hand, in many parts of the country, healthier Americans—especially younger ones—will see their premiums double or triple under the law.

Congress should subpoena the enrollment data
If CMS won’t provide this information, on the mix of patients enrolling in Obamacare’s exchanges, Congress should subpoena it. Congress could also get the data directly from insurers like Aetna and Humana that are participating in the exchanges.
What we need to know is: What is the breakdown of enrollees by age? How many people in each age group are signing up for bronze vs. silver vs. gold plans? This is the kind of data that can help us compare the pool of enrollees in the exchanges to the normal U.S. population. Ideally, we’d see data on what percentage have chronic conditions like Type 2 diabetes, high cholesterol, and high blood pressure, once insurers have had several months’ experience with the patient population.
It’s almost certain that, so far, this enrollment data is not encouraging. Because if it was encouraging, CMS would have released it.
Not a lot of time left
Unless CMS changes its mind, for the umpteenth time, the 2014 deadline for purchasing an Obamacare insurance plan is March 31. Within weeks of that deadline, insurers are going to have to start filing their proposed premiums for the 2015 plan year.
If their experience in 2014 is poor, we might see a second round of rate shock. Only this time, it won’t have been caused by Obamacare’s costly changes to the design of the insurance plan, but by the fact that the law incentivized healthy people to drop out of the market.
It’s good news that the administration has improved the ability of Americans to sign up for coverage on Healthcare.gov. But if you ever want to know the real story with Obamacare, you have to pay attention to what the administration isn’t telling you.




http://www.cnbc.com/id/101301953

  




Obamacare enrollment hits 2 million—lots more to go

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Published: Monday, 30 Dec 2013 | 4:05 PM ET
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Obamacare enrollments surpass 2 million mark
Monday, 30 Dec 2013 | 2:09 PM ET
CNBC's John Harwood reports the unofficial tally of Affordable Car Act enrollments has surpassed 2 million sign ups. The Obama Administration's original projection was 3.3 million by the end of 2013.
Obamacare is now the 2 million person plan.
At least 2,016,387 people have enrolled nationally in private insurance plans sold through federal and state-run health exchanges as of Monday, an analysis of official and unofficial data by CNBC.com has revealed.
While that number is well below the 3.3 million people federal officials last fall projected would be signed up by Dec. 31, it represents a strong rebound from the dramatically low level of enrollments seen in October and most of November, which reflected the serious technological problems on the federal HealthCare.gov exchange and several state exchanges.
And experts Monday said that with three more full months of open enrollment in Obamacare insurance left to go, millions more will likely sign up, possibly enough to top the 7 million total sign-ups that officials had projected last fall before the HealthCare.gov launch debacle.
Connecticut's exchange crowed Monday about becoming the first exchange to outpace original projections for its enrollments.

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"CMS [Centers for Medicare & Medicaid Services] projected that Connecticut would enroll a total of 33,000 consumers by the end of the enrollment period. As of December 23rd, there were 34,295 Connecticut consumers enrolled in private plans through Access Health CT," said Kevin Counihan, CEO of Access Health CT, the state's exchange. 
"This is a tremendous accomplishment; however, our work is far from done. We will continue working to provide even more consumers with access to quality, more affordable health-care coverage through the duration of open enrollment," Counihan said.
"I wouldn't be surprised if we exceed 7 million [nationally] by March," said Timothy Jost, a law professor who specializes in health-care legal issues at the Washington and Lee University School of Law. "I'm encouraged by the fact that we've got close to 2 million people signed up [officially] and in time we're going to get a lot more people signed up by March 31."
Jost noted that major national and state-based ad campaigns by supporters of the Affordable Care Act, which were supposed to launch in the fall, were suspended because the problems on HealthCare.gov made it unwise to encourage people to go to a website that was effectively not working.
With the resolution of much of the tech troubles on HealthCare.gov—which sells Obamacare insurance in 36 states—"there's going to be a very aggressive effort to get people to sign up" beginning in January, Jost said.
On Sunday, the head of the CMS announced that "more than 1.1 million people enrolled in a qualified health plan" on HealthCare.gov "from Oct. 1 to Dec. 24."
"More than 975,000 of those enrolling" did so in December, noted the official, Marilyn Tavenner, administrator of the CMS. "December enrollment so far is over seven times that of October and November."
By adding HealthCare.gov's announced enrollment to the officially reported tally of 797,530 sign-ups on the 15 health exchanges run by the remaining states and the District of Columbia, the officially announced tally is just below 1.9 million.
But a dramatic surge of enrollments in California and several other states in recent weeks, the most recent numbers not yet reflected in the official data, brings the true tally to what is likely to be at least 2.016 million as of Monday.
That surge came with the approach of deadlines for enrolling in coverage that begins Jan. 1.
Obamacare debate rages on
Even though the HealthCare.gov website is working and the number of people signing up has increased significantly, the battle over Obamacare will continue to rage in Congress this year. NBC's Brian Mooar reports.
"Everyone said all along that people were going to wait until the last month to enroll," said Washington and Lee's Jost. 
But he added that a "big problem is that we just don't have any idea how many people would have enrolled if people could have enrolled in the first two months."
"The numbers tell us that the website [HealthCare.gov] didn't work for the first two months," Jost said.
Jonathan Wu, chief analyst at the consumer finance website ValuePenguin.com, said the 2 million enrollment benchmark is "pretty good considering how many problems they had, considering they lost almost two months of enrollment."
"They should be pretty pleased," Wu said.
But now, Wu said, the "tricky part" is continuing what has become a relatively strong pace of enrollments into the first quarter of 2014.
"At this point," Wu said, "anybody who really needs insurance has probably gotten it."
"Now you have to convince the rest of the people why this is a good deal for you," he said. "I think the heaviest list is people who didn't have insurance before, and didn't see the need for insurance."
Many such people will be younger, less-affluent adults, whose tight budgets and relative good health will make buying insurance less of a pressing need, Wu said.
"My concern is whether younger people will find this to be a really good deal or not," he said.
Most adult Americans who don't have health insurance in 2014 through either their employer, the Obamacare exchanges or government health programs like Medicare and Medicaid, are subject to a tax penalty of $95 or 1 percent of their income, whichever is higher.
Wu said it remains an open question for younger adults whether that penalty, known as the individual mandate, will be "enough to push them into the market" and buy insurance they didn't previously have.