Tag Archives: amateur hour

Feds Can’t Verify $2.8 Billion in Obamacare Subsidies | Washington Free Beacon

The federal government cannot verify nearly $3 billion in subsidies distributed through Obamacare, putting significant taxpayer funding “at risk,” according to a new audit report.

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) released an audit Tuesday finding that the agency did not have an internal system to ensure that subsidies went to the right enrollees, or in the correct amounts.

“[The Centers for Medicare and Medicaid Services] CMS’s internal controls did not effectively ensure the accuracy of nearly $2.8 billion in aggregate financial assistance payments made to insurance companies under the Affordable Care Act during the first four months that these payments were made,” the OIG said.

So what does CMS do when they learn about the control issue (as if they didn’t already have a clue)?

In response to the audit, CMS said they issued a regulation to change their accounting methods.“CMS takes the stewardship of tax dollars seriously and implemented a series of payment and process controls to assist in making manual financial assistance payments accurately to issuers,” they said.

THEY ISSUED AN EFFING REGULATION. Oh yeah, that will fix everything.

A Rube Goldberg law implemented by a Rube Goldberg system. The phrase Keep It Simple Stupid (KISS), never came within light-years of anyone involved with writing or passing Obamacare.



Another Obamacare Supporter Just Got A Hard Dose Of Reality – Chicks on the Right

This time from Covered California – Another Obamacare Supporter Just Got A Hard Dose Of Reality – Chicks on the Right. Poor Melissa Klein of San Francisco discovers the unfortunate reality that the government is decades behind Amazon.

Another liberal learns the hard lesson of big government bureaucracy. Click on the link to get the details. This paragraph sums it up regarding expectations for Obamacare exchange subsidies and health care nirvana…

I find a number of things absolutely fascinating about her story – not the least of which that she expected government healthcare exchanges to work with the same fluidity of ordering a product from Amazon or some other private online retailer. I hesitate to use the tired old analogy of standing in line at the DMV but – the same people who make a trip to the DMV utterly painful are the same people you have running government healthcare! 

It’s sad that it’s taken THIS long for people to get it – but until government regulations actually affect your life, you keep buying into the washed-out academic theories that haven’t been proven, even though those theories have had plenty of time to show their merits. That is, if they had any merit to begin with.

Welcome to Reality Town, Melissa. You won’t enjoy your stay.

Earth to enlightened liberals and progressives, it’s PRIVATE industry that can build websites and fulfillment systems such as Amazon. To expect that of your government, especially once a dose of politics is mixed in, is well, how should I say it…. Un effing realistic.


‘I am going to stab a bitch’; Liberal journalist discovers the joys of Obamacare

The wonderful auto-renewal system at Connect for Health Colorado failed for liberal journalist Laura Krantz –  ‘I am going to stab a bitch’; Liberal journalist discovers the joys of Obamacare | Twitchy. As you might guess, her solution is single payer but that’s to be expected.

Others apparently have the same problem, which is no surprise. There’s not an easy way to post the tweets except by screen capture so I recommend reading the whole thing.

All you had to do to “break” Connect for Health’s auto-renewal system was log in and look at alternate plans. I put “break” in quotes as this is how the system was designed. That said, it’s not clear that’s what happened in this case and why would her 2014 coverage be cancelled?



Shared Eligibility System: Who IS in charge?

Who’s in charge of the Shared Eligibility System (SES)? Balance of Power: De-glitching Colorado healthcare. Former Connect for Health Colorado Ellen Daehnick, who was terminated as a board member by Governor John Hickenlooper, discusses the enrollment issues, incompetence and general overall accountability issues that exist at Connect for Health Colorado and whomever is in charge of the Shared Eligibility System. Video, and text, at link.

The main topic of discussion is the Shared Eligibility System (SES) and the overall lack of accountability.

In her roughly year-and-a-half on the board of Connect, she says she couldn’t get answers to basic questions like this about the systems like SES, which were implemented to make the exchange work.

“You don’t have a responsible individual or entity, you don’t know who’s at fault, or who has the power to fix the problem,” Daehnick said. “You want to know who has the power to fix this and make it better.”

Apparently no one. It would be really nice if the Democrats would stop protecting the whole Connect for Health, Medicaid, Colorado Peak infrastructure but they continue to live in a fantasyland.

But committee Democrats defended the exchange’s performance as impressive— starting from scratch in a complex regulatory environment, they said.

You can’t make this stuff up. Getting back to the SES and Ms. Daehnick, I agree with every word spoken by her. Governor Hickenlooper better have a damn good reason for “firing” her. SHINE THE LIGHT on the problem Gov.

As a broker I or my clients have encountered numerous problems with Connect for Health (or SES or Medicaid, take your choice). Very few have been directly addressed by a specific person. One way or another we worked it out, but it takes hours of unproductive time and effort. I don’t see how 2016 open enrollment can be any worse.



Avoid the health exchange if you’re NOT subsidy eligible… Here’s why

Video: ObamaCare exchange not allowing addition of newborns to policies « Hot Air.

Let’s just say it’s one giant PITA.

Actually, no it wouldn’t be “more affordable” for families already paying for family coverage, which would likely be most of those seeking to add a newborn to their policy. And if they don’t qualify, then it’s a moot point anyway. That eligibility could have been determined through the ObamaCare exchange, had it been properly designed to deal with additions of newborns.

Instead, thanks to the run-around Healthcare.gov requires, families end up running out of time to add their newborns to their policies — and health insurers can’t step in and assist them any more:

Sure enough, CHIP denied her baby. Now when she turns to the marketplace to try and add her daughter, they turn her away.

“They denied us, saying we went over our time limit and there was no evidence we tried adding her to our insurance,” Maggie said.

Maggie says she protested sending marketplace workers copies of their own emails promising to extend the window but it did no good.

One executive from a Utah insurer says anyone who gave birth in 2014 will have the same problem, and it’s mystifying to Shaun Greene. “Insurance companies have been doing that for years,” Greene told KUTV about adding newborns to policies. “It’s not difficult.” Not until government takes it over, that is. (emphasis added)

I have not endured this particular situation in Colorado but have had some that are similar. However, I can say that Connect for Health Colorado is pretty good at creating incident numbers and allowing enrollment once the situation is resolved.

In Colorado, and apparently with healthcare.gov, almost any issue that isn’t a “straight enrollment” ends up being delayed. In the minds of the consumer, they are dumbfounded by the apparent incompetence. I have had two cases of adding family members, neither one has gone smoothly. In one situation, the family member was added the day after the enrollment was done. It took over 40 days and a plea to Connect for Health management to get this resolved.

This Rube Goldberg of a healthcare law boggles the mind.

If you’re not subsidy eligible, DO NOT use the exchange. In this case, it serves no purpose. However, if you are subsidy eligible or you might be, you MUST use the exchange if you want to preserve you eligibility. Even if you don’t want an advanced subsidy (monthly payments), you must use the exchange to claim your subsidy at the end of the year on your tax return.




Obamacare Penalties lead to possible open enrollment

Democrats Beg Obama to Bend Obamacare Rules to Avoid Tax Penalties for Millions – Breitbart.

Reps. Sander Levin (D-MI), Jim McDermott (D-WA), and Lloyd Doggett (D-TX) have strongly requested a special sign-up for the uninsured who will all be hit with a $325 fine or two percent of their income (whichever is higher) for failure to enroll in 2015. In 2016, the Obamacare tax penalty will be an average $1,100, reports the Associated Press. For 2014, the Obamacare tax was $95 or one percent of income.

“Open enrollment period ended before many Americans filed their taxes,” the three lawmakers said in a statement. “Without a special enrollment period, many people (who will be paying fines) will not have another opportunity to get health coverage this year.”

They passed the law to find out what was in it, and they didn’t see this coming?


Connect for Health Colorado: What’s the problem?

I checked with Connect for Health Colorado today regarding a client that started the disenrollment process on Dec 16. Here is what I learned:

  •  The disenrollment was transmitted to the carrier on Dec 19
  • As of today, it is pending acknowledgement from the carrier

The process was started 52 days ago, or to be gracious 49 days ago if we go with the date that Connect for Health transmitted the disenrollment. What does Connect for Health say?

Oh, it takes 21 days for the date to be transmitted and the carrier to acknowledge and it can take another 7 days for the carrier to process the disenrollment.

What bothers me the most is they make the above statement as if the status quo is OK and to expect more is beyond their comprehension.

YOU CAN NOT MAKE THIS STUFF UP. This level of mediocrity is unacceptable. The most politically correct statement I can make is that “amateur hour is alive and well over at Connect for Health.”

Vast quantities of data are successfully transmitted and received that are intricately involved in our we live our daily lives WITHOUT INCIDENT. It’s so common place that we don’t even think about it. Ordering a book on Amazon, downloading a book/file/graphic, bank transactions… all of these occur on a daily basis such that we don’t give them a second thought.

But Connect for Health Colorado can’t successfully transmit data, OR of course, the carriers can’t receive the data. STILL, they are in this together so I call dibs on it being Connect for Health Colorado’s problem. This was a big issue in 2014 and for it to remain a big issue for 2015 is totally unacceptable.

Amateur Hour at Connect for Health Colorado. What a disappointment.


Harvard Prof’s meet Obamacare and they don’t like it

Allow me to translate for you. Harvard Professors are spoiled brats. Talk about “checking your privilege” Harvard Ideas On Health Care Hit Home, Hard – NYTimes.com.

“Harvard is a microcosm of what’s happening in health care in the country,” said David M. Cutler, a health economist at the university who was an adviser to President Obama’s 2008 campaign. But only up to a point: Professors at Harvard have until now generally avoided the higher expenses that other employers have been passing on to employees. That makes the outrage among the faculty remarkable, Mr. Cutler said, because “Harvard was and remains a very generous employer.” (emphasis added)

Cry me a river.


Colorado Exchange struggles with both Consumers and Insurers

Health insurers owed $20 million, worker warns of ‘very low’ 2015 exchange sign-ups | Health News Colorado.

On the consumer front…

“Our enrollments are very, very low because of system issues,” said Jackie Sievers, a director of enrollment for four assistance sites in western Colorado.

She called in to an exchange board meeting and said she only has been able to complete about one in five applications.

“Other sites in my region are reporting 1 percent (completion rates) or even lower. My concern is that our open enrollment period is much shorter this year and we have some pretty significant issues and are having trouble getting people signed up,” Sievers said.

She said the system incorrectly calculates federal tax credits, known as APTC — which stands for advanced premium tax credits. The credits come from the federal government and are designed to make health insurance more affordable. On top of problems with the tax credits, Sievers said anyone seeking coverage through the small business portal, known as SHOP, can’t complete applications. (SHOP is for small group coverage – Ed)

On the insurance company front…

While workers are struggling to help people sign up for 2015, board member Steve ErkenBrack called attention Monday to the fact that exchange system problems have left insurance companies waiting for millions in payments for customers who qualified for federal tax credits this year.

ErkenBrack is president of Rocky Mountain Health Plans, a large insurance carrier. He asked Connect for Health’s interim CEO Gary Drews to do a better job of updating board members on problems the exchange is facing, rather than focusing primarily on rosy updates.

ErkenBrack cited problems with the APTC reimbursements that could cost carriers millions and drive them away from Colorado’s exchange. And he said that Colorado’s systems continue to enroll some customers simultaneously in private plans and Medicaid. So far, about 3,300 people have been caught in the “simultaneous enrollment” snafu. While the customers have double coverage, it’s unclear who will pay their claims: taxpayers or private insurance companies. Furthermore, they are not allowed to receive both Medicaid and federal tax credits. Earlier this year, insurance industry representatives warned that some of the individual claims could reach $1 million each.

“Both of these are critical issues,” ErkenBrack said on Monday.

And let’s pile on while were at it…

Dr. Mike Fallon, another board member, said insurance carriers are “our customers also and if they are not being paid tens of millions,” that’s a significant problem.

“We take this incredibly seriously. This is a big risk for us,” Work said.

Sue Birch, director of Colorado’s Medicaid programs and a non-voting board member, questioned whether the exchange should consider insuring itself in case carriers suffer losses as a result of problems accounting for tax credits.

“There’s enormous potential for liability,” Birch said.

You really can’t make this stuff up. I believe that Connect for Health Colorado has the best of intentions and works very hard. I personally like all the people I’ve met from that organization. All that said, color me “doubtful” they are on the road to success.



Doctors grade Obamacare

Why doctors give Obamacare a failing grade | TheHill.

  •  You can keep your doctors – NOT
  • Medicaid, not so great
  • Deluge of paperwork and reporting requirements

So what grade would doctors give Obamacare?

The Physicians Foundation made shockwaves last month when it released its 2014 Survey of America’s Physicians. The survey’s top-line finding: Of the 20,000 doctors surveyed, almost 50 percent stated that Obamacare deserves either a “D” or an “F.” Only a quarter of physicians graded it as either an “A” or a “B.”

Let’s take a closer look as to how Obamacare has affected Medicaid. Many of my (potential) clients are delighted if they qualify for Medicaid or if their children qualify for CHP+. Perhaps CHP+ offers better services than Medicaid for adults but I’m doubtful.

No matter which option they chose, Obamacare forced my patients to make trade-offs between pricing, access, and quality of care.

Obamacare’s Medicaid expansion exacerbated this patient crisis. Arizona, the state in which I practice, expanded Medicaid in 2013 under the assumption that it would give the poor better access to medical care. Yet many of the new Medicaid enrollees—perhaps as many as 80 percent of them, according to one recent study—were merely forced off their private insurance plans and into Medicaid.

Several of my patients experienced this first-hand. They have found that Medicaid offers sub-standard health care compared to the private insurance they used to have. Their choice of doctors has been severely curtailed, even more so when it comes to specialists. Often they resort to the local emergency room rather than waiting weeks to get medical attention in a doctor’s office. An Oregon study revealed a 40 percent increase in ER visits among new Medicaid enrollees.

Unsurprisingly, patient health suffers when illnesses and diseases remain untreated, hence Medicaid’s persistently poor ratings on patient health. Unfortunately, my patients were forced into this broken system without a second thought.

Perhaps it was without a 2nd thought or perhaps it was with malice. The government creates a problem and then only they can fix it. Of course, with their recent displays of incompetence, they may have overplayed their hand.

Let me also comment on Medicaid. Under Medicaid, reimbursement to doctors is much less than that of regular insurance or even Medicare. I don’t care how you slice and dice it, from a big picture point of view, if the doctors don’t believe they are being fairly paid, the qualify of care dispensed is going to decrease.


Vermont fires creator of its ‘unacceptable,’ glitchy ObamaCare site

What month is this? Oh yea, August and open enrollment starts in a little over 3 months. Vermont fires creator of its ‘unacceptable,’ glitchy ObamaCare site | Fox News.

An estimated 14,000 Vermonters are tied up in “change of circumstance” glitches with Vermont Health Connect. Since CGI launched the site this past October, health officials have received a steady stream of complaints from people unable to make adjustments to plans online.

Chief of Health Care Reform Lawrence Miller explained CGI’s firing in a statement to press.

“For many, Vermont Health Connect works as it should. For others, the system is still failing them and causing deep frustration. That is unacceptable to me, and we will explore every option and take every step to make this system work for all Vermonters,” he said. “Today’s changes are steps in that direction and more can be expected in the coming weeks.”

The Colorado Exchange, Connect for Health Colorado, uses the same contractor as Vermont, Massachusetts, healthcare.gov and Hawaii, CGI. CGI has now been terminated from Vermont, Massachusetts and healthcare.gov.

If I had to say…. being able to change coverage in the middle of a policy period is a Qualifying Life Event and I don’t believe changes have gone all that smoothly in Colorado either. They do seem to have initial sign ups under control if you can do the Medicaid dance.  Uugh.



Billing issues crop up on health plans sold through Colorado exchange

Billing issues crop up on health plans sold through Colorado exchange – The Denver Post.

Pueblo resident Lisa Bridwell said she has spent hours trying to get billed for the health insurance she purchased through the state exchange, and she’s afraid her coverage will be dropped because the exchange and Kaiser Permanente can’t get the billing issue straight.

Bridwell and her husband signed up for insurance effective May 1, and since then she received only one bill — and that bill was sent after she already paid that month by phone.

“I’m afraid of going to the doctor and being told (the policy) is void,” she said. “They’re having a lot of problems, and I’m not sure what they’re doing.”

How big is this issue?

Exchange chief executive Patty Fontneau said billing delays were a big issue at the beginning of the year but not at this point.

“I believe there are exceptions and problems, and we will absolutely get them resolved and investigate,” she said.

Fontneau said the billing category includes people calling with questions and not just problems, but she conceded the exchange does not know what percentage of the roughly 1,800 customers who called last month had problems with or didn’t receive their bills.

“Is it a huge problem?” she asked. “I don’t believe so. We haven’t been hearing that.”

I believe Patty Fontneau is playing politics. Keep in mind that it’s now July and there are still billing issues…. that’s intolerable. Also, it’s a damn big problem if it’s your problem.


Thousands to Be Questioned on Eligibility for Health Insurance Subsidies

What a mess – Thousands to Be Questioned on Eligibility for Health Insurance Subsidies – NYTimes.com.

Federal subsidies for the purchase of private insurance are a cornerstone of the Affordable Care Act. More than eight out of 10 people who selected health plans through the exchanges from October through mid-April were eligible for subsidies, including income tax credits. So far this year the federal government has paid out $4.7 billion in subsidies, and the amount is expected to total $900 billion over 10 years.

Since June 1, the government has notified hundreds of thousands of people that “the information in your application doesn’t match what we found in other records.” Accordingly, the notice says, “you need to follow up as soon as possible and provide more documents to make sure the marketplace has the correct information.”

“If you don’t send the needed documents,” it says, “you risk losing your marketplace coverage or help you may be receiving to pay for such coverage.”

Be careful out there.


More Scrutiny for Failed Cover Oregon Rollout

More Scrutiny for Failed Cover Oregon Rollout.

Cover Oregon is the name of the state health insurance exchange for The Beaver State. The name is now synonymous with perhaps the nation’s largest IT failure. More than $300 million in federal grant money was at stake. The state had already spent an estimated $200 million on the website that has yet to register a single Oregonian for healthcare. It may be a couple of years before the website will be up and fully functioning.

Apparently most folks in Oregon don’t need health insurance. If they do, perhaps they won’t re-elect these clowns.