Tag Archives: exchange readiness

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.


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.



Dems stop bill seeking oversight of Colorado health exchange bonuses

Connect for Health Colorado has a friend with Democrats – Dems stop bill seeking oversight of Colorado health exchange bonuses – The Denver Post.

The state House Health, Insurance and Environment Committee on Thursday killed a Senate bill that would have required legislative approval of any pay bonus given to employees of the state health insurance exchange.

The Democrat-controlled committee voted 7-6 along party lines to indefinitely postpone Senate Bill 52, a three-line bill giving the Legislative Health Benefit Exchange Implementation Review Committee oversight over bonuses for all 40 to 50 employees of Connect for Health Colorado.

Bill co-sponsor Jon Keyser, R-Morrison, said Coloradans are required to pay a fee for a system that hasn’t been working properly, and it was reasonable for the legislative committee to have oversight of any federal taxpayer dollars paid out as bonuses.

“The (exchange) board of directors may view this as intrusive, … but sunshine is the best disinfectant,” Keyser said.

Sunshine would be good as Connect for Health is not a transparent organization. However I find this final paragraph most offending…

But committee Democrats defended the exchange’s performance as impressive— starting from scratch in a complex regulatory environment, they said. Another layer of review of employee compensation on top of review by the exchange board, which itself is appointed by the legislature, is unnecessary, said committee chairwoman Rep. Beth McCann, D-Denver.

I’m sorry, the Democrats live in an alternate universe. The exchanges performance is not impressive, no way now how. Most disappointing was the lack of improvement from 2014 to 2015 and the screw-ups in the Shared Eligibility System (SES) and auto-renewal.

SES was supposed to seamlessly take subsidy eligible applicants from Connect for Health Colorado to the Colorado PEAK (Medicaid) website where they applied for Medicaid and back again once a determination was made. Applying for Medicaid is necessary step if you wish to receive a subsidy on a monthly basis. If the applicant was accepted for Medicaid, then they were done. If they were denied, Medicaid determined their premium assistance, along with a case number and authorization number and in an ideal world they were returned to Connect for Health Colorado to resume shopping. It was expected that an immediate determination and a seamless shopping experience would occur for 80% of applicants. I think I had ONE applicant where that actually worked.

This process was riddled with errors, not the least of which is the Medicaid application itself, which I will hasten to point out is NOT under Connect for Health Colorado’s jurisdiction.

The auto-renewal process was supposed to make it easy to simply let an insured’s policy renew. Unfortunately, if an insured went into Connect for Health to shop for plans and simply followed their nose, the auto-renewal was cancelled without notice to the consumer. There WAS a way to shop where the auto-renewal wasn’t cancelled but a typical consumer would have no idea how to do that.

These two issues were major disappointments. Other issues were almost no improvements to the broker or consumer shopping experience (i.e. website interaction). Yes, there were some improvements and some were of note but there were so many other issues that could have been addressed with just a little programming time.

As a broker, I moved as much business that was not subsidy eligible off the exchange that I could. If you are NOT subsidy eligible and don’t expect to become eligible during the year (i.e. how secure is your job…) then there is absolutely NO reason to use Connect for Health Colorado.


Connect for Health CO: Exchange snafus trip up thousands

Exchange snafus trip up thousands as more cost overruns mount | Health News Colorado.

Amateur hour at Connect for Health Colorado:

A multi-million dollar IT system that Colorado officials promised would make signing up for health coverage simple has instead snagged thousands of customers and now will cost several hundred thousand dollars — if not millions — to fix.

Managers at Colorado’s health exchange, Connect for Health Colorado, plan to ask their board members on Monday to approve an emergency infusion of $322,000 for the next month to try to help customers get coverage by the Feb. 15 deadline. No warranty covers the work that the additional money will fund, the exchange’s chief technology officers said on Friday.

So who EXACTLY IS the exchanges Chief Technology Officer? Inquiring minds want to know.

Other interesting factoids…

About half of the 21,000 people who bought private insurance through the end of December through the exchange have not qualified for tax subsidies. They can skip the problematic sign-in system if they don’t want to try to qualify for subsidies.

This is not exactly correct. I believe what they are trying to say is +/- 10,500 applicants elected to not try and get a monthly subsidy. They may still be eligible for premium assistance on their tax return. Also, here’s a HINT:


Time out for a self serving advertisement: Oh, by the way…  if you’re in Colorado and need a broker, please contact me at 303.495.3045 (or text me at 303.859.1709)! The cost to you is the same as if you did it yourself. Moving on…

The big issue has been the Shared Eligibility System between Connect for Health and Medicaid.

Colorado officials were supposed to build the shared system in 2013 and failed to do so. Since then, Medicaid head Sue Birch repeatedly has promised she would build a simple, streamlined system that would be as easy to use as Kentucky’s much-hailed sign-up system, Kynect. Colorado officials informally said the system here would be like “Kentucky on steroids.”

Instead, the system is limping along, and Drews this week had to send an apology note to exchange partners that outlined more than two dozen “known and reported issues.” Click here to see Drews’ letter.

“We realized issues have been difficult and frustrating for many since the start of open enrollment, and they have hampered your ability to serve your customers,” Drews wrote. “While we don’t anticipate a perfect system when launching new technology and programs, we certainly had higher expectations than we’ve delivered.”

Exchange board members were furious Thursday, saying they felt cornered into approving additional spending without adequate advance notice.

“We’re being told there’s no time for suggestions. We have to have it done right away,” said Dr. Mike Fallon, a board member.

“These problems didn’t start today,” Fallon said. “It’s every issue: you approve it or the sky is falling.”

Enough with the faux outrange Dr. Fallon, certainly you have your own internal and external sources of information on how Connect for Health is performing? If not, you should resign from the Board of Directors.

A side note on Connect for Health enrollment propaganda statistics..

Exchange spokesmen routinely report “enrollment gains” by lumping renewals and Medicaid sign-ups with the new customers who sign up for private health insurance.

You can’t make this stuff up.


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.



Fixing the Covered California Obamacare Exchange

California spends $13.4 million to fix Obamacare service woes – LA Times.

California’s health insurance exchange hired two outside firms for $13.4 million to address long wait times for consumers calling about their Obamacare coverage..

Covered California said it will pay $9.8 million to Faneuil Inc. and $3.6 million to Maximus Inc. to add more call-center capacity during the next open enrollment season starting Nov. 15.

“We had call response times that were far too long,” said Peter Lee, the exchange’s executive director. “We were swamped.”

Many consumers and insurance agents have complained about the exchange’s shoddy customer service and long hold times. In August, the exchange answered 1% of calls within 30 seconds, far short of its 80% goal.

The average wait time was under five minutes Thursday, according to the exchange.

Let me get this right, the Covered California has a 5 minute wait time and we’re not even in open enrollment? Best of luck for open enrollment.


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.


Oregon will drop its Obamacare exchange. What now?

Oregon will drop its Obamacare exchange. What now?.

After failing to launch a fully functioning Obamacare enrollment Web site, it looks like Oregon’s health insurance exchange will be taken over by the Obama administration. It’s a sign of how deeply flawed the Oregon enrollment system is despite initial lofty hopes, and a further indication of how much HealthCare.gov has improved since its own awful rollout.

The Oregon exchange board is scheduled to vote on the recommendation Friday, but as my colleague Amy Goldstein reported Thursday, federal officials have strongly encouraged the state’s move to HealthCare.gov. That would make Oregon the first state to abandon its enrollment system, presenting some immediate policy questions.

Wonder how much money was flushed down the toilet by the idiots running the Oregon exchange?


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.


$1.2 billion failed exchange amateur hour

Obamacare’s Failed State Exchanges – Reason.com.

The federal government spent more on broken state-run exchanges than it did on its own troubled system. Of the 14 states, plus the District of Columbia, that established their own health insurance coverage under Obamacare, seven remain dysfunctional, disabled, or severely underperforming. Development of those exchanges was funded heavily by the federal government through a series of grants that totaled more than $1.2 billion—almost double the $677 million cost of development for the federal exchange. (emphasis added)

When was the law passed, remind me one more time?

  • Passed the Senate 12/24/2009
  • Passed the House 3/21/2010
  • Signed by Obama 3/23/2010

What date is it now?  2/27/2014

Days from singing signing of Obamacare until today: 1437

Days from singing signing of Obamacare until open enrollment started: 1289

Yet 50% of the state run exchanges couldn’t get their act together.


Oregon exchange amateur hour

Congressmen want probe of Oregon’s Obamacare exchange.

An Oregon congressman and other legislators on Thursday called for a federal probe of Oregon’s deeply troubled Obamacare health insurance exchange, which has been unable to enroll anyone online despite receiving $305 million in federal grants.

“The catastrophic breakdown of Cover Oregon is unacceptable and taxpayers deserve accountability,” U.S. Rep Greg Walden, R-Ore., and other leaders of the House Energy and Commerce Committee wrote in a letter to the General Accountability Office, naming Oregon’s health exchange.

Apparently Oregon is the worst…

“Although the rollout of the Patient Protection and Affordable Care Act has been problematic nationwide, no state has had more complications than Oregon,” Walden and the other congressmen wrote. “The state of Oregon’s exchange website, Cover Oregon, has been such a technological failure that the site has been unable to enroll anyone months after the start of the open enrollment period.”

Wow, at least Maryland enrolled 33,000 people.

The site has had so many technical difficulties that its enrollment is a paltry 33,000—significantly below what officials had hoped to see for Maryland, which is one of just 14 states operating its own Obamacare marketplace.

Amateur hour. Remind me again, how long did they know this was coming down the road?


Maryland fires Obamacare exchange IT contractor

Amateur hour – Maryland fires Obamacare exchange IT contractor.

Some may say it’s a couple of months late and $65 million short, but Maryland finally fired the contractor that designed its botched Obamacare exchange.

It’s nice to know how much money is too much money. They should have done this months ago with less than 40 days left in open enrollment.


An Obamacare supporter’s misadventures with HealthCare.gov

An Obamacare supporter’s misadventures with HealthCare.gov | The Daily Caller.

Our troubles may strike some as trivial and particular, although they wouldn’t if it happened to them. And anyone who wants a successful system – as we do – must understand that these nightmares are happening across the nation to the very people who want Obamacare to work.

This story appears to be the Deliverance version of signing up for Obamacare.

Unfortunately, having dealt with many clients, it’s all to believable.

  • Restricted provider networks
  • Restricted formularies
  • Complicated subsidy eligiblity
  • Possibly higher premiums

All of the above are gifts of Obamacare.

If you don’t qualify for a subsidy or it is very small, my recommendation is:

  • Do NOT use the exchange
  • Contact a broker
  • Purchase directly from the carrier, which will also avoid security issues with the exchange websites.