Tag Archives: implementation

$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.


Coverage gap in states that didn’t expand Medicaid

Millions Trapped in Health-Law Coverage Gap – Yahoo Finance.

Bob Miller for The Wall Street Journal Hair stylist Ernest Maiden doesn’t make enough money to qualify for federal subsidies to buy health insurance but also is ineligible for Medicaid.

The 2010 health law was meant to cover people in Mr. Maiden’s income bracket by expanding Medicaid to workers earning up to the federal poverty line—about $11,670 for a single person; more for families. People earning as much as four times the poverty line—$46,680 for a single person—can receive federal subsidies.

But the Supreme Court in 2012 struck down the law’s requirement that states expand their Medicaid coverage. Republican elected officials in 24 states, including Alabama, declined the expansion, triggering a coverage gap. Officials said an expansion would add burdensome costs and, in some cases, leave more people dependent on government.

The decision created a gap for Mr. Maiden and others at the lowest income levels who don’t qualify for Medicaid coverage under varying state rules. The upshot is that lower-income people in half the states get no help, while better-off workers elsewhere can buy insurance with taxpayer-funded subsidies.

This is not an issue with states that expanded Medicaid, of which Colorado is one.


Obamacare Tech Surge

You have 30 days… Google, Oracle Workers Enlisted for Obamacare ‘Tech Surge’ – Businessweek.

Google Inc. (GOOG:US), Red Hat Inc. (RHT:US), Oracle Corp. (ORCL:US) and other technology companies are contributing dozens of computer engineers and programmers to help the Obama administration fix the U.S. health-insurance exchange website.

The help is arriving as the government’s main site for medical coverage remains plagued by repeated outages a month after its Oct. 1 debut. Michael Dickerson, a site reliability engineer on leave from Google, and Greg Gershman, innovation director for smartphone application maker Mobomo, are among those helping, the Obama administration said today.


Obamacare Exchanges Vs. Employer Health Insurance

Obamacare Exchanges Vs. Employer Health Insurance | Bankrate.com.

If you already have health insurance through your job, you’re probably wondering whether Obamacare will give you some new options. Will you be able to comparison-shop for a plan on the new online exchanges that might be better than your employer health insurance? The answer is a big, resounding “maybe.”

Well, in almost all cases the answer is “no” if your employer is offering major medical coverage.

Here’s the big hiccup: Unless your employer’s coverage for an individual is considered unaffordable under the law (that is, if your share of the premiums costs more than 9.5 percent of your household income) or inadequate (picking up less than 60 percent of the cost of covered benefits), you aren’t eligible for a government subsidy to help pay for your insurance. Subsidies are one of the things that can make plans on the new state exchanges appealing.

And if you’re not eligible for a government subsidy, the cost of coverage through the “Marketplace”, the politically correct term for “exchange”, is going to be high, as many are finding out.

Of course shopping and comparing SHOULD be SIMPLE. For exchanges that are run by the states, that may be the case. For example, in Colorado it’s very easy to shop without registering. You can even get an accurate estimate of your subsidy and receive quotes with the premium adjusted for your subsidy. ALL WITHOUT REGISTERING!!!

The government exchange, Healthcare.gov, which covers 37 states does NOT allow you to browse. In fact, you can’t see plans and pricing to the very last step of the process. This is detailed by Avik Roy in his Forbes colum: Crashing Because It Doesn’t Want You To Know How Costly Its Plans Are

A growing consensus of IT experts, outside and inside the government, have figured out a principal reason why the website for Obamacare’s federally-sponsored insurance exchange is crashing. Healthcare.gov forces you to create an account and enter detailed personal information before you can start shopping. This, in turn, creates a massive traffic bottleneck, as the government verifies your information and decides whether or not you’re eligible for subsidies. HHS bureaucrats knew this would make the website run more slowly. But they were more afraid that letting people see the underlying cost of Obamacare’s insurance plans would scare people away.

HHS didn’t want users to see Obamacare’s true costs

“Healthcare.gov was initially going to include an option to browse before registering,” report Christopher Weaver and Louise Radnofsky in the Wall Street Journal. “But that tool was delayed, people familiar with the situation said.” Why was it delayed? “An HHS spokeswoman said the agency wanted to ensure that users were aware of their eligibility for subsidies that could help pay for coverage, before they started seeing the prices of policies.” (Emphasis added.)

I don’t see how you can argue this conclusion.


Federal Exchange amateur hour is larger than the end user experience

Obamacare’s Federal Exchanges are Failing at Every Level – Hit & Run : Reason.com.

More then likely you have already read about all the issues the healthcare.gov end users are experiencing. Unfortunately, that is only a small part of this complex system. It also appears the information being transmitted to the actual insurance companies is bogus. Reason reports….

Here is one example from a carrier–and I have received numerous reports from many other carriers with exactly the same problem. One carrier exec told me that yesterday they got 7 transactions for 1 person – 4 enrollments and 3 cancelations.

For some reason the system is enrolling, unenrolling, enrolling again, and so forth the same person. This has been going on for a few days for many of the enrollments being sent to the health plans. It has got on to the point that the health plans worry some of these very few enrollments really don’t exist.

The reconciliation system, that reconciles enrollment between the feds and the health plans, is not working and hasn’t even been tested yet.

So far, healthcare.gov has documented issues with it’s web interface to the public and it’s interface with health carriers. Take a look at the flowchart below and see how many other communication interfaces that need to work flawlessly for healthcare.gov to operate as expected.


Anatomy of Obamacare flowchart





Avoid the Obamacare penalty: Why the real deadline is Feb. 15


Obamacare 101: Why the real deadline is Feb. 15 (+video) – CSMonitor.com.

When it comes to the Obamacare penalty, what a difference a day makes.

But the uninsured have until March 31 to be covered and avoid paying a fine. That’s because under the law, Americans can go uninsured for up to three months without penalty. (After that, in the first year, the fine is as low as $95, then escalates in the following years.)

So if one wants to push buying insurance right up to the edge, logic would dictate that the deadline is March 15, right?

Not so fast! Most companies start their policies on the first of the month, and so to be covered on March 31, one has to buy insurance that starts on March 1. To get insurance that starts on March 1, one has to sign up by around Feb. 15.

Time your purchase accordingly.



Tech experts wary of more Obamacare website glitches

Tech experts wary of more Obamacare glitches – Brett Norman and Jason Millman – POLITICO.com.

The deafness of the Obama administration….

“Despite the widespread belief that the administration was not ready for the health law’s Oct. 1 launch, top officials and lead IT contractors looked us in the eye and assured us all systems were a go,” House Ways and Means Committee Chairman Fred Upton (R-Mich.) said in a statement Thursday. “Instead, here we are 10 days later and delays and technical failures have reached epidemic proportions.”

Fears of technical issues being uncovered in a serial fashion…

“If we are already running into issues at the user account stage, we’re going to run into a lot more issues when we get to the more complex operations at the [subsidy] eligibility determination,” said Leavitt’s Schuyler. “That’s the reality. It’s a very complex process, and I think it’s going to get worse before it gets better.”

Didn’t I use to post – Prediction chaos?


11 Pieces of Obamacare Conventional Wisdom That Shouldn’t Be So Conventional – Bloomberg

11 Pieces of Obamacare Conventional Wisdom That Shouldn’t Be So Conventional – Bloomberg.

  1. Once Obamacare goes into effect, it will be impossible to substantially cut it back.
  2. Accountable Care Organizations are certain to bring down overall health spending
  3. Obamacare works because it gets money from deadbeats who go to the emergency room and then stiff the rest of us for the cost.
  4. Emergency room use will decline.
  5. People can game the system by going without insurance and then buying it when they get sick.
  6. Breaking the link between health insurance and employment will spur entrepreneurship.
  7. Obamacare will reduce the budget deficit
  8. The Independent Payment Advisory Board is going to radically change the relationship between you and your doctor.
  9. People with pre-existing conditions will be able to buy insurance in the private market for the first time.
  10. Obamacare will bend the cost curve.
  11. Obamacare will make bankruptcy a thing of the past, at least for the people who gain coverage.

I disagree with point #9 by the way. In general if you have a serious pre-existing condition, the only way to procure coverage was to sign up with the state risk pool. Perhaps that’s what Megan did and she wasn’t aware?


10 things Health Exchanges won’t tell you

10 things Obamacare won’t tell you – 10 things – MarketWatch.








  1. You might want to avoid signing up on Day One
  2. Yes, some workers are being required to use exchanges – but not these exchanges
  3. Expect to be confused
  4. Don’t bother asking our staff for recommendations
  5. Blue states do it better
  6. Abuse our honor system at your peril
  7. You’ll still pay for this, even if you don’t use it
  8. We’re a magnet for hackers and con artists
  9. You might not be able to keep your doctor
  10. Competition is for the greater good – except when there aren’t any competitors

and I would like to add number 11….

 11. If your income is above 400% of the Federal Poverty Level, there is no need to shop on the exchange. Exchanges are for subsidies and to determine eligibility for expanded Medicaid and CHP+.



Florida Among States Undercutting Health Care Enrollment – NYTimes.com

Florida Among States Undercutting Health Care Enrollment – NYTimes.com.


As many states prepare to introduce a linchpin of the 2010 health care law — the insurance exchanges designed to make health care more affordable — a handful of others are taking the opposite tack: They are complicating enrollment efforts and limiting information about the new program.

Chief among them is Florida, where Gov. Rick Scott and the Republican-dominated Legislature have made it more difficult for Floridians to obtain the cheapest insurance rates under the exchange and to get help from specially trained outreach counselors.

Missouri and Ohio, two other states troubled by the Affordable Care Act, have also moved to undercut the law and its insurance exchanges, set to open on Oct. 1. In Georgia, the state insurance commissioner, Ralph T. Hudgens, has said he will do “everything in our power to be an obstructionist.”

So far the article hasn’t given specifics as to actions the states have taken. We do get this specific example…

Even among states hostile to the law, Florida became an outlier this year when it passed a bill removing for two years the state insurance commissioner’s ability to approve insurance rates for new health plans, she said. This leaves Floridians vulnerable to higher rates at a time when the new health plans will be introduced.

It will soon become apparent if this resulted in higher rates for Floridians or not. It could be that they have higher rates BUT more complete doctor/facility networks.


From Bronze to Platinum Plans, What Will New Insurance Exchange Premiums Cost?

Excellent video/article: From Bronze to Platinum Plans, What Will New Insurance Exchange Premiums Cost? | PBS NewsHour | Sept. 25, 2013 | PBS#disqus_thread.

Among the details released today: Customers will be able to choose from a variety of plans, ranging from lower-cost plans in a bronze or silver category with less coverage to higher-cost ones known as gold or platinum with greater coverage and benefits.

The average monthly premium for an individual buying insurance through one of the cheaper options will be $328 a month. Then it gets complicated.