Questions Congress should ask Sibelius.

[OmCheeto]

Are they throwing in a free Unicorn, too?

I didn't see that, but it may have been in the fine print.

On a more serious note, I just watched a 9 minute video which explained to me:
1. Why Oregon now has the lowest health insurance rates in the country.
2. Why I didn't really sign up. (I didn't really want to, as I'm still employed, but was curious what I had to look forward to in 216 days.)
3. What this Rommneycare thing really is.
4. Why the Oregon website didn't crash. (Until today... )

Anyways, for those who don't live in Oregon, sucks to be you. In the future, you may want to elect people who have you in mind. Our current governor is an ER Doctor.

Wow! Look at this:

John Kitzhaber listed by magazine as second most influential figure in American health care

I did not know that.

hmmmm...

Maybe we should elect doctors, instead of lawyers and bad actors, to represent us in Washington DC. They might cure our ills.

 

[OmCheeto]

...
I wonder how many people are hitting the website just to see if it works? ...

I just found out another fun fact:

Cover Oregon: some significant progress fixing health exchange: still no enrollment; feds delay penalty deadline

The website still has not enrolled anyone.

Ouch!

Well, at least I got to see the numbers.

 

[Locrian]

I am doing what is legally required of me.

You are not legally required to make an account on the exchange, nor are you required to purchase a policy on it.

It is interesting hearing about people's attempts, though, and I'd love an update when you finally do get singed up through the exchange, if you choose to.

 

[Evo]

You are not legally required to make an account on the exchange, nor are you required to purchase a policy on it.

It is interesting hearing about people's attempts, though, and I'd love an update when you finally do get singed up through the exchange, if you choose to.

I don't believe that a person can sign up when they are already covered under a health policy.

 

[Vic Sandler]

You are not legally required to make an account on the exchange, nor are you required to purchase a policy on it.

You make a good point. One way to make the ACA work is to make it so difficult to use that nobody uses it. Everybody just buys insurance on the open market. However, I'm like edward's son, I would benefit from the ACA if only I could get signed up. We are the ones who are going to jeopardize this program unless we can convince some invincible youngsters to join us. We are the ones who are going to spend 5 hours and 5 hours more trying to get in. Will they?

 

[edward]

I don't believe that a person can sign up when they are already covered under a health policy.

They have that covered. It depends on the Value of your current policy, Cost vs coverage, as to whether a person can enroll or not.

Even with the website working it could be confusing for a lot of people. On the other hand the part of the website that shows where local help is available is working for me.

https://localhelp.healthcare.gov/#a...r=0&shop_filter=0&chip_filter=0&navc_filter=1

It looks like a lot of people just want to jump in and see if they can enroll. It won't work that way even when the website is functional. People are going to have to follow instructions and have the information required available.

Even the non functioning website shows what information is needed for the many various types of situations.

 

[edward]

Curiosity is a good thing. Altogether I have spent about 5 hours trying to set up my ACA account without success and my posts have been an accurate account of that failure. It is meant for the benefit of those who are curious, and without thanks. I am doing what is legally required of me. I do not appreciate your attempts to impeach my motives in the guise of leading questions. I am not to blame for the failings of the website nor for the failings of the 1-800 number. I am the messenger. You are not the first to question the motives of those who point out these sign up problems. The phrase is "Don't root for the ACA to fail.". Any problems there may be with the ACA are not the fault of the naysayers, but even if they were, that would be a reason to make sure the website worked on day one. A project of this importance should have been unit tested, integration tested, and should have been rolled out in selected markets first. Requirements should not have been changed at the last minute. You shouldn't need to enter any personal information at all to browse the site. And on and on. What on Earth would they have to before you were concerned about this?

Be patient. They system is not functioning. On numerous occasions I have waited more than five hours just to see a doctor at the VA. Despite the long waits I was still a VA volunteer.

Now that I am on Medicare I have a supplemental policy that pays for all medical bills and use the VA only to get free meds. That sounds greedy but it saves both myself and the VA a lot of time. That time can be used to serve others.

 

[Locrian]

The state sites are awesome.

Well, not all state sites have had a smooth opening (see Hawaii). Furthermore, some of them that have been "signing people up" haven't actually been enrolling people (no 834's to insurance companies).

Having said that, there are some definite successes in the list of state exchanges. Washington State is another example of success, I think:

Washington has enrolled 35,000 residents in the state exchange, Kreidler said, and applications for coverage of another 69,822 people have been completed.

“The federal hub is working from our perspective, for our interactions validating incomes and eligibility and the like,” Kreidler said.

(Note the irony of that article, though - those states who relied on the federal exchange getting all upset because of the poor service from HHS)

And this really underscores the source of the problems in the federal exchange - it's the federal government. I'm seeing lots of memes on the internet trying to make it less the fed's fault. It's too hard communicating with all those insurance companies! It's too hard communicating with the rest of the gov't! None of that is true.

 

[Locrian]

I don't believe that a person can sign up when they are already covered under a health policy.

They should be able to sign up, they just aren't eligible for subsidies.

It's possible they can sign up, but not through the exchange, I suppose, but I'm pretty sure they can.

 

[Vic Sandler]

I think there has been some mis-information in this thread. Here is a second opinion.

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/10/03/obamacare-qa-what-if-i-already-have-health-insurance/

As I understand the video, you can get insurance from the exchange with a subsidy even if you already have insurance. The exception would be that if you get insurance from your employer and it meets certain criteria, then you can't get the subsidy. If you buy your own insurance, there are no conditions.

 

[OmCheeto]

...
[The motto of Robert Heinlein applies here: There ain't no such thing as a free lunch.]
...)

That is hilarious. Those were my notexact words to my sister yesterday on Facebook.

OmCheeto: I signed up for Obamacare last week. It's going to cost me $75 per month. Now I know why the 1% wanted to kill it.

SissyCheeto: why, you get free health insurance already?

OmCheeto: Free? It costs my company $600 per month. Somebody is paying for that. There's no such thing as "free".

 

[Locrian]

The exception would be that if you get insurance from your employer and it meets certain criteria, then you can't get the subsidy.

I think they just have to offer it (subject to that criteria); you don't have to be getting it.

 

[Vic Sandler]

I don't believe that a person can sign up when they are already covered under a health policy.

They should be able to sign up, they just aren't eligible for subsidies.

It's possible they can sign up, but not through the exchange, I suppose, but I'm pretty sure they can.

I think they just have to offer it (subject to that criteria); you don't have to be getting it.

You are correct. However, I was addressing the previous two quotes.

 

[Vic Sandler]

Today is unfortunate day 27. I am encouraged by the following error message:

The System is down at the moment.
We're working to resolve the issue as soon as possible. Please try again later.
Please include the reference ID below if you wish to contact us at 1-800-318-2596 for support.
Error from: https%3A//www.healthcare.gov/marketplace/global/en_US/registration%23signUpStepOne
Reference ID: 0.cd87b17.1382865145.1ac71ff3.238110

Note that the information in the error message is intended to aid the programmers in fixing the problem. This is the first time that I have seen this type of error message from the site. I called the number and spoke to a very pleasant woman who had no clue what to do with the reference ID. She said she would try to find out. I doubt she will succeed. It seems that no one in programming told the call center personnel what to do with these reference IDs.

As you may know, I spent two and a half hours on the 1-800 number giving them my particulars so they could enter it into the system. So I also asked her if she could bring up that information on her computer. She said that under normal circumstances she would be able to, but that currently the system is down. Since the system is down for me as well, this is compatible with the suspicion that when you call in, you are speaking to someone who enters your information into the same webpage that you yourself cannot access because of login issues.

Edit: I just tried a second time and got the following error message:

Internal Server Error - Read

The server encountered an internal error or misconfiguration and was unable to complete your request.
Reference #3.16111f45.1382870107.1110fe5b

No mention of who I should contact with this reference ID. I contacted no one. Perhaps they have created their own error log and there is no need to contact them.

 

[OmCheeto]

...
4. Why the Oregon website didn't crash. (Until today... )
...

Yay! Ours is back up. It appears they did a software upgrade.
Last week they had the tax credits on the left hand, the prices on the right, and you had to do the math in your head.
Today they are displaying "$25 per month with tax credit".
There are 72 plans available.
The most expensive plan is: "$305 per month with tax credit"

The above two quotes are based on a non-smoking 55 year old single male making $20,000 per year.

If I raise the income to $200,000 per year, I get the actual, non-tax credit prices:
Low: $276
High: $634
These prices seem fairly reasonable.

Ha! I love opinion's. They can be so funny. Bolding mine.

This one was published in the WSJ in January.

ObamaCare's Health-Insurance Sticker Shock
Health-insurance premiums have been rising—and consumers will experience another series of price shocks later this year when some see their premiums skyrocket thanks to the Affordable Care Act, aka ObamaCare.

The reason: The congressional Democrats who crafted the legislation ignored virtually every actuarial principle governing rational insurance pricing. Premiums will soon reflect that disregard—indeed, premiums are already reflecting it.

Boogymancare 1, Matthews & Litow 0

------------

I also ran over to the Washington state site yesterday. Their prices are comparable.

I also ran across a private site which appears to do the same thing, but doesn't mention the tax credits: http://www.healthinsurance.org

Does anyone know how much the government spent on the ACA web site?
The healthinsurance.org website seems simple enough.
They even have more options. They list 90 plans, ranging from $115 to $741.
Maybe the government should have just commissioned them to run the program for them.

 

[Locrian]

There are lots of misconceptions associated with comparing pre- and post-2014 premiums. Whether one comes to the conclusion that premiums have gone up or down seems to depend mostly on one's political point of view.

Imagine this example:

• In 2013 there are three car models, priced 15k, 20k, and 25k.
• It comes out that in 2014, all three models will have their cost go up by 30%, but a new, stripped down car will be offered for $12,500.

Did car costs go up or down? It's hard to say until we know which models people will purchase and whether they liked them enough to purchase them again.

• If people find the new, stripped down car perfectly functional and significant numbers buy it in 2014 and 2015, then we can probably say prices went down.
• If no one buys the cheap one, prices went up.
• If some people buy the cheap one in 2014, but hate it and no one does in 2015 then prices went down in 2014, and have a large jump in 2015.

Something similar has happened with individual health insurance premiums. Overall, PPO/HMO plans with similar attributes to those pre-2014 are more expensive than they were before (though how much differes HEAVILY on what state you're looking at). However, at least one major insurer has introduced plans with stripped down networks. They're sufficient, but they exclude many providers and hospitals that people in those cities are used to going to. The company used this leverage to bring down provider prices and significantly undercut the competition.

Do these thin-network plans represent savings? Absolutely, they could, if people are satisfied with the result. If people try it and bail in 2015, then savings will have been short lived.

To determine the impact of the ACA on premiums we need two critical pieces of information:

Small Group & Individual enrollment.
Small Group & Individual block emerging claims experience.

We'll have enrollment in early 2014, and claims by early 2015.

Beware making judgements prior to having that information.

Some other considerations:

• If people are buying plans with higher deductibles/copays, their premium may go down, but their total spending could either go up or down.
• If people buy plans with higher deductibles and do not have the cash to pay those deductibles, health spending will go down in the short term, but health outcomes may get worse.
• Because individual and small group members are now in a single risk pool, it is possible rates for individuals go down and small group member's rates go up.
• There is a lot of confusion between premium rates and after-subsidy rates - the rate someone pays after their subsidy is not the plan premium.
• As I mentioned, the impact on the individual market differs hugely by state.
• Because the new age curves result in the young subsidizing the old, be careful what age you're comparing rates at; older individuals are more likely to come to the conclusion that rates have gone down, when it is a localized effect.

 

[mheslep]

...

The above two quotes are based on a non-smoking 55 year old single male making $20,000 per year.

If I raise the income to $200,000 per year, I get the actual, non-tax credit prices:
Low: $276
High: $634
These prices seem fairly reasonable.

Ha! I love opinion's. They can be so funny. Bolding mine.

This one was published in the WSJ in January.Boogymancare 1, Matthews & Litow 0

...

To tally the score I think you would need the before ACA price. Apparently it was $140 for the lowest cost plan for a 55 year old in Oregon, now $276, i.e. a near 100% increase.

 

[turbo]

To tally the score I think you would need the before ACA price. Apparently it was $140 for the lowest cost plan for a 55 year old in Oregon, now $276, i.e. a near 100% increase.

Does that include the Fed rebate, or not?

 

[Locrian]

Having said that, there are some definite successes in the list of state exchanges.

Did I http://www.reuters.com/article/2013/10/28/us-usa-healthcare-idUSBRE99Q0DH20131028?

 

[SteamKing]

The ACA is a complex undertaking, no question about it. The law alone is more than 2500 pages and there are currently more than 12000 additional pages of regulations which have been generated as a result. The provisions of the law are still currently being litigated in various courts and may wind up for review before the Supreme Court again. Portions of the law have been suspended from implementation by the Administration (read Employer Mandate for 2014). On top of all this, trying to write a software system which puts all of this in motion so that Joe and Jane American can purchase insurance is quite a daunting prospect. And then there will be the inevitable computer shut downs due to mechanical failure, power loss, natural disaster, whatever, which will throw random monkey wrenches into the system. All of this assumes that in future years, Congress will not pass additional health care legislation, which probability is vanishingly small once the system is running.

It was once said that being Secretary of Defense was an almost impossible job to fill due to the size of the department itself and the critical nature of its proper functioning from day to day. Sec. Sebelius is finding out that being Sec. of HHS will soon eclipse the scope of the duties of the Sec. Def., if it already hasn't. Being President will not nearly be as stressful a job as being Sec. of HHS in the future, IMO.

 

[Office_Shredder]

On top of all this, trying to write a software system which puts all of this in motion so that Joe and Jane American can purchase insurance is quite a daunting prospect.

This statement doesn't seem to be particularly true to me. I have been able to get quotes from car insurance companies online for years now; health insurance is more complicated but not that much more complicated.

 

[SteamKing]

Your car insurance quote is not trying to check various federal databases to make sure you are entering accurate data. Basically, the insurance company wants to know what make, model and year car you drive, your sex, your age, and where you live. If you provide false info to the insurance company, you'll wind up with a canceled policy if they find out. If you provide false info on healthcare.gov to get health insurance, you might be liable to pay some fines or reimburse the gov't for improperly obtained tax credits. With the IRS administering portions of the law, you might get hit with a perjury charge.

It's like this article says, healthcare.gov is more than just a website:

http://www.dailykos.com/story/2013/10/21/1249417/-Healthcare-gov-isn-t-just-a-website-dagnabbit#

You will be sharing some pretty sensitive information during enrollment for health care coverage. How secure is this site? What happens if it gets hacked? What happens if your data falls into the wrong hands?

Would that healthcare.gov be as simple as amazon.com or esurance.com. The reality is, it is not.

 

[edward]

Both health insurance and car insurance companies share more about us than we realize.

My daughter in law's car was was hit in the rear and she was taken into emergency for x-rays and a concussion. At that point she did say that her injuries were due to a vehicle accident but at that time had no information on the driver at fault. My son arrived and gave the hospital their family health insurance information just to speed up the process.

Apparently hospitals get a bit anxious when they don't know to whom to send the bill.

Before my daughter in law even recovered from her severe headache her own auto insurance, Geico, called and asked for a statement.

She hadn't given the hospital the name of her auto insurance company.

Two days after the accident a private attorney called claiming he could take care of everything for her.

In case of a severe accident or illness where transport is needed the ambulance company also has your info. OPPs forgot, so do the Paramedics.

 

[edward]

Your car insurance quote is not trying to check various federal databases to make sure you are entering accurate data. Basically, the insurance company wants to know what make, model and year car you drive, your sex, your age, and where you live. If you provide false info to the insurance company, you'll wind up with a canceled policy if they find out. If you provide false info on healthcare.gov to get health insurance, you might be liable to pay some fines or reimburse the gov't for improperly obtained tax credits. With the IRS administering portions of the law, you might get hit with a perjury charge.

It's like this article says, healthcare.gov is more than just a website:

http://www.dailykos.com/story/2013/10/21/1249417/-Healthcare-gov-isn-t-just-a-website-dagnabbit#

You will be sharing some pretty sensitive information during enrollment for health care coverage. How secure is this site? What happens if it gets hacked? What happens if your data falls into the wrong hands?

Would that healthcare.gov be as simple as amazon.com or esurance.com. The reality is, it is not.

I presume sensitive information would include financial information. All of the credit agencies already have that, are they safe?

 

[Office_Shredder]

Your car insurance quote is not trying to check various federal databases to make sure you are entering accurate data. Basically, the insurance company wants to know what make, model and year car you drive, your sex, your age, and where you live. If you provide false info to the insurance company, you'll wind up with a canceled policy if they find out. If you provide false info on healthcare.gov to get health insurance, you might be liable to pay some fines or reimburse the gov't for improperly obtained tax credits. With the IRS administering portions of the law, you might get hit with a perjury charge.

If I go to esurance I can give them my name and address and they will look up my car for me. Then they ask me for my social security number and tell me that they cannot give me an accurate quote without it, because they use that number to look up credit information (where legal) and driving records. I didn't go past this point on their website because I'm not interested in buying car insurance and I felt the point was proven. They are looking things up and verifying information based on what you enter, they aren't taking your word for it. Why is it so much harder for health insurance companies to do this?

Amazon.com is going to have my credit card information on file, and esurance is going to have my social security number passed to them, what information are you giving to healthcare.gov that is so much more sensitive than these?

I don't know if healthcare.gov is trying to go above and beyond what esurance or amazon is doing from an IT standpoint - I don't know if it's true, and I don't know if it's not true. But I don't see how it is so far above and beyond that they are above reproach when they screw the pooch and fail to deliver on the goals that were set. It seems like they are doing a similar setup to what every e-business ever does: get information from the consumer, verify it, let them shop (and usually they let you shop before verifying your information). If it's really too hard to do on the fly for the information they need then they should have set up the system so that when you make an account, they spend 24 hours verifying your information after which you can shop or something, rather than the mess we have now. Or just trust that you tell the truth and verify after you pick your policy (which doesn't have to occur on the exchange level).

 

[SteamKing]

Well, it's too bad the healthcare.gov was a no-bid contract. If it had been handled thru normal bidding channels, you could have submitted a bid.

If you haven't figured it out already, dealing with the government at its easiest is about 10 times harder than dealing with the private sector. Everybody in govt. has some form to fill out in zintuplicate or some quota to meet. It matters not a whit to the govt. functionary you are dealing with if you get served today or next year. He can't get fired from his job. If you screw up at your private sector job, you can be shown the door anytime.

A lot of promises were made about all of this when ACA was being passed. At the time, nothing existed but 2000 pages of legislation. Now, realities are setting in, the promises have turned out to be vapor, and hard deadlines for implementation of a functioning system are fast approaching. All offers of delay of the individual mandate were haughtily dismissed by the Senate democrats during the recent budget negotiations. Some senators up for re-election in 2014 are reportedly considering support for delaying the individual mandate. Congress has already cut its deals about coverage for themselves and their staffs. They will not personally get hit with penalties for lacking coverage in 2014 and beyond because they are already covered and will not need to navigate the bowels of healthcare.gov.

It has already been suggested that healthcare.gov has swallowed more money than amazon.com and several other commercial websites required to get up and running.

 

[Vic Sandler]

This is the 28th unfortunate day for the ACA website. The site was down all day yesterday and a good part of today, but it is up now. I still can't log in. I called the 1-800 number and they told me they can't access my information even though it was input using the 1-800 number, not the website. That is, the problems with the website are not the only problems with the program as a whole. This time I got to speak to a supervisor, but it didn't do me any good. However, I was told that my case was being upgraded and that I would be receiving a call within 48 hours from a problem solving team that presumably has more effective tools at its disposal. I was also told that the 48 hour promise was not to be taken seriously and I shouldn't get upset if it were to take until Friday before they contact me.

 

[Vic Sandler]

The ACA is a complex undertaking, no question about it.

Let me be clear about this. After three and a half years of preparation and $600 million cost, I can't log in. That is not because of the 2500 page law or the 12000 page regulation. I am concerned, however, that once I do log in, problems related to the page count will commence.

The 2014 subsidy is based on your 2013 income, but the IRS only has your 2012 information, so what are they using it for? If they can access my records in the IRS database in order to see if I entered my information correctly, then why do they need me to enter my information at all? If you expect your 2014 income to be substantially different from 2013, then you can use your estimate of your 2014 income instead. I know this because the woman on the 1-800 line told me so and collected both my 2013 estimate and my 2014 estimate.

 

[Locrian]

The 2014 subsidy is based on your 2013 income,

To clarify, the 2014 subsidy is based on your 2014 income (and you note this, I think, in your second paragraph). Prior years' income will be used to help estimate what your subsidy should be in 2014.

However, if the estimate is wrong, it will show up in your taxes in April of 2015.

Edit: I think the rest of your post supports this, but I still think clarification for other readers is warranted.

 

[russ_watters]

Sure they can. It just takes a while. It's just as much a mistake to think the government cannot run a complicated program effectively as it is to expect them to run it effectively from day one.

Well certainly not every program fails, and I didn't mean to imply that if you read it that way, but some programs do fail. Governments like to think that since they lack profit motive; time, money and political will are infinite resources, but they aren't. Eventually, they run out and some programs fail. For example, the FAA's Advanced Automation System of the late 1980s and early 1990s:
https://www.google.com/url?sa=t&rct...nNsLL2wTsFGgMYDeA&sig2=mM2ichooQ55d2hgGcGyyYw

But it should be obvious that complexity and odds of success are inversely related to each other.

 

[Vic Sandler]

To clarify, the 2014 subsidy is based on your 2014 income.

If you want information about the ACA, you can call the 1-800 number. If you want correct information, call Locrian.

 

[Vic Sandler]

Today is unfortunate day 29, I have made no progress logging in. Here is an article that claims there was a window of opportunity for me to hack into my own account, but that the window is now closed.
http://money.cnn.com/2013/10/29/technology/obamacare-security/index.html?hpt=hp_t1

Here is an article that claims Obama knew we couldn't keep our existing insurance regardless of whether we liked it or not. His new line is that even though we can't keep the insurance we like, we will be able to replace it with insurance that he likes.
http://finance.yahoo.com/news/white-house-knew-millions-couldnt-101800242.html

 

[lisab]

Well, the ACA is quite clear that penalties (read taxes) are to be assessed for individuals who don't have coverage in calendar year 2014. <snip>

A penalty you pay for breaking the law is not the same as a tax.

You can easily avoid penalties, but no one can avoid taxes .

 

[russ_watters]

A penalty you pay for breaking the law is not the same as a tax.

You can easily avoid penalties, but no one can avoid taxes .

Sure, except for the fact that a federal penalty for not buying a commercial product/service would be unConstitutional. The administration sold it to the USSC as a tax and won on that argument:

Although the Supreme Court declared that the law could not have been upheld under an argument based on the regulatory power of Congress under the Commerce Clause, the Court declared that the legislatively-declared "penalty" was constitutional as a valid exercise of the Congressional power to tax, thus upholding the individual mandate.

http://en.wikipedia.org/wiki/Consti...on_and_Affordable_Care_Act#U.S._Supreme_Court

Personally, I agree with you.

 

[Vic Sandler]

The administration sold it to the USSC as a tax and won on that argument:

I don't know if the administration sold it in that fashion, but the next day they denied that the penalty was a tax.
http://abcnews.go.com/Politics/OTUS/white-house-roberts-obamacare-mandate-penalty-tax/story?id=16679772

White House: Sorry, Roberts, Obamacare mandate is a penalty, not a tax

The dateline of the story is June 29, 2012, and the date of the USSC decision was June 28, 2012 according to your link.