THCB

Healthcare.gov Is Working. But Is It Working Well Enough to Withstand the Enrollment Surge?

From 27,000 enrollments in October to a reported 100,000 enrollments in November, the Affordable Care Act’s website is apparently working better and getting more people signed up.

But is it fixed well enough to handle the expected wave of at least many hundreds of thousands of people eager to get guarantee issue health insurance for the first time or replace a canceled policy by January 1?

Here are some of the press reports covering the December 1 HealthCare.gov relaunch:

  • Reuters: “A surge of visitors clogged the U.S. government’s revamped healthcare insurance shopping website on Monday, signaling that President Barack Obama’s administration has a way to go in fixing the portal that showcases his signature domestic policy.”
  • Bloomberg reporting on a navigator’s experience: “It’s still kind of glitchy. Now it just kicked me out. It went back to the front page. I’ve been here all afternoon and it’s been like that.”
  • Miami Herald: Long waits, error messages, unresponsiveness. Hallmarks of the troubled launch of the Health Insurance Marketplace at healthcare.gov continued to stymie South Florida residents and counselors trying to access the website on Monday––more than two months after the October 1 launch, and despite the government’s self-imposed deadline of Nov. 30 for the system to function smoothly for the ‘vast majority of Americans.”
  • Los Angles Times: “The Obama administration’s overhauled healthcare website got off to a bumpy relaunch Monday as a rush of consumers caused an uptick in errors and forced the administration to put thousands of shoppers on the HealthCare.gov site on hold.
  • Ezra Klein, Washington Post: “Of course, that means the site still suffers a disastrous outage rate.” And, “We have no idea whether the 200 fixes left on the list are really important ones, or really difficult ones. The repair job is likely proceeding quickly enough to protect Obamacare from the most severe threat to its launch: Democrat-backed legislation unwinding the individual mandate or other crucial portions of the law.

And then there is the backroom. The administration apparently decided that it was more important to fix the front-end of the system before the back-end was fixed. Do they think that big customer service issues come January, if the “834” back-end enrollment problems are not fixed by then, will be blamed on the insurance industry and not the administration?

  • Associated Press: “Private insurers complain that much of the enrollment information they’ve gotten on individual consumers is practically useless. It is corrupted by errors, duplication or garbles. Efforts to fix the underlying problems are underway, but the industry isn’t happy with the progress and is growing increasingly concerned.”

As I have said before, the Obama administration is likely in the midst of a four month project to properly fix and test this system. It will likely be at least late January or early February before not just HealthCare.gov but the other key information systems supporting the new law are built and repaired to just minimal standards.

Maybe the best news for HealthCare.gov is that you can finally look at actual plans and prices for your age and family in your community without having to open an account and sign-in. Finally, people can easily see for themselves just what kind of plan is available for them and at what pre-subsidy cost. They can also access a chart telling them if they are eligible for a subsidy or reduced cost sharing but not calculate it for themselves.

My definition of a fixed HealthCare.gov is a site that encourages enrollment rather than discourages it. Time will tell––but only about three weeks time before the December 23 enrollment deadline for having coverage on January 1.

Maybe, however haltingly, we are finally getting to the main event. The day when people can get a good idea for themselves just what value Obamacare presents for them. The premiums, the deductibles and co-pays, as well as the provider networks. Not just the people who are now uninsured or have had their policy canceled, but also those who don’t need Obamacare today but think they might someday. All of them voters focused on finding out for themselves what this Obamacare thing really is.

Nobody can spin the main event.

Robert Laszewski has been a fixture in Washington health policy circles for the better part of three decades. He currently serves as the president of Health Policy and Strategy Associates of Alexandria, Virginia. You can read more of his thoughtful analysis of healthcare industry trends at The Health Policy and Marketplace Blog, where this post first appeared.

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wickedsupplement-testosterone boostersAurthurJohnwickedsupplement-Test boosterBob Hertz Recent comment authors
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wickedsupplement-testosterone boosters
Guest

Nice Tips !!. I enjoyed these tips. Keep sharing.

archon41
Guest
archon41

And the bottom line is, as long as our line of credit with the Chinese is still good, we can continue to eat the seed corn.

John Ballard
Guest

Mark Blyth’s book about Austerity was just named one of the ten best books of the year by Financial Times. Look it up. Or if you have the time (and can understand his Scottish accent delivered at a NASCAR pace) here is a one-hour video you might enjoy.
http://youtu.be/JQuHSQXxsjM

Bobby Gladd
Guest

Good tip. Another good read, Graeber’s “Debt: the first 5,000 years:” Presaged here:

http://canopycanopycanopy.com/issues/10/contents/to_have_is_to_owe

Bob Hertz
Guest
Bob Hertz

Note to John: I cannot agree with you on the contraception mandate. Although I am a liberal even a radical, I take the side of the plaintiffs like Hobby Lobby. The plaintiffs have never made the slightest attempt to prevent their employees from using contraception. They just do not want to pay for this product. Given that contraceptive devices I think cost about $50 a month, the corporation is not being a tyrant. There is a tendency in heated debates to say that if a health product is not insured, then the patient is being denied the product. If the… Read more »

John Ballard
Guest

I understand. I was being facetious about the blood transfusion example, but in the case of contraception we will have to agree to disagree. I dare not argue too strongly my case, though, since I am surrounded where I live by others who would be in agreement with you. In recent years I have found myself becoming an infidel, surrounded by good, salt of the earth people persuaded that one cannot be a good Christian without being Republican. Thank goodness that is off-topic in this thread. My cost argument is simple. Contraceptives are a normal part of good medical care… Read more »

archon41
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archon41

They was a time when we could sell everything we could produce, and it certainly wasn’t because employers were gratuitously paying employees more than their skill sets were worth on the open market. We have become uncompetitive, not only with the Chinese, but with Germans, Finns, Swedes, Japanese, and even the French. We have allowed the playing field to become so tilted that, when the employer (think Hostess) is threatened with a strike, his only realistic options are to knuckle under or to go into bankruptcy. We have allowed the backbone of our economy, construction, to become not only “work… Read more »

John Ballard
Guest

You are correct that exports were once the backbone of our economy. It’s fair to say that exports are the foundation of every country’s economy, which is why “balance of payments” or “trade balances” are so damn important. Globalization made the whole world competitive and the developing world, thanks to technology and global communication, is leaving colonial exploitation in the dust, even if their politics leaves a lot to be desired. We’ve come a long way since the Swiss figured out that a pound of fine watches was worth much more than a pound of raw steel. Heck, some places… Read more »

Peter1
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Peter1

“We have become uncompetitive, not only with the Chinese, but with Germans, Finns, Swedes, Japanese, and even the French.” The Germans, Finns, and Swedes set their minimum wages by collective bargaining, France set its minimum wage at about $12 U.S. in 2013 (35 work week) and Japan ranges from $8 to $11. All but China have some form of single-pay/government controlled health care. As for union membership I got this from Wikipedia as well. “In the mid-1950s, 36% of the United States labor force was unionized. At America’s union peak in the 1950s, union membership was lower in the United… Read more »

Peter1
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Peter1

“where the decisions that must shortly made by employer and employee alike are being laid on the table by HR managers.”

You don’t think that was happening before ACA? I welcome more people getting bumped into the individual market, that will bring costs front and center and reduce the awakening to single pay.

Peter1
Guest
Peter1

Another reason for single pay, we are not getting any value from insurance.

http://www.nytimes.com/2013/12/03/health/as-hospital-costs-soar-single-stitch-tops-500.html?hp&_r=1&

archon41
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archon41

“God bless us every one!” cried Tiny Tim, “and subsidies for all!”

So how do we account for the ominous finding of recent opinion polls when, thus far, so few have been directly affected? I can give you one reason: All over the country, employees are being dragooned into “educationals,” where the decisions that must shortly made by employer and employee alike are being laid on the table by HR managers.

Bob Hertz
Guest
Bob Hertz

Note to John Ballard: Thanks for your thoughtful posts. You mentioned that better tax deductibility would help some persons afford insurance. First I agree that raising the threshold from 7.5% to 10% was a crummy part of the ACA bill. In so many cases, the drafters were terrified of raising taxes on the middle class or even the upper middle class. This led them to go dumpster diving for extra revenue such as extra 1099’s and tanning salon taxes. But my real point is that tax deductions are not always very effective. I may have the numbers wrong, but consider… Read more »

Bobby Gladd
Guest

And, you have to view such things from the perspective of the MARGINAL benefit (i.e., itemized deductible vs the std deduction).

We are just addicted to our endlessly tweaked no-value-adding hypercomplexity.

But, then, UnitedHealthGroup’s CEO Helmsley must continue to get his $14 million a year compensation package — a mere 100x that of the average primary care doc. He’s struggling to get by, too, y’know. The top hedge fund guys make multiples of his pittance.

John Ballard
Guest

Scrawny is right. And it’s even worse than it looks, since the ten percent cap is only for insurance premiums. They will surely spend more than that for medical costs not covered by insurance — dental, optical, mileage, what’s left of the donut hole and who knows what else. I’d say that couple is in a pile of medical bills big enough to accelerate their Medicaid spend-down. Unless they have a pile of untapped assets, they are on a fast track to destitution. Medical costs need to come down faster and sooner if we expect to leave any assets for… Read more »

archon41
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archon41

“Pissing into the wind” would be more apt.

archon41
Guest
archon41

I was most gratified to read, this morning, that Harry Reid and other congressional democrats are exempting their staff from the burdens of Obamacare. I mean, these are people who really, really care, and they shouldn’t be punished like this.

John Ballard
Guest

I suppose you would also favor of having veterans and active duty military losing their actual government insurance (VA and armed forces medical service corps) and returning to the private sector. Oh, and don’t forget Tricare for dependents.

Sarcastic comments like that make me wonder why I try to discuss anything in detail. It’s like pissing in the ocean…

archon41
Guest
archon41

Mr. Laszewski delivered himself of a masterful exposition of this “hopeless mess” on The Kelly File last night. That was followed by a rant by Alan Colmes, which I’m sure John and Peter would greatly have enjoyed.

John
Guest
John

A successful application is one thing, but who has received a notice from their insurer that they have been successfully enrolled.

wickedsupplement-Test booster
Guest

I am very conscious about my health because I take proper food but it is not effective for me. Keep sharing !!

archon41
Guest
archon41

Perhaps we need to put aside this “redistribution of health care” approach (fueled by class and partisan animosity), and do the math on improving, to an acceptable level, the quality of care received by the indigent and uninsurable (along with measures that might actually reduce the cost of health care.)

John Ballard
Guest

With all due respect, friend, that “redistribution” trope pushes my button in a big way. There is redistribution, alright. But it isn’t what is advertised by most people who use the term. It has to do with new wealth and where it is going. I’m not talking about income but *wealth* and they are not the same. Income is the source of new wealth, but it is NOT wealth until it is calculated as a function of NET WORTH. That is the definition of “wealth.” Net worth = assets minus liabilities. Negative net worth means there is no wealth. Plenty… Read more »

John Ballard
Guest

As for reducing the costs, I refer you to another rant elsewhere that starts “insurance is not the problem. Insurance is nothing more than risk management for how charges are to be paid (or not). The real problem is the amounts being charged, which are more often than not way more than they should be.” Costs have a lot to do with uneven distribution… ** Geographic — giant footprints in affluent areas and virtually non in poor and rural areas, ** professional compensation — extravagant executive compensation at the top and poverty-level wages at the bottom, ** huge amounts of… Read more »

Peter1
Guest
Peter1

I don’t know, is the tax exemption on employer paid health care, redistribution or distribution?

John Ballard
Guest

Good observation. Group insurance is by definition health care cost. It is also a human resource expense, not very different from the employer’s matching “contribution” to Social Security. (Don’t you love that word contribution? It makes it sound optional, doesn’t it?) Both outlays are an expense on the balance sheet, and are by definition an employee benefit. Fewer employees or lower wages means lower expenses against profits. Every dollar of group insurance provides the employer accounting credit against taxable profits. Making premiums non-taxable was a clever way of making group insurance more attractive than individual insurance to all parties concerned… Read more »

Aurthur
Guest
Aurthur

“A long-term goal should be uncoupling employment from health care altogether. That would end “job lock” and at the same time put health care costs in plain view of the two parties that should be paying closest attention — providers and their patients.” Sounds good until you consider the facts, like: 1) HIPAA passed in 1996 “solved” the job lock problem, remember. 2) When you uncouple health care from employment, you no longer have the employer (you know the evil profit driven bastards) doing all the leg work, including educating themselves, shopping, negotiating, and usually providing partial payment (ok, tax… Read more »

John Ballard
Guest

I’m sure if we met in person, Aurthur, I would find you to be a very nice guy. Meantime, it’s probably best we agree to disagree about any comment I write.

Bob Hertz
Guest
Bob Hertz

Note to archon41: It is galling to me to hear well-paid tenured professors like Jon Gruber and Paul Krugman say that the persons over 400% of poverty who do not get subsidies are unimportant. Although I normally vote Democratic, I will not mind seeing Obama pilloried by the persons over 400% (which remember is just $62,000 of annual income for a couple.) I would however like someone in Congress to suggest that the subsidies be extended to higher incomes, and phased out gradually instead of having a “cliff” like so many other government programs. If any readers of this blog… Read more »

John Ballard
Guest

One way to help those a little further up the ladder would be lowering the tax destructibility threshold for medical costs. This year medical expenses not reimbursed over ten percent of AGI are deductible for those who itemize. That’s something of an improvement, but anybody whose medical expenses exceed ten percent of AGI is still in some deep shit. That really needs to change. How many people can afford to make ends meet on vinety perxent of what they earn? Very few, I think. Four or five percent would be more helpful, since dental, optical, drugs and anything else not… Read more »

archon41
Guest
archon41

Soon, an Obama adoring media will be showing us with heart-warming accounts of how some have benefited under the ACA. There will also be losers, those who earn too much to qualify for subsidies. “Shocking” is hardly an overstatement of the premiums and deductibles they will be subject to. Many of them will conclude, with considerable justification, that they were cozened, by calculated misrepresentations, into supporting the architects of this act. They are not going to react well to homilies about being on the “wrong side of history.”