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Tag: guaranteed issue

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.

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Health Care and Constitutional Chaos

The Supreme Court’s decision on the constitutionality of the Affordable Care Act (ACA) will likely be handed down on the last day of this year’s term. If the Court finds that the ACA—either in whole or in part—violates the Constitution, the health care industry will be shaken to its core. And, no matter what legal justification the Court uses to invalidate the ACA, the structure of constitutional law will be severely undercut. The resulting medical and legal chaos will be expensive, divisive, and completely unnecessary. Nothing in the text, history or structure of the Constitution warrants the Court overturning Congress’s effort to address our national health care problems.

For the health care industry, a decision striking down the entire ACA would be an absolute disaster. Physicians, hospitals, and private companies have been shifting how they practice medicine in anticipation of the ACA’s implementation. They’ve been creating accountable care organizations,[1] envisioning a significant reduction in uncompensated care, and enjoying increased Medicare and Medicaid reimbursement in primary care settings.[2] That will all vanish if the ACA is struck down. Moreover, seniors will pay more for prescription drugs and young adults will be taken off their parents’ insurance. The private insurance industry, which has seen its market shrink significantly over the last decade,[3] will see a real chance to reverse that trend disappear. According to one estimate, if the ACA is overturned, insurers may lose over $1 trillion in revenues between 2013 and 2020.[4]

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