Submit your comments on this article | |
Government | |
States Lowering the Bar for O-Care Implementation | |
2013-07-05 | |
Facing tight deadlines and daunting workloads, states across the country are scaling back ambitions for implementing the Affordable Care Act. At a monthly board meeting of Connecticut's health insurance exchange, members of the standing-room-only crowd got a reminder that they, too, were behind schedule. The insurance marketplace they were working on nights and weekends won't be completely ready on time. "It is highly complex, it's unprecedented and it's not going to be smooth," Kevin Counihan, chief executive of the state's exchange, Access Health CT, told the group. The man whose job didn't exist until O-care. Who is paying HIS salary? That's why Connecticut -- like other states across the country -- has lowered the bar, doing what it can in the time it has left before the health-care law's major programs are launched Oct. 1. Although the states are promising to provide new marketplaces for individuals to compare and buy health insurance plans, the Web portals will be a bare-bones version of what was initially envisioned. Can't you already get comparisons at Progressive? And then there are the federal setbacks. The Obama administration has put off significant aspects of the health-care overhaul as it races to finish provisions that will give Americans more insurance options and provide many with financial assistance to buy coverage. On Tuesday, the White House announced a decision to delay the "employer mandate," a requirement that employers with 50 or more workers provide coverage. Once again demonstrating it is harder to actually govern than to bloviate. "In 2011, there was this 'we're going to save the world' mentality," said Rebecca Pearce, executive director of the Maryland Health Benefit Exchange. "In 2013, it focuses more on how do we deliver on the requirements of the law." Another executive's salary paid by borrowing from the Chinese. The District of Columbia and 15 states -- including Connecticut -- are building their own marketplaces. Those jurisdictions, among the Affordable Care Act's most ardent supporters, took on the responsibility of building Web portals that are at the heart of the federal health-care overhaul. Most states, eschewing the heavy workload, left the task to the federal government. The White House expects 7 million people to buy health insurance or enroll in Medicaid through these Web portals. Millions more are likely to browse these sites for health plans and explore possible options under the federal law, which imposes an "individual mandate" requiring most people to obtain coverage or pay a penalty. Or be excused through a political favor. In Oregon, officials decided to delay a feature that would allow consumers to customize searches for rating the coverage provided by insurers. And a feature for insurance brokers to track the consumers they enroll will wait for two to four months. How will brokers keep track of potentially thousands of customers in the interim? Cover Oregon's executive director, Rocky King, suggested that they might use "index cards". "I know the agents will have all their Excel worksheets," King said. "We've gone to them and said: You're our priority sales force, but you're not necessarily the priority for how you access the system. The consumers are. " Connecticut has made progress. It was the first state to complete an intensive technology test in which the state's portal successfully connected to a federal data hub. But officials have learned that good news can have a downside. The state agency spent weeks reprogramming its Web site after the federal government shrank the insurance application from 21 pages to three. When the Supreme Court struck down a key element of the federal Defense of Marriage Act, Access Health CT board members cheered. Then, they remembered that it would add to the workload: The marketplace would now need to recognize same-sex marriages, a coding change unlikely to be ready for October.
Van Loon. He's in the right place! | |
Posted by:Bobby |
#25 Oh wow. Personal insults from the super lib. Surprising. Oh I am shocked. |
Posted by: DarthVader 2013-07-05 22:06 |
#24 Badanov - goose, gander. Go back and read the ad homin swill and childish insults directed at me by your boy Beavis, homo euro et al My bad. Thought you wanted a debate. Sorry Keep heading in that direction. |
Posted by: badanov 2013-07-05 22:02 |
#23 Thanks for the tip Lex; wouldn't have checked out Beavis' KP plans without you. They smoke my current policy. |
Posted by: swksvolFF 2013-07-05 20:15 |
#22 Badanov - goose, gander. Go back and read the ad homin swill and childish insults directed at me by your boy Beavis, homo euro et al |
Posted by: Lex 2013-07-05 20:10 |
#21 equitable system now This is my favorite part of the chew toys arguments. If all sucks fairly for everyone, that's a plus |
Posted by: Beavis 2013-07-05 20:02 |
#20 Of course, the smart, fair, efficient and effective way to expand the risk pool to the max is through single payer This proves you don't understand risk pools. Insurance is the transference of an unknown, risk, for a known, money. If I underwrite Dolly Parton's tits for x amount of money and charge y, my exposure for the next pair hasn't changed. |
Posted by: Beavis 2013-07-05 19:55 |
#19 Lex, you are veering dangerously close to ad hominem responses. If you want to continue with here, you'd better stop. You still haven;t answered the question: If health insurance is so evil, why are citizen's forced to buy health policies? |
Posted by: badanov 2013-07-05 19:52 |
#18 I'm sorry I do understand this better than you ever will Lex or is it Chesney Elmeter4351 now? Ever figure out if Ezra Klein is Kliff in drag? BTW your 2 day tirade has been with UHC now suddenly it's Anthem, they deny your lithium? |
Posted by: Beavis 2013-07-05 19:45 |
#17 Re Beavis's second cut-and-paste effort, from Glenn Kessler, this is more credible - at least these are closer to actual contracted rates - yet Kessler, too, is engaged in a sleight-of-hand. Argument by individual anecdote won't cut it here. It's to be expected that rates will rise for SOME - not most, not all - people, specifically ultra low-risk, younger, healthy plan members like the single 25 year-old that Kessler cherry-picks as his sole example. The whole point of a large risk pool is that healthy people subsidize the people who are very ie very expensively sick. So a small sliver of the population - young healthy singles - that's been paying nothing or close to nothing is now going to pay something closer to a reasonable rate in line with what everyone else pays so as to ensure access to people who've had been shut out of the system entirely by rapacious, cherry- picking for-profit insurers. The ACA should have eliminated profit altogether from the private insurance sector, but the political reality is that, alone among industrial democracies, we've allowed these jackals to buy off our political class, so the ACA is a compromise that, alas, preserves the worst feature of the system. Fortunately, next year Californians will vote to FINALLY at least introduce some effective insurance regulation to healthcare, so the worst effects of for-profit insurers' tricks will be mitigated from 2015 onward. Of course, the smart, fair, efficient and effective way to expand the risk pool to the max is through single payer, funded by a generalized tax such as a VAT. Your healthy single 25 year- old would end up paying even more into this system than he would via higher premiums as per the ACA. But single payer, ah, that's the road to serfdom, right? Can't have a rational, efficient, equitable system now, can we? How would Beavis earn his keep? |
Posted by: Lex 2013-07-05 19:42 |
#16 "Beavis" lives up to his namesake. Avik Roy's ridiculous pseudo-analysis is a joke. if Beavis actually knew what he was talking about, he would not be cutting and pasting from Roy's ridiculous pseudo-analysis. Clue #1 for Beavis: numbers scraped by an aggregator for complex insurance plans have little relationship to actual, final quotes. Only a fool or a hack would rely on these bogus numbers. Clue #2: even if one were to get a low rate from one of the old, unregulated, pre-ACA plans, the old system allows insurers to rapidly jack up the new policyholder's rates. Bait-and-switch is not only legal under the current joke of a system in CA, it's routine. Yours truly signed up with Anthem last year and saw them raise rates on us TWICE, by 24% and then another 23%, WITHIN SIX MONTHS. Somehow your brilliant Forbes magazine analyst - the guy you think is so eloquent and insightful that you put aside your own vaunted expertise and let him do all your talking for you - failed to understand this most basic of all the shitty stunts routinely pulled by the health insurance mafia. There are plenty of additional errors in this joke of a piece, but I'll leave it here for now. Someone who doesn't even grasp the concept of bait and switch (perfectly legal under the current system btw), who relies on BS from an aggregation site rather than actual contracted rates, isn't to be taken seriously. (And yet even Roy had to gently remind his clueless NRO readers that, er, they too are recipients if taxpayer-subsidized insurance: $300 billion per year from tax-exempt subsidies for employer-sponsored plans; $700 billion per year from th Social Security Act aka Medicare.) Beavis, come clean. You're not really an expert. You're just shilling for one of the current system's birds of prey. Anthem? UnitedHealth? Do tell, frontman. |
Posted by: Chesney Elmeter4351 2013-07-05 19:20 |
#13 Trailing wife - I'm well aware of IT implementation cloosterphuques. Fear of same and their massive price tags are what keeps single-source IT vendors in business. Re the source of the article, Sarah Kliff, interesting that the 'burgers have yet to post any of her articles or the many others detailing California's and Oregon's huge success so far in attracting exceptionally affordable plan bids from insurers participating in the states' ACA exchanges. As usual, the defenders of our current Frankenstein-kloodge have it backwards: instead of collusion, price-gouging, DOB for people who deserve benefits and predatory behavior of all kinds, we now are seeing real competition among ethical plan providers in a transparent and properly regulated market. And slimeball firms like UnitedHealth are exiting the market, leaving a cleaner and more consumer-friendly marketplace. Again, to make it really simple, the predatory old system gave Californians 170% price INCREASES over the last decade. The new ACA exchanges are bringing price DECREASES, plus access to insurance hundreds of 000's of Californians whom the old system cruelly allowed the rapacious providers to deny altogether due to the BS pretext of a "ore-existing condition." Do you guys like having your pockets picked? Why on earth would you stand up for the broken, ridiculously wasteful, financially ruinous old non-system? Here's Kliff: http://m.washingtonpost.com/blogs/wonkblog/wp/2013/05/23/california-obamacare-premiums-no-rate-shock-here/?wprss=rss_ezra-klein |
Posted by: Lex 2013-07-05 16:47 |
#12 Don't forget the lawyers, they will do well. |
Posted by: swksvolFF 2013-07-05 16:40 |
#11 None, Matt. After all, they are just voters and peasants. But you can bet that contractors who contributed to the cause will get some very lucrative contracts. |
Posted by: Ebbang Uluque6305 2013-07-05 16:07 |
#10 I ask you, if the system is this complicated, what guarantee do we have that the boodle will wind up in the pockets of Democratic voters, like Congress intended? |
Posted by: Matt 2013-07-05 15:30 |
#9 Imagine my surprise when assigned to a $ 4.5m SW development project under DIA when it is discovered that the Army had already developed [and was using] a nearly identical, but infinitely more advanced capability. Funding and research grants for the DIA program continued, and may yet continue today. Sadly, the waste to be found in SW and IT development project within the beltway is legion. |
Posted by: Besoeker 2013-07-05 14:43 |
#8 TW, I'm one of those that commented before if my memory is correct. You are absolutely correct. I worked for SAP trying to help guide the SAP portals package of "tools" for Naval Aviation. The fustercluck was mind-boggling and the "solution" was for contractors to be hired enmasse with contractors hiring contractors. It was a total disaster living up to every nightmare of an out of control IT project; and even inventing a few new nightmares. |
Posted by: AlanC 2013-07-05 14:28 |
#7 I might add that, for some strange reason, whenever any level of government gets involved in a computer project you can multiply the cost by about a million. |
Posted by: Ebbang Uluque6305 2013-07-05 14:18 |
#6 Heck OS, even the people who rattle for collectivization had to concede that in order for it to be implimented it had to be done right the first time. They got palosi the carrot, reid the stick, and obama the cart driver. Sebilius was almost immediately handing out do not have to follow the law cards, obama who thinks the best way to promote this law is to be so involved with golfing that there is no way he has enough time to actually oversee this historical tax, and at its peak crises point decides a tour de afrique is the right thing to do. I'm sure they have their top. men. earnestly trying to get this put together, and here they decide to punt until after the next election cycle. And who is going to data entry those techno illiterates into the databank? How many languages? How many people will need to be hired to do the data entry? If its a tax issue and people cannot afford the accountants to figure this out for them, will there need to be a |
Posted by: swksvolFF 2013-07-05 13:04 |
#5 Any number of competent systemengineers could have looked at the requirements, timeline and resources, and told you that this was impossible. Oh wait, THEY DID! But Obama, Reid, Pelosi and company ignored them. If we had a truly free press (not the self-enslaved one we have now), those 3 people would be getting hammered for their malfeasance in passing Obamacare before they read it and adequately discussed it with the public. |
Posted by: OldSpook 2013-07-05 12:24 |
#4 There is the Right way and the lex way, and I too am interested in the difference. I have been expecting a 30% increase to supply chain costs, and have seen 10% over the last 18 months. But hey, glaad to see hooters turned into poles on the employee I can't hire's dime. Wait, that person is unemployed so its on my quarter. |
Posted by: swksvolFF 2013-07-05 12:12 |
#3 We discussed this at great length here some months ago, but I can't find the link -- sorry. As I recall, a number of Rantburgers have direct experience with this kind of thing at both the state and federal levels, and concluded bluntly that the project is not do-able for any amount of time or money. If someone could find the link, I would be grateful. It would be useful, particularly for Lex, who has a background in government and computer stuff, but wasn''t around at the time. |
Posted by: trailing wife 2013-07-05 12:04 |
#2 What a fostercluck. If DOMA requires a manual work-around, we'll do that. ewwweue. |
Posted by: swksvolFF 2013-07-05 11:52 |
#1 The District of Columbia and 15 states -- including Connecticut -- are building their own marketplaces. Those jurisdictions, among the Affordable Care Act's most ardent supporters, took on the responsibility of building Web portals that are at the heart of the federal health-care overhaul. Most states, eschewing the heavy workload, left the task to the federal government. Web portals can be damnably difficult to build, maintain and protect from hackers. Expensive too. Just serving up static web pages is hard enough but when you put a database and a whole lot of programmed, interactive features into it you go to a whole other level of complexity. I suppose it is the contemporary way to do business but you run into a whole lot of very contemporary problems too. I wonder if they'll outsource any of the programming to foreign countries? Maybe they'll hire some H1B workers. At any rate, it will cost a fabulous amount of money. |
Posted by: Ebbang Uluque6305 2013-07-05 11:48 |