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ObamaCare

healthcare.gov opens at midnight on the day of the government shutdown and lambert finds a bug

[And if you have your own experiences to share, and especially screen dumps, please add them in comments or contact me. Either Federal Exchanges, or state exchanges. I'm especially interested in Covered California! Thank you! --lambert]

Nice timing.

john.smith@gmail.com from Maine had a registration #FAIL at step 3. Here's the screen dump:

Read below the fold...

ObamaCare: ObamaCare's mental health coverage

One of ObamaCare's features not often touted is that mental health coverage is one of the essential benefits. Unfortunately, mental health coverage has all of ObamaCare's other coverage problem, except moreso. About the benefits:

Long-awaited improvements in insurance coverage for mental conditions and addictions are expected to become more widely available this year as a result of two major steps that the Obama administration has taken.

The president’s signature Affordable Care Act includes mental health care and substance abuse treatment among its 10 “essential” benefits, which means plans sold on the public health care exchanges must include coverage.

In addition, rules to fully carry out an older law — the Mental Health Parity and Addiction Equity Act of 2008 — were issued in November, after a long delay. The parity law says that when health insurance plans provide coverage for mental ailments, it must be comparable to coverage for physical ailments. For instance, plans cannot set higher deductibles or charge higher co-payments for mental health visits than for medical visits, and cannot set more restrictive limits on the number of visits allowed.

So far, so good. So, knowing what we know about ObamaCare, what would be the first question to ask? Read below the fold...

ObamaCare Clusterfuck: Democrat hack Joan Walsh makes Ezra Klein look like a paragon of integrity

It wasn't easy! Yeah, I subscribe to Salon's news feed, so every once in awhile I hold my nose and click through to Joan Walsh, "progressive":

Ezra Klein trolled the right by declaring that it means “Obamacare has won,” which is pretty funny given that he helped lead the national freak-out over Healthcare.gov’s troubles back in October.

Read below the fold...

ObamaCare Clusterfuck: Obama throws Sebelius under the bus, brings in a Rubinite

Politico:

Health and Human Services Secretary Kathleen Sebelius is resigning six months after a disastrous rollout of President Barack Obama’s signature health law, according to administration sources.

On Friday, Obama will nominate Sylvia Mathews Burwell, the director of the Office of Management and Budget, to replace her.

Sebelius, 65, gave no hint of her imminent departure as she testified Thursday before a Senate panel.

So, did she fall or was she pushed? I say pushed: Read below the fold...

mellon's picture

The bad actors in Washington can't even be original. Will the same-old 1994 good cop/bad cop scheme succeed again in 2014?

Assuming the reader has already read the two papers linked at the bottom, and keeping in mind the made for TV drama now playing itself out in Washington, now, please take a look at The Selling of "Clinton Lite", by Trudy Lieberman, from the March/April 1994 issue of Columbia Journalism Review, Read below the fold...

ObamaCare Clusterfuck: Paul Krugman's TINA hackery on single payer becomes floridly delusional

Get a load of this:

And as Sahil Kapur reports, at least a few of them are coming to a terrible realization: there is no alternative [TINA]. You can’t just support the popular pieces of reform, in particular coverage for preexisting conditions, and scrap the rest. As Jonathan Gruber taught me, and I and others have said many times, reform is a three-legged stool that requires community rating, the individual mandate, and subsidies; take away any leg and it collapses. And Kapur finds a GOP aide who admits to the awful truth: any workable GOP plan would look pretty much the same as Obamacare.

There is an alternative, even for Republicans: Read below the fold...

ObamaCare Clusterfuck: NEJM: ObamaCare delays "appear to exceed the traditional scope of the President's enforcement discretion"

Shorter: They're illegal.* The New England Journal of Medicine, the gold standard:

The Legality of Delaying Key Elements of the ACA
In the administration's view, the delays are a routine exercise of the executive branch's traditional discretion to choose when and how to enforce the law. As the Supreme Court noted in its 1985 decision in Heckler v. Chaney, 1 an executive agency “generally cannot act against each technical violation of the statute it is charged with enforcing.”

Read below the fold...

ObamaCare Clusterfuck: Will there be double-digit price increases in 2015, or will there be even crappier plans?

Insurance industry insider Bob Laszewski writes:

To properly price the exchange health insurance business going forward the carriers have to sharply increase the rates. A senior executive for Wellpoint, which sells plans in 14 Obamacare exchanges, is quoted in a Reuters article telling Wall Street analysts there will be big rate increases in 2015, "Looking at the rate increases on a year-over-year basis on our exchanges, and it will vary by carrier, but all of them will probably be double digits."

If the health plans do issue double digit rate increases for 2015, Obamacare is finished.

There are a ton of things that need to be fixed in Obamacare. But, I will suggest there is one thing that could save it.

Crapify the plans! Read below the fold...

ObamaCare Clusterfuck: Obama claims 6 million sign-ups, but as usual the numbers are soft

KHN:

The Congressional Budget Office originally estimated that 7 million people would sign up for the exchanges by the end of the enrollment period. After computer problems botched the Oct. 1 rollout, the CBO revised that estimate down to 6 million. Federal officials have said they do not yet know how many people who have enrolled have paid their first month’s premium. Insurance industry officials have reported that about 70 to 80 percent of enrollees have paid.

So, the lowballed 6 million figure is really 6,000,000 * 80% = 4,800,000. But KHN misses the key point! Read below the fold...

ObamaCare Clusterfuck: Jon Walker discovers that rentiers charge rent

FDL:

[T]his working paper from Mark Duggan, Amanda Starc, Boris Vabson is about Medicare Advantage I think its provides some insight into the core problem with the entire design of the Affordable Care Act’s coverage expansion. It looks at what was the result off the government overpaying for seniors in Medicare Advantage, which is an exchange where seniors shop for subsidized private insurance. From the summary:

Our results demonstrate that the additional reimbursement leads more private firms to enter this market and to an increase in the share of Medicare recipients enrolled in [Medicare Advantage] plans. Our findings also reveal that only about one-fifth of the additional reimbursement is passed through to consumers in the form of better coverage. A somewhat larger share accrues to private insurers in the form of higher profits and we find suggestive evidence of a large impact on advertising expenditures.

If you spend a lot of money on a Rube Goldberg [hat tip, DCBlogger] system with middle middlemen some benefits will trickle down to regular people but huge amounts of money will be eaten up in profits and waste.

I don’t doubt the Affordable Care Act will actually help some people, but at an exorbitantly inflated price because of how inherently wasteful the design is. This creates a needless burden for all taxpayers and premium payers on the exchanges.

If only we had known this when ObamaCare was being passed! Read below the fold...

ObamaCare Clusterfuck: I'm not the only one saying ObamaCare is like a maze for lab rats

Here's the graphic that Kaiser (!!) is using:

Read below the fold...

ObamaCare Clusterfuck: Obama relaxes the deadline for the individual mandate

Bob Laszewski was right. WaPo:

The Obama administration has decided to give extra time to Americans who say that they are unable to enroll in health plans through the federal insurance marketplace by the March 31 deadline.

Federal officials confirmed Tuesday evening that all consumers who have begun to apply for coverage on HealthCare.gov, but who do not finish by Monday, will have until about mid-April to ask for an extension.

Under the new rules, people will be able to qualify for an extension by checking a blue box on HealthCare.gov to indicate that they tried to enroll before the deadline. This method will rely on an honor system; the government will not try to determine whether the person is telling the truth.

Nudge nudge wink wink. Boy, I bet all the people who took the mandate seriously are feeling pretty stupid right now. Read below the fold...

ObamaCare Clusterfuck: Is the individual mandate a dead letter law?

Bob Laszewski seems to think so:

Will the 2014 mandate to buy health insurance be enforced come tax time?

It sure doesn't look like it.

To be sure, the administration is not making any major announcements prior to the close of open enrollment on March 31 the better to get as many people to sign-up as possible. ...

A Treasury Department spokesperson (the IRS is charged with enforcing the mandate) said, "the rules are clear and taxpayers should be able to determine whether they had coverage for 2014, or if not, whether they owe a fee." But the spokesperson then pointed out the fee will be imposed only on those who don't have a valid exemption.

What's a valid exemption?

The administration just published a list of 14 valid exemptions with the first 13 including such things as having suffered from a flood or other disasters, the death of a close family member, and not finding an affordable alternative for a cancelled policy.

Then there is the 14th exemption: "Another hardship in obtaining health insurance." That is all number 14 says. ... Read below the fold...

Obamacare Clusterfuck: Some premiums to double in 2014

The Hill:

Health industry officials say ObamaCare-related premiums will double in some parts of the country, countering claims recently made by the administration.

The expected rate hikes will be announced in the coming months amid an intense election year, when control of the Senate is up for grabs. The sticker shock would likely bolster the GOP’s prospects in November and hamper ObamaCare insurance enrollment efforts in 2015.

"... I think everybody knows that the way the exchange has rolled out … is going to lead to higher costs,” said one senior insurance executive who requested anonymity.

The insurance official, who hails from a populous swing state, said his company expects to triple its rates next year on the ObamaCare exchange.

The hikes are expected to vary substantially by region, state and carrier.

BWA-HA-HA-HA-HA-HA!!!! Read below the fold...

ObamaCare Clusterfuck: Democrats organize civil disobedience for Medicaid expansion (but not, of course, for single payer)

Atlanta Journal-Constitution:

More than 40 people were arrested Tuesday in a string of protests targeting Gov. Nathan Deal’s decision not to expand Medicaid in Georgia under the Affordable Care Act. Dr. Raphael Warnock of Ebenezer Baptist Church where the Rev. Martin Luther King Jr. was pastor, was among those placed in handcuffs by Georgia State Patrol troopers. Warnock and a group of supporters staged a sit-in outside of Deal’s office Tuesday afternoon. They were arrested without incident and led away as the remaining crowd of protesters sang “We Shall Not Be Moved”

So fucking pathetic and tragic. Surely Dr. Raphael Warnock knows there is a better alternative for his congregation, and the protesters, then neo-liberal infested and cheapass Medicaid?* If he doesn't, he's a fool. If he does, he's a cynical manipulator. Read below the fold...

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