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ObamaCare Clusterfuck: New 3-page eligibility form may screw states that are farthest ahead on their exchange software

Ha. Obama's big public relations push screws the states that took ObamaCare most seriously, and have done the most work:

[T]he decision [for the shorter forms] could pose problems for states that are already far along in developing their exchange IT systems, according to the executive director of one state-run exchange.

Kevin Counihan, CEO of the Connecticut Health Insurance Exchange, said the change announced Tuesday came after his exchange has already completed coding required for system integration based on the original, 21-page application. The state exchange's IT system may not recognize data from the new form.

Wowsers. Who could have predicted that a late-stage change on all the inputs to the fucking system would cause ripple effects on dependent subsystems? But read on for CMS's response:

Counihan voiced his concerns today to Chiquita Brooks-LaSure, deputy director on policy of CMS' Center for Consumer Information and Insurance Oversight at the National Health Insurance Exchange Summit in Arlington, Va. “Is there anything HHS can do to stop making changes right now,” Counihan asked her.

Brooks-LaSure responded that states have the option of using the new, streamlined application that's three pages long or can still use the original, longer document.

Well, great. If you accept that the original, 26-page sucked, here are the options that CMS just gave the good folks in CT:

1. Start recoding, and try to get the Feds to cover the budget over-run, or

2. Use the 26-page form, and watch your enrollment decrease because of the rotten user experience. Which is exactly what Obama says will happen: "People aren’t going to have the patience to sit there for hours on end."

So Obama throws the CT exchange under the bus because PR, and (as usual) those who trusted the guy got betrayed. Obama's making the Rick Perrys of this world -- the states that don't want to build their own exchanges -- look awfully good, and making his own supporters in CT look awfully stupid.*

NOTE * But then, trusting Obama is stupid. So there's that.

NOTE Oh, and more changes to come, kidz! Obama promises:

"[OBAMA:] Those kinds of refinements, we’re going to continue to be working on."

Ever been on an IT project where top management kept making changes all the way 'til the last minute? How'd that go?

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Rainbow Girl's picture
Submitted by Rainbow Girl on

Great word choice by Obama-PR-Man. Makes it sound like every gut re-do of the whole system is really just a new paint color for the crown moldings.

I feel bad for Connecticut only insofar as they trusted Obama. If they have to start raising taxes to finance a full overhaul of their IT Exchange, there will be a revolution in Connecticut. That could be a good thing.

beowulf's picture
Submitted by beowulf on

That reminds me, you know what else was three pages? Sam Gibbons's 1991 bill to make Medicare universal. It would have expanded benefits, eliminated monthly premiums and increased Medicare taxes. But the heart of the bill was this sentence:

Every individual who is a citizen or national of the United States or who is an alien lawfully admitted for permanent residence or otherwise lawfully residing permanently in the United States under color of law is entitled to hospital insurance benefits under part A of title XVIII and to supplementary medical insurance benefits under part B of such title, beginning with January 1,1993. [that is, roughly a year and a half after bill was introduced]

It should go without saying that there is Senate precedent for a bill like this (that amends Title XVIII of the Social Security Act) to pass via the filibuster-proof reconciliation process. But then the Washington Generals aren't supposed to win so forget I even mentioned this.

Rainbow Girl's picture
Submitted by Rainbow Girl on

This needs to get out there with Lambert's One-Liner about LBJ getting Medicare rolled out to all over-65-ers in one year. Without computers.

"Medicare Parts A and B for All: Pass the three page bill."

beowulf's picture
Submitted by beowulf on

I'd call it universal Medicare (which isn't perfect) to differentiate it from the more comprehensive benefits package of Medicare for All. Besides since 1991 they've added Part C ( Medicare Advantage) and Part D (drug coverage).

Seeing as the military's Tricare program has stronger benefits for military members, retirees and their families than Medicare does for seniors (an anomaly probably due to Ted Kennedy serving on Senate Armed Services and not Finance Committee), one thing I'd change about Gibbons's bill would be to to simply require Medicare to provide at least the level same medical and dental benefits as Tricare (instead of that business about preventive care-- which Tricare already covers).

Rainbow Girl's picture
Submitted by Rainbow Girl on

Ah. So why not Tricare for All?

Any Medicare for All should be Parts A,B,C plus a new "D" that doesn't embed pharmaceutical company gouging or donuts -- i.e., RX coverage with price schedules as negotiated directly by Fed Gov with pharma companies with no carve outs or curly cues or formularies.

beowulf's picture
Submitted by beowulf on

Tricare is run by the Dept of Defense, There's no technical reason Congress couldn't just open it up to everyone but administratively it makes it more sense to supersize Medicare (in HHS) instead of Tricare.

As for supplemental insurance... well, Tricare by itself is pretty awesome. Yes, it already negotiates drug prices w/ low co-payments and no donut holes. Deductible for single person is $50 with a $500 annual catastrophic cap for families, $100 w/; a $1000 annual cap and Tricare ordinarily doesn't charge any premiums.

A 3 page bill that put everyone into universal Medicare with Tricare benefits and no premiums would get everyone on the bus. Then, whatever else needs fixed can be addressed in a follow-on Medicare for All bill (which might be more than a few more pages). :o)

katiebird's picture
Submitted by katiebird on

Although I'm pretty cynical about a future of politicians "voting" on each and every medical benefit. Wish I could think of another option.