Obama On Obamacare: Honesty Is NOT The Best Policy

obama-obamacare-boston-speech

This weekend showed the mendacity of the Obama Administration on the continued debacle of the rollout of the Affordable Care Act.

Saturday was the deadline that Obama himself proclaimed for full functionality of the Healthcare.Gov website.  We were told, all last week, that the government was working day and night to achieve ‘success’.  And then Sunday morning, Voila!  The White House proclaimed they had achieved their goals.

Except for one problem:  the reality is that the website is far from fixed.

First, the metrics that the White House themselves have used for ‘success’ has been slowly been moving downward since Obama made his proclamation in early October.  At first, it was that 80% of applicants could complete their insurance purchasing process through the website.  Then, it was that 80% of people could actually complete the application on the website, and have the process completed in steps unrelated to the internet (paper applications, for example).  Now, the criteria is that at 80% of people can sign on to the website.  They no longer even discuss completing the process.

Even more laughable is that HHS states that they have achieved their goal of the website being up and running 90% of the time.  Let us put aside the fact that 90% success of a website is pathetic; what is even worse is that 90% is noninclusive of downtime from scheduled maintenance that the website requires almost daily.  So when the website isn’t down for fixes..it is functioning at 90%.  Not much of an achievement.

“Healthcare.gov on Dec. 1 is night and day from where it was on Oct. 1,” Jeff Zients, who was brought in to oversee fixes to the troubled Obamacare website, declared during a Sunday conference call.  That may be true, but that doesn’t mean we have achieved any level of success.

Furthermore, when HHS was specifically asked by Washington Post Health Care blogger Sarah Kliff whether their problem with the 834 forms (essential data necessary to insurers to complete the purchasing process) have been solved..they refused to answer.

My contacts in the insurance industry have said that there have been small improvements, but overall, the problems persist.  So much so, the insurance industry put out a statements stating that although the website has improved, major problems remain, and are nowhere near to fixed.

Today the White House was proclaiming that 100,000 people have signed up to Obamacare in November, claiming another victory.  Again, this can only be considered a victory if you wear rose-colored glasses.  Yes, it is better than the 26,000 sign ups in October, but a fraction of the 800k expected in November.  At the current pace, Obamacare would need approximately 56k purchasers a DAY to achieve their goal of 7 million by the end of March.

The White House would be better served by admitting the truth.  Admission of the faults in the program such as that the entire program is running well behind schedule, and needs to be delayed, and that the website may need to be rebuilt are simple realities that the public may be willing to forgive.  The administration seems to be unwilling or unable to make such an honest assessment, either because of political or practical realities.  But trying to fool the American people that any of these metrics are any type of ‘success’ is likely a level of mendacity that will only lead to failure.

 

Obamacare Rollout: What We Know, 1 Month Later

20130403_Obama_Sebelius-620x320

So, as November 1st arrives, we were supposed to get a good feel if the rollout of the Affordable Care Act was going as planned, trajectory of insurance purchasers, relative cost comparions, etc.

We really have none of the above.

The website debacle has basically brought the entire process to a standstill.  People either were unable to purchase insurance, or were so turned off that they didn’t bother.

So what we don’t know, and the data lacking therein, far outnumbers the things that we demonstrably do know.

So, to get past the political spin, what data is there? What, if any, conclusions (partial or otherwise) can we make?  What do we know, for certain?

1.  The Website has issues; major issues. 

The website problem is not a simple fix.  Testimony this week on Capitol Hill clearly demonstrated that.  The officials from the Department of Health and Human Services, as well as contractors paid to build the web platform, didn’t agree on much, but they did agree on that.

A repeated promise was made in hearings however:  that the website would be operational by November 30th.  That is a dubious promise.  If the problems that exist in the website are as reported, it is not simply fixing a few lines of code that will make everything all right. There are major isuses, not only with the code but the basic structure of the system, the transfer of data from the web platform to-and-from major databases, and communication with the insurers themselves.

It will take a Herculean effort to truly make the system operational by the end of November.

Furthermore, the tech surge that President Obama largely seems to be rhetoric, as the majority of those chosen to run the new effort are long term Beltway insiders.  If anything should give you pause, that should.

2.  Medicaid enrollees are far outnumbering purchasers of insurers. 

This may be the most worrisome part of what has happened over the last month, even more than the website issues.  Fundamentally, the entire premise of the ACA rests on the balance of having new people buy insurance on the markets, to partially ‘subsidize’ those millions being added to the Medicaid rolls.

As a Washington Post article today noted, on many of these exchanges, Medicaid enrolles are ounumbering purchasers 9:1. That is a death knell for the system if it continues.  As the CBO reported from the beginning, we need closer to a 1:1 ratio (the CBO says the ratio of Medicaid enrollees:insurance purchasers should be approximately 9.1:7.9, to be precise) to maintain fiscal sustainability.

However, we simply don’t know if this is a short term blip or a long term trend.  This could all be a result of the poor website functionality, which then had a ripple effect in the marketplace.  Or it could honestly be that purchasers don’t like what they see, and may choose option B, the Obamacare tax penalty…which would be fiscally disastrous for the system.  That would be the leading edge toward the ‘death spiral’ that the Administration and insurance industry fears so much.

3.  The Administration has come catch up to do to make their enrollment targets for 2014. 

To maintain the system, they need a minimal number of paying customers in the Exchanges, as described above.  The number the CBO has stated is approximately 7 million by the target date (which, after the White House pushed it back, is now the end of March).

They had expected to sign up about 500,000 people by the end of October.  That number will be missed by a large margin.  Secretary of HHS Kathleen Sebelius refused to release the numbers, but most estimates state that the number of policies actually sold will be far less than 100,000

That number is not going to significantly improve in the month of November, because the website is still largely nonfuctional. Then comes the busy month of December, with the intrusion of the holidays.

My guess (and it is only a guess) is that they may not meet their goal for October 31 of 500k purchasers even as of January 1, 2014.

If that holds true, or even if they do better than expected and get up to 1 million person mark, that means that they will have to sign up 6 million persons in three months time.  That is a huge hill to climb.

4.  Liberals blaming Republicans for this mess don’t really have many facts backing up the claim.

Liberals to this day are blaming the ‘intransigence of Republicans’ for the failures in the system.  However, this has been simply disproven:  go to a number of states that have Democrat Governors and legislatures, that have been implementing Obamacare from the beginning, and see if they are doing better.

For the most part, they are not.  Take Oregon, who as of earlier this week, had not had any purchasers of insurance through their exchanges, though they have had tens of thousands of enrollees in Medicaid.  California, New York and others are not much better.

This is largely not a political problem at this point, but a problem of managerial competence or lack thereof.

5.  We have anecdotal evidence of people paying more for insurance after losing their insurance.

This is ONLY anecdotal evidence at this point; and that makes it very hard to really analyze.

Definitely millions of people are losing their current insurance because of the ACA and associated retgulations that are term limiting those insurance plans.  Democrats can blame the insurers, but that is a lie:  the full responsibilty of that process lies with the ACA.  The vast majority of these plans would still exist today if not for the ACA; it is as simple as that.

As for increased health care premiums, we won’t know for a long time if that is a systemic problem, or an isolated one.  Democrats claim those cases are the exception, Republicans claim they are the rule.  The truth is neither side has enough data to make such absolute claims.  And that data will take a long time in coming.  It may take months, but more likely years to know if the ACA is bending the cost curve up, down, or has no effect.  I have my suspicions, but there are only that:  suspicions.

6.  Conservatives should not rejoice; the plan can still be saved.

I know, this is a shocking statement coming from me, considering I have been so pessimistic about the system as a whole.  But the truth is, if there were competent managers in charge of this, this rollout could have gone much better.

The website debacle has a snowball effect, to be sure. We don’t know how many people, but certainly hundreds of thousands of people if not more would have gone on to the exchanges and, most likely with the help of subsidies, purchased insurance if they were allowed to.

Incompetence prevented that.

Where the rubber meets the road is getting people who will not receive a significant subsidy to purchase on the exchanges.  Now, this is really the hard part for Democrats.  So far, from what little I have seen, the insurance plans on the exchanges are more expensive and provide less financial coverage than many plans that were available prior to the ACA.

Democrats will counter that these plans provide ‘more’ coverage.  There is some truth to that, but much of that coverage is not really beneficial to the majority of consumers.  Furthermore, remember that the primary demographic that they must convince to open their pocketbooks and purchase insurance, instead of paying the penalty, is the young, healthy American.  How many of these people are thinking about ‘better’ coverage when they don’t use the coverage they have today?  Are they going to be willing to pay $100-$200 more a month for something they don’t use?

We simply don’t know the answer to that.

Overall, it has clearly been a rough month for supporters of Obamacare, as nothing seemingly has gone right in their rollout.  Can the system be saved? Yes, but it will take not only a Herculean task on the IT side, but a lot of selling by President Obama and the White House, along with a lot of luck, to convince people to do what is not in their short term interest (i.e. purchasing more expensive health insurance) while promising dubious long term benefits.

Obamacare’s Debacle Denialists: The Sebelius Hearing Version

BX1TF_tCIAAaRFn

I have, both here and on social media, talked a lot about the denial the left is suffering from when confronting the realities of the train wreck that the Obamacare implementation has become.

Today’s hearing with Health and Human Service Secretary Kathleen Sebelius was a perfect example.

As the person in charge of this implementation, you would presume that she would have the most up-to-date information on the program.  That she would be able to quickly and promptly answer where in the process the repair of the exchange website we are.  And, that she could tell us what the legal standard for the law is.

You would be wrong on all counts.

To put it succinctly, Sebelius’s testimony also turned into a train wreck.

But let us give her credit.  Sebelius started the day by taking full responsibility for the website’s failures.  Good, right?  The only problem is, she spent the rest of the day trying to convince the hearing members that it wasn’t her fault, but everyone else’s.  She primarily blamed the contractors for not telling her the truth that there were problems with the site; that is, of course, now documented to be false.  They have documented that they were not provided the access or authority to test the site fully, and that authority only resides at HHS.

But it gets worse.  When questioned about the websites security measures, she could not confirm that it was ever tested for security leaks.  Again, to the contractors credit, they documented that they sent a memo to Sec. Sebelius in the end of September stating this fact…and yet HHS did little or nothing to insure the security of millions of Americans’ data.

Sebelius then made what I thought was going to be the most remarkably stupid comment of the day (but wasn’t) when she claimed…wait for it…that the website has never crashed.   She claimed,  “It is functional, but at a very slow speed and very low reliability.”  But as the graphic at the top of this post shows, the site was not functional during her testimony.  You would think she would have checked before going out there and made this ludicrous statement.

As if things couldn’t get worse, Sebelius was then asked why she didn’t go to the Washington, D.C. exchange to get her own insurance.  She claimed that because she is a Federal employee it would be illegal for her to do so.  The problem?  That is completely and factually incorrect, as the graphic from the HHS site shows:

eli

In other words, the HHS Secretary doesn’t know that the law she is trying to implement would allow her to join the D.C. exchange, as her own HHS website clearly shows. You cannot make this level of incompetence up.

After all that, you wouldn’t think that Ms. Sebelius could worsen this debacle; you would, of course, be wrong. During the exchange asking her about the legality of her joining the D.C. exchange, her hot mic caught this little tidbit:

Rep. Billy Long (R-Mo.) asked her to answer, “yes or no,” whether she’d be willing to drop her federal employee health coverage and buy insurance in the exchanges if she could.

“If you can, will you?” he said.

Sebelius claimed that she thought it would be illegal for her to use the exchanges — but that’s not actually true.

Then Rep. Henry Waxman (D-Calif.) made a unanimous consent request so he could ask a question out of turn. Sebelius turned to a colleague and said, “Don’t do this to me.” Those words were caught on her microphone.

Well, frankly, who could blame her?  I don’t want Obamacare to do this to any of us.

But the line of the hearing still hasn’t been mentioned.

Rep. Greg Harper (R-Miss.) asked Sebelius repeatedly whether President Barack Obama was responsible for the troubled rollout of the health-care law that has left HealthCare.gov, the website where consumers are supposed to purchase insurance, largely dysfunctional.

Sebelius repeated that she and the Department of Health and Human Services were ultimately responsible. This led to a back-and-forth between the two, in which Harper tried to pry the answer he wanted out of her before his time for questioning expired.

“While I think it’s great that you’re a team player and you’re taking responsibility, it is the President’s ultimate responsibility, correct?” he said.

“Well, you’re clearly, uh, whatever,” Sebelius said. “Yes. He is the President. He is responsible for government programs.”

Let me give you a little hint folks: if you are testifying in front of Congress, the body representing the American people, don’t ever respond to a question with the term “Whatever”.

The entire hearing was a debacle, and did nothing to support the claim of the left that the Obamacare implementation is in competent hands.  If anything, it gave more support to the argument that the Obamacare debacle denialist brigade is still in charge.

tumblr_mvho2iHujQ1s6znabo1_r1_400

The Left’s Obamacare Debacle Denialists

Obamacare launch in 3...2...1....d'oh.

Many of my liberal friends are apparently quite happy to live in an alternate reality.

In this reality, the Obamacare rollout is going just great; the issues are simple ‘glitches’ that can easily be remedied.  And of course, none of this will have repercussions to the larger program, nor will the public be turned off by the apparent hiccup.

Yeah, it must be nice living in that world…because the real world is not so great.

See this story from Oregon:

Is the Affordable Health Care Act making health care unaffordable for some people?

Some customers of Regence Blue Cross Blue Shield, one of Oregon’s largest insurance providers, say that’s exactly what’s happening. They say they are finding their health care plans are dramatically changing under the Affordable Care Act.

“Policy holders are seeing almost double their monthly premiums,” said a KATU viewer named Larry in an email. He said his wife’s premium will increase by $300 under the Affordable Care Act.

Cover Oregon spokesman Michael Cox says most insurance plans that focus on lower premiums and higher deductibles will be replaced by plans with lower deductibles and higher benefits.

Or this story from Illinois:

The Tribune‘s Peter Frost found that a typical user in the system — a 33-year-old single father in this case — would see his premiums “more than double” from the current average of $233 a month. But if the single dad wants his premiums to remain in range, he’ll need to sign up for an annual deductible of $12,700. The average deductible before ObamaCare for this consumer would have been $3,500.

You will note I specifically chose states which are run by Democrats, where the states set up their own exchanges, and everything is going as Democrats planned.

If this is success, I would hate to see failure.  I would assume that ‘failure’ scenario has zombies and floods of lava involved.

Oh, but it gets worse.  In a post on the liberal blogging site the Daily Kos, a long time diarist posted his new reality…of much higher premium costs.

My wife and I just got our updates from Kaiser telling us what our 2014 rates will be. Her monthly has been $168 this year, mine $150. We have a high deductible. We are generally healthy people who don’t go to the doctor often. I barely ever go. The insurance is in case of a major catastrophe.

Well, now, because of Obamacare, my wife’s rate is gong to $302 per month and mine is jumping to $284.

I am canceling insurance for us and I am not paying any $#%#^# penalty. What the hell kind of reform is this?

If you take a look, be sure to read the comments section.  It is riddled with hate filled rants about how this poster is idea a GOP plant, a troll, or a liar.  A few helpful commenters told others to hold back the attacks until they knew the facts…to no avail.

This is pretty common in the left-wing bubble these days.  Many liberals have convinced themselves that there is no possible way Obamacare could fail.  They simply have faith that Obama could not be that incompetent.

It is almost a religious level of fervor.

To be sure, there are a couple liberal commentators that are facing the hard truths of this big government failure. Robert Gibbs, former Communication director, had this to say:

“This was excruciatingly embarrassing for the White House and for the Department of Health and Human Services.”

“This was bungled badly. This was not a server problem, like too many people came to the website. This was a website architecture problem.”

“When they get this fixed, I hope they fire some people…”

A glowing endorsement, indeed.

Ezra Klein, Washington Post blogger and longtime Obamacare aficionado, was even more harsh; and even better, it is while he was on MSNBC:

“The way this I.P. is going is a disaster, I really don’t think people should soft pedal what a bad launch this is. They’ve done a terrible job on this website,” Klein said on Monday’s Morning Joe.“We’re a couple of weeks in and people can’t sign up, people have tried 20, 30, 40 times, I mean it’s one thing for that to be true the first three or four days, it’s another thing for it to be true two or three weeks in.”

Klein went on to say this in his blog:

So far, the Affordable Care Act’s launch has been a failure. Not “troubled.” Not “glitchy.” A failure. But “so far” only encompasses 14 days. The hard question is whether the launch will still be floundering on day 30, and on day 45.

Kudos to Klein and Gibbs for…facing glaringly obvious reality.

This is fundamentally the problem when you create a big government solution to a large-scale problem.  When you create such a program, facts be damned; success is about political victory, not necessarily making the lives of Americans better. And if facts get in the way of that, ignore the facts.  It is frightening how many otherwise rational liberals have totally deluded themselves into believe that Obamacare is a guaranteed success, when nothing can be farther from the truth.

Furthermore, there is no culpability in big government.  In most private ventures, a failure of a $600 million program to meet its most basic goals would result in a demand for and ultimately receipt of a resignation.  What are the chances of Obama demanding HHS Secretary Kathleen Sibelius to resign, and her submitting her resignation?  Slim to none.  Because in government, you can do no wrong.

Today, most Democrats are oblivious to the realities that Gibbs and Klein are stating.  They still believe Obamacare is the bait-and-switch sale job that Obama sold to them in 2010.  They are still under the illusion this is a plan that will cover everyone (it will not), will reduce the debt (the CBO and GAO say that those cuts are less and less likely), and that it will cut the average American family’s premiums by $2,500 (always a joke, now proven to be a joke).

But self-delusion is a powerful thing.  And although a majority of Americans now see Obamacare as damaging to their well-being, liberals appear to be willing to go down fighting, to defend a reality that simply doesn’t exist.

Healthcare.gov…Most Expensive Website Ever?

404-care-obamacare-glitch

I was rambling over on Twitter this morning, and stumbled upon a question that needs to be answered.

Is the debacle that is the website Healthcare.gov possibly the most expensive website creation of all time?

The question is a complicated one.

First, you have to eliminate all ‘intranet’ systems; in other words, platforms that were built only for internal use.  Systems such as those built at the NSA and CIA probably cost more, but we would never know because such information is top-secret.  Additionally, they have security requirements that nobody else would ever have.

Second, how much did Healthcare.gov actually cost to create?  Originally the website had $93 million budgeted.  That number has clearly ballooned, and the most common number used today is $634 million.  That number may be overstating the reality.  Based on this website accounting government spending, the actual number may be closer to $463 million that was actually spent after the ACA became law.  Still, that is an astronomical amount.

It is very difficult to compare this to the private sector, but let us try.  From Digital Trends:

Facebook, which received its first investment in June 2004, operated for a full six years before surpassing the $600 million mark in June 2010. Twitter, created in 2006, managed to get by with only $360.17 million in total funding until a $400 million boost in 2011. Instagram ginned up just $57.5 million in funding before Facebook bought it for (a staggering) $1 billion last year. And LinkedIn and Spotify, meanwhile, have only raised, respectively, $200 million and $288 million.

If you want to compare to other government health care sites around the world, the United Kingdom’s National Healthcare Service site cost around  £21m….still a fraction of the Obamacare site.

Of course, like most things in the Federal Government, we will never really know what it costs.  Once you build a black hole in government, it sucks up material and costs without any discretion.  But to claim that Healthcare.gov, a site that in some respects cannot even create user passwords and has barely been able to complete even a small percentage of its total tasks so far, is among the most expensive web portals in internet history is probably not unreasonable.