THURSDAY, NOVEMBER 14, 2013
California's Health Insurance Exchange Enrollment Says a Lot About What Could Have Been and What Still Has To Happen
Covered California, the state-run Obamacare health insurance exchange, announced yesterday that 59,000 people have so far signed up for health insurance.
Given that California amounts to about 10% of the nation's population, this would suggest a smooth running federal exchange might well have enabled the Obama administration to have met its national first month goal of 500,000 sign-ups.
But the California enrollment also points to the real challenge Obamacare faces.
In the first month, 84% of the enrollees did not qualify for a subsidy. It has been widely estimated that about half of all potential enrollees will eventually qualify for a subsidy. As Covered California's chief executive said, "Those are individuals who have been waiting a lifetime for health coverage."
Covered California is not scheduled to release any age data until next week, but the health plans already know what they are getting. The President of the California health insurance trade association also said yesterday, "It is important for the exchange to achieve a balance in enrollment between the old and the young and the sick and the healthy to allow costs to be spread among all people."
These Healthcare.gov problems have been a sideshow for Obamacare. The main event will be about whether more than just those who have been "waiting all of their lives" to get guarantee issue health insurance they are sure to make money on will eventually sign-up in adequate numbers.
Given that California amounts to about 10% of the nation's population, this would suggest a smooth running federal exchange might well have enabled the Obama administration to have met its national first month goal of 500,000 sign-ups.
But the California enrollment also points to the real challenge Obamacare faces.
In the first month, 84% of the enrollees did not qualify for a subsidy. It has been widely estimated that about half of all potential enrollees will eventually qualify for a subsidy. As Covered California's chief executive said, "Those are individuals who have been waiting a lifetime for health coverage."
Covered California is not scheduled to release any age data until next week, but the health plans already know what they are getting. The President of the California health insurance trade association also said yesterday, "It is important for the exchange to achieve a balance in enrollment between the old and the young and the sick and the healthy to allow costs to be spread among all people."
These Healthcare.gov problems have been a sideshow for Obamacare. The main event will be about whether more than just those who have been "waiting all of their lives" to get guarantee issue health insurance they are sure to make money on will eventually sign-up in adequate numbers.
After Obama Meeting, Insurers Question Plan’s Workability
By REED ABELSON and SUSANNE CRAIG
A day after they were caught off guard by President Obama’s proposal to prevent cancellation of insurance policies for millions of Americans, top executives of some of the biggest insurance companies emerged from a meeting at the White House on Friday, expressing mixed feelings about whether the idea could work in every state.
The hastily called meeting was an attempt by the White House to address the growing frustration of the nation’s insurers over the administration’s fumbling of the health care law. It came just a day after the president announced on television that insurers could now continue coverage for people whose policies were being canceled because they did not meet the new law’s standards.
The cancellations had left the president vulnerable to assertions that he had gone back on an often-repeated promise that consumers could keep their current plans if they were happy with them.
Mr. Obama met with chief executives from more than a dozen of the nation’s largest companies in the Roosevelt Room for more than an hour in a session that insurers said was wide-ranging. Other issues discussed included a suggestion being floated by some in the insurance industry that they be allowed to enroll people directly, rather than through HealthCare.gov, the government’s troubled website. But the insurers said the president had agreed that fixing the site’s remaining problems was a critical priority.
The insurers, many of whom expressed anger that the president had not consulted them before Thursday’s announcement, said they had come away from the meeting willing to work with the White House on the cancellation issue and still protect the financial viability of the new insurance marketplaces. They did not discuss in detail how the president’s goal might be achieved.
The participants included executives of WellPoint, Aetna, Cigna, Humana and Kaiser Permanente, as well as several nonprofit Blue Cross plans.
After the meeting, Karen Ignagni, president of America’s Health Insurance Plans, the industry trade group, said only that it had been “very productive.”
Under the White House proposal, which would affect the 10 million or so people who already have individual policies, insurers would no longer have to cancel policies for 2014 that failed to meet the Affordable Care Act’s standards. The final decision on whether to allow insurers to continue selling those plans is up to insurance regulators in each state.
Obama acts to ease health insurance plan cancellations
Some people might be able to renew policies that were going to be canceled, although it's unclear how many will be affected. The fix mollifies rebellious Democrats.
By Noam N. Levey, Kathleen Hennessey and Michael A. Memoli
7:09 PM PST, November 14, 2013
| advertisement |
WASHINGTON — President Obama's plan to help millions of consumers facing health insurance cancellations calmed Democrats on Capitol Hill on Thursday even as its practical effect appeared unclear.
The decision could give some consumers who like their health plans the chance to keep them into 2015, allowing the president to say he honored his pledge that his health law would not force Americans to give up their coverage.
"This fix won't solve every problem for every person," the president said in remarks at the White House, in which he took responsibility for the law's botched rollout. "But it's going to help a lot of people."
Obama's decision appeared to tamp down a rebellion among Democrats worried about a backlash over the Affordable Care Act in next year's election. But some prominent Democrats are still pressing for a more substantive legislative fix.
Public support for the law, which was never robust, has faltered in the wake of the policy cancellations and the debut of the flawed federal online insurance marketplace.http://www.latimes.com/nation/la-na-obamacare-fix-20131115,0,671555,print.story
House Approves Bill That Allows Policy Renewals
By ASHLEY PARKER and ROBERT PEAR
WASHINGTON — Defying a veto threat from President Obama, the House approved legislation on Friday that would allow insurance companies to renew individual health insurance policies and sell similar ones to new customers next year even if the coverage does not provide all the benefits and consumer protections required by the new health care law.
The vote was 261 to 157, with 39 Democrats bucking their party leadership and the White House to vote in favor of the bill. Hours after the vote, Mr. Obama and top aides met for over an hour with insurance executives after industry leaders complained Thursday that they had been blindsided by a White House reversal on canceled policies. The president described the meeting as a “brainstorming” session about how to ensure changes to the health care law go smoothly.
The insurance representatives, from more than a dozen companies, said they would work with the administration to protect the financial viability of the new marketplaces, but did not say how. Afterward, Karen Ignagni, the president of America’s Health Insurance Plans, a trade group, said it was a “very productive” meeting,but would not go into detail.
The legislation approved by the House would go further than the fix announced on Thursday by Mr. Obama, who said he would temporarily waive some requirements of the law and allow insurers to renew “current policies for current enrollees” for a year.
Many of the Democrats who supported the bill are facing tough re-election fights back home, and expressed deep frustration with how the administration had handled the early carrying out of Mr. Obama’s signature health care law. Representative Nick J. Rahall II, Democrat of West Virginia, who voted for the legislation, said that the White House deserved an “F-minus” for its botched rollout of the Affordable Care Act.
“I’m disgusted about it,” Mr. Rahall said. “I think heads should roll downtown. Whoever was responsible or may have known that this was going to occur should no longer be employed.”
Representative Ron Barber, Democrat of Arizona, who also joined Republicans in voting for the bill, was equally scathing, calling the rollout “a disaster.”
“My constituents are pretty upset,” he said, “and so am I.”
Representative Fred Upton, Republican of Michigan and the chief sponsor of the House bill, said it would fulfill a promise that Mr. Obama had made to the American people and then broken.
Health Site Infighting Detailed in Emails
By ERIC LIPTON
WASHINGTON — Senior federal officials involved in building the HealthCare.gov website were deeply concerned this summer about delays as well as weaknesses in the quality and size of the contractor teams assigned to parts of the project, emails released by congressional investigators on Friday show.
The emails offer some of the first detailed evidence of which federal government officials had at least some knowledge that the start-up of the health care exchange might be troubled.
Henry Chao, the deputy chief information officer at the agency overseeing the project, warned seven other officials in July that the lead contractor, CGI Federal, had better accelerate the work.
“I just need to feel more confident they are not going to crash the plane at takeoff,” he wrote on July 16 to colleagues at the agency, the Centers for Medicare and Medicaid Services.
Mr. Chao’s general concerns about the pace of the project were known; he told industry executives at a conference in March that he was worried, remarking, “Let’s just make sure it’s not a third world experience.”
But the email exchanges released on Friday make clear that there was growing friction between the federal government and CGI, a Canadian company, as the project missed various deadlines even as the Oct. 1 start-up of the federal marketplace site was approaching.
There apparently was also tension between two contractors: CGI, which was leading the effort, and QSSI, a Maryland company that was supposed to test the computer programs to ensure that they worked. A spokeswoman for CGI declined to comment. But two company employees involved in the effort, who asked not to be named because they were not authorized to speak on the record, said the problem was not CGI’s work, but a lack of clear federal oversight, as bureaucrats argued over which tasks should take precedent.
“This is internal infighting and reflects the lack of a strong, single manager at C.M.S. to drive the program,” one employee said.
Who’s Sorry Now?
By GAIL COLLINS
Barack Obama’s loyal supporters are heavy of heart. Perhaps their chief source of comfort is that the Obamacare mess hit the headlines at about the same time as the crack-smoking mayor of Toronto. At least the president didn’t claim he was drunk when he wrote the health care bill.
Obama, obviously not a guy who enjoys self-abasement, has been on an apology tour. He sat down with NBC News and said he was sorry that people whose health insurance plans were canceled “are finding themselves in this situation, based on assurances they got from me.”
While far from emotionally satisfying, this did rise a tad above the classic blame-the-victim apology. (See football player Richie Incognito on his racist phone call to a black teammate: “... I’d apologize to his family. They took it as malicious. I never meant it that way.”)
The chaos surrounding the rollout of health care reform is a terrible blow to people who’ve been standing behind the president through thin and thin. They had already come to grips with the fact that the guy who once taught constitutional law wasn’t going to protect their privacy from government snoops. That their old peace candidate really loved the idea of shooting people down with drones. That he was probably never going to be able to deliver on serious immigration reform, or gun control or even expanded preschool.
But there was still affordable health care, a goal that had been eluding presidents since Teddy Roosevelt, which had required so many breathtaking leaps of political faith to pass and protect. One achievement so big it was pretty much enough.
And then the website didn’t work and longstanding promises were broken and the whole thing was turning into a joke on the Country Music Association Awards.
“I think it’s fair to say that the rollout has been rough so far,” the president said at the start of his press conference on Thursday.
I think it’s fair to say that is an understatement.
‘Baby steps’ toward better health care
By E.J. Dionne Jr.,
For those who believe that providing health insurance to all Americans is a moral imperative, there is something even more depressing than the Obama administration’s failure to get the health-care Web site working.
There can be no evasion, of course, of the shock that the administration would let its most significant initiative be jeopardized by its own profound failures of execution. AsNational Journal’s Ron Brownstein pointed out, universal coverage was always seen by progressives as a way of enhancing confidence in government’s ability to do good. It was not supposed to undercut popular faith in Washington’s capacity and competence. So President Obama was right to take responsibility for this snafu on Thursday in the most remarkable expression of presidential penitence of his term in office — and, perhaps, of any recent presidency.
But in a better political world, the president’s political opponents wouldn’t simply be trying to wreck the prospect of getting health insurance to millions of uninsured Americans. They would be joining in efforts to make the system work better. This is what happened when Massachusetts went for universal health care, led Republican Mitt Romney. As has been widely reported, there were early problems with the Massachusetts effort, too. But both parties were committed to making the system work, and they did.
The proposal offered by Rep. Fred Upton (R-Mich.), cast as a way of providing relief for those in the individual insurance market who had their policies canceled, was actually a Trojan horse. It was not a “fix” at all. It was designed to gut the core provisions of Obamacare.
In the meantime, most Republican governors refused to set up state insurance exchanges, and many rejected the Medicaid expansion, depriving 5 million to 6 million lower-income Americans of a chance to get insurance.
It is because of this parade of horribles that I was so moved by a letter to The Post this week from James V. Rives of Arlington, Va. Mr. Rives was responding to a column I wrote asking why members of the right-to-life movement were not speaking up forcefully in favor of requiring maternity coverage in all health insurance plans. I argued that one of the best ways to bring the abortion rate down was to provide women and the children they chose to bring into the world with full medical coverage.
In his letter, Mr. Rives described himself as a “pro-life conservative,” and my hunch is that he might well disagree with the first several paragraphs I have written here.
But Mr. Rives did something that has happened all too rarely in the health-care debate: He offered a clear and quite interesting proposal:
“Routine prenatal, labor and delivery care would make an ideal test-case for a universal single-payer system,” he wrote.
Health care website may be starting to work, Maine sources say
Only 271 Mainers were able to enroll in insurance plans online through the first month, but the federal government has promised improvements.
By Joe Lawlor jlawlor@pressherald.com
Staff Writer
Stephen Costanza of Portland crossed his fingers and waited for the result of his last click on the famously faulty healthcare.gov, the last step he had to complete to get health insurance for 2014 through the Affordable Care Act.
“The wind must have been blowing in the right direction and Tinkerbell must have flown by, because it worked,” Costanza said, laughing.
From Oct. 1, when enrollment started, through Nov. 2, just 271 Mainers successfully signed up for coverage through the health insurance marketplace, according to data released this week by the U.S. Department of Health and Human Services.
But Costanza, 53, and others who have been signing up could be on the leading edge of a new chapter in the implementation of the Affordable Care Act. Some users of healthcare.gov say it might finally be starting to work.
In recent days, the website’s performance has improved enough to enable more people to sign up for insurance, numerous sources said Thursday and Friday.
The website has been plagued by glitches and crashes since its launch. In the 36 states where consumers must rely on the federal system, including Maine, only 26,794 people had navigated their way through the website to select insurance plans as of Nov. 2. The success rate was far higher in the states that opted to create their own online insurance marketplaces.
Staff Writer
Lack of younger enrollees threatens exchanges
By Michael R. Blood
The Associated Press
LOS ANGELES — Among the concerns surrounding the rollout of President Barack Obama’s health care overhaul was that too few young, healthy people would sign up — a problem that could undermine the financial viability of the federal law.
The insurance industry has increasing cause for concern as early enrollment reports suggest a trend that could cause insurance premiums and deductibles to rise sharply. Along with the paltry enrollment numbers released this week, officials in a handful of states said those who had managed to sign up were generally older people with medical problems.
Insurers have warned that they need a wide range of people signing up for coverage because premiums paid by adults in the younger and healthier group, between 18 and 35, are needed to offset the cost of carrying older and sicker customers who typically generate far more in medical bills than they contribute in premiums.
The first set of enrollment data revealed that 106,000 people signed up for coverage nationwide, far short of the 500,000 initial sign-ups the Obama administration had expected. In states where officials discussed more detailed information, it also became apparent that the people who flocked to the exchanges after they opened Oct. 1 were those who were desperate for coverage.
In California, the state with the largest uninsured population, most of those who applied were older people with health problems, according to a state health care official. In Kentucky, nearly 3 of 4 enrollees were over 35. In Ohio, groups helping with enrollment described many of those coming to them as older residents who lost their jobs and health coverage during the recession.
The Associated Press
Our View: Outrage over Obamacare problems misdirected
The shortcomings of the Affordable Care Act aren’t as serious as the shortcomings of the system it replaces.
The American health care “system” is an outrage.
Forty-eight million people have no health insurance at all. When they get sick or in an accident, they have to pay out-of-pocket for the most expensive care in the world, risking bankruptcy every time they get out of bed.
Nineteen million Americans buy health insurance on the individual market with no subsidy from an employer. Their coverage has become so expensive, millions opt for high-deductible, low-coverage plans in the hope that their policies will give them enough coverage to avoid a financial catastrophe. For years, employers have been scaling back the plans they offer in order to reduce their exposure to escalating premiums, shifting costs onto employees.
Thirty-seven percent of American adults, both those with and without insurance, went without recommended care between February and June of this year because of the cost of visiting a doctor or filling a prescription, according to a study by The Commonwealth Fund. The same study found that 40 percent of Americans spent $1,000 or more for health care over and above their insurance premiums.
But what’s the reason for the outrage that dominates the news lately? A balky website? A broken presidential promise?
There actually are serious problems with the Affordable Care Act, but they are not the ones we have been hearing about. They are political problems that put the future of the law at risk.
Now we have an Obamacare baseline. Here are 6 things to look for in future numbers
Posted Nov. 14, 2013, at 11:24 a.m.
Enter numbers into the ongoing and continually escalating political scuffle over President Barack Obama’s health care law.
After weeks of not releasing them while tamping down expectations, the Obama administration on Wednesday published figures detailing how many people succeeded in purchasing insurance through the technologically beleaguered healthcare.gov website in its first month.
One revelation? Obamacare so far owes most of the success it has had to the states that actually took matters into their own hands. The 16 states (plus Washington, D.C.) that aren’t relying on the federal government to run their online health insurance exchanges are responsible for the bulk of successful enrollments.
Just a quarter of the 106,185 people who successfully completed applications, evaluated their insurance options, selected plans and signed up for coverage during the initial enrollment period — Oct. 1 through Nov. 2 — did so through the federally facilitated marketplace that relies on healthcare.gov, according to the Department of Health and Human Services enrollment report.
The states that are operating their own insurance marketplaces haven’t all had an easy go of it, but they’ve been able to address their issues and enroll people in health insurance without waiting on an Obama administration that flubbed its healthcare.gov debut to get its act together.
Maine is one of the 34 states whose Obamacare fate is tied to the success of healthcare.gov. According to the enrollment report, just 271 Maine residents successfully signed up for coverage in Obamacare’s first month. More than 3,500 completed the applications — for policies that would cover almost 6,500 people — needed to start the process.
With the first wave of numbers as a baseline, here are six things to watch for as the Obama administration promises to fix healthcare.gov and the end of the open enrollment period approaches:
— According to the Congressional Budget Office, more than 85 percent of the 7 million people expected to sign up for insurance through Obamacare’s exchanges in 2014 will qualify for subsidies meant to make coverage more affordable. However, just 30 percent of the people who found out they were eligible for a marketplace plan last month earn incomes low enough to qualify them for subsidized coverage. In Maine, the number is 42 percent. (Those who qualify for subsidies must have incomes between 100 percent and 400 percent of the federal poverty level.) If that proportion doesn’t change significantly as the first open enrollment periods come to an end, it’ll show Obamacare has a problem enrolling lower-income people.
— The Obama administration Wednesday didn’t release much information about those who have signed up for insurance. Next time, we hope the federal government releases an age breakdown so we know whether the young people on whose premiums the health care law’s viability depends are buying coverage.
— According to the Obama administration, there’s no reason to think early enrollments aren’t keeping pace with projections that 7 million people will sign up for insurance through the online marketplaces for 2014. Perhaps that will become more evident during future rounds of enrollment figure releases.
Enter numbers into the ongoing and continually escalating political scuffle over President Barack Obama’s health care law.
After weeks of not releasing them while tamping down expectations, the Obama administration on Wednesday published figures detailing how many people succeeded in purchasing insurance through the technologically beleaguered healthcare.gov website in its first month.
One revelation? Obamacare so far owes most of the success it has had to the states that actually took matters into their own hands. The 16 states (plus Washington, D.C.) that aren’t relying on the federal government to run their online health insurance exchanges are responsible for the bulk of successful enrollments.
Just a quarter of the 106,185 people who successfully completed applications, evaluated their insurance options, selected plans and signed up for coverage during the initial enrollment period — Oct. 1 through Nov. 2 — did so through the federally facilitated marketplace that relies on healthcare.gov, according to the Department of Health and Human Services enrollment report.
The states that are operating their own insurance marketplaces haven’t all had an easy go of it, but they’ve been able to address their issues and enroll people in health insurance without waiting on an Obama administration that flubbed its healthcare.gov debut to get its act together.
Maine is one of the 34 states whose Obamacare fate is tied to the success of healthcare.gov. According to the enrollment report, just 271 Maine residents successfully signed up for coverage in Obamacare’s first month. More than 3,500 completed the applications — for policies that would cover almost 6,500 people — needed to start the process.
With the first wave of numbers as a baseline, here are six things to watch for as the Obama administration promises to fix healthcare.gov and the end of the open enrollment period approaches:
— According to the Congressional Budget Office, more than 85 percent of the 7 million people expected to sign up for insurance through Obamacare’s exchanges in 2014 will qualify for subsidies meant to make coverage more affordable. However, just 30 percent of the people who found out they were eligible for a marketplace plan last month earn incomes low enough to qualify them for subsidized coverage. In Maine, the number is 42 percent. (Those who qualify for subsidies must have incomes between 100 percent and 400 percent of the federal poverty level.) If that proportion doesn’t change significantly as the first open enrollment periods come to an end, it’ll show Obamacare has a problem enrolling lower-income people.
— The Obama administration Wednesday didn’t release much information about those who have signed up for insurance. Next time, we hope the federal government releases an age breakdown so we know whether the young people on whose premiums the health care law’s viability depends are buying coverage.
— According to the Obama administration, there’s no reason to think early enrollments aren’t keeping pace with projections that 7 million people will sign up for insurance through the online marketplaces for 2014. Perhaps that will become more evident during future rounds of enrollment figure releases.
Growing old in Maine doesn’t have to mean living in a nursing home
There’s no place like home, especially as you grow older.
Figuring out how best to support the increasing number of retiring baby boomers, so they can remain in their homes and communities as long as they wish, however, is a big question without one clear answer.
Aging has recently been the subject of round table discussions initiated by state legislative leaders; and AARP released a report in September on how to create an “age friendly” Maine. Not only do people simply prefer to stay at home as long as possible, it’s better for their quality of life and health — and less expensive for taxpayers — than long-term care.
Here are some positive local initiatives that could be expanded, replicated or reimagined in other towns:
— In Knox and Waldo counties, the nonprofit SAIL Midcoast — for an annual fee — offers seniors transportation, shopping, electronics help, yard work and personal care. It’s an alternative to assisted living, or living with family, that allows seniors to remain in their homes. It’s part of the Village to Village Network; other “villages” are being developed in Maine.
— Friends of Aroostook County provides fresh produce and firewood to seniors in need and individuals with low incomes.
— Saco is developing a long-term strategy for how best to respond to the needs of aging residents. The comprehensive approach is examining transportation for the elderly, how to maintain social activities and how to ensure access to health care. Bowdoinham underwent a planning process that resulted in a senior center that provides lunch and social activities — and a van to pick up residents to bring them to the center.
— Bath and several other communities have programs where older adults living independently can call the police department each morning to let someone know they’re safe; if they don’t call, and someone can’t reach them, an officer goes out to check on them.
There are also initiatives in other states that Maine might emulate. Montpelier, Vt., for example, is building on the concept of time banking, only focusing on seniors. The goal is to involve the community at large by exchanging services and time to help elders age in place.
No comments:
Post a Comment