Max Baucus: Obamacare rollout ‘unacceptable’
One of the Senate’s chief Obamacare authors admonished the administration on Wednesday for the flawed rollout of the president’s chief legislative accomplishment.
“Needless to say, it has been a rocky rollout. Problems have plagued the website and limited the ability of Americans to buy the health insurance” they need, Senate Finance Committee Chairman Max Baucus said at the opening of a hearing with Health and Human Services Secretary Kathleen Sebelius about the rollout of the Affordable Care Act.
“This is unacceptable,” he added. “It has been disappointing to see members of the administration say they didn’t see the problems coming.”
Sebelius told the committee that the site will be repaired by the end of the month amid a “couple of hundred” functional repairs that have been identified. “We are into the list but we are not where we need to be,” she said.
(PHOTOS: 10 Sebelius quotes about Obamacare website)
But she stressed that shutting down the website completely — in response to questions from Baucus — is not an reasonable option.
Sebelius is testifying in the Senate today amid growing consternation with the problematic rollout of the Obamacare website and the firestorm over cancelled health policies.
She is before the Finance Committee for the first time since last April when Baucus memorably told her he worried about a “train wreck” if implementation of the health law did not get better. On Wednesday, he addressed the “train wreck” comment indirectly, saying his words have been used to “malign” the law. “Make no mistake, I believe in this law,” he said.
Baucus stressed that Sebelius should remain in her post amid calls for her resignation.
Max Baucus: Obamacare rollout ‘unacceptable’
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| One of the Senate’s chief Obamacare authors admonished the administration on Wednesday for the flawed rollout of the president’s chief legislative accomplishment. “Needless to say, it has been a rocky rollout. Problems have plagued the website and limited the ability of Americans to buy the health insurance” they need, Senate Finance Committee Chairman Max Baucus said at the opening of a hearing with Health and Human Services Secretary Kathleen Sebelius about the rollout of the Affordable Care Act. “This is unacceptable,” he added. “It has been disappointing to see members of the administration say they didn’t see the problems coming.” Sebelius told the committee that the site will be repaired by the end of the month amid a “couple of hundred” functional repairs that have been identified. “We are into the list but we are not where we need to be,” she said. (PHOTOS: 10 Sebelius quotes about Obamacare website) But she stressed that shutting down the website completely — in response to questions from Baucus — is not an reasonable option. Sebelius is testifying in the Senate today amid growing consternation with the problematic rollout of the Obamacare website and the firestorm over cancelled health policies. She is before the Finance Committee for the first time since last April when Baucus memorably told her he worried about a “train wreck” if implementation of the health law did not get better. On Wednesday, he addressed the “train wreck” comment indirectly, saying his words have been used to “malign” the law. “Make no mistake, I believe in this law,” he said. Baucus stressed that Sebelius should remain in her post amid calls for her resignation. |
Notes Reveal Chaotic White House Talks on Health Care Site
By ROBERT PEAR
WASHINGTON — More than 100 pages of “war room notes” released by congressional investigators on Tuesday offer a window into the chaos that overwhelmed the Obama administration as the federal health insurance marketplace started up last month and officials realized that its problems could not be fixed quickly.
The documents were made public just as Marilyn B. Tavenner, the administrator of the Centers for Medicare and Medicaid Services, who oversaw the creation of the troubled website, wrapped up her testimony at a Senate hearing in which she faced tough questioning from Democrats and Republicans alike.
Senator Barbara A. Mikulski, Democrat of Maryland, told Ms. Tavenner that the problems with the federal insurance website, HealthCare.gov, could deter people from enrolling and threaten the success of President Obama’s health care overhaul.
“There’s been a crisis of confidence created in the dysfunctional nature of the website, the canceling of policies and sticker shock from some people,” said Ms. Mikulski, a strong supporter of the 2010 health care law.
The documents — notes of meetings between federal officials and government contractors working to fix the insurance exchange — were released by Representative Darrell Issa, Republican of California and chairman of the House Committee on Oversight and Government Reform. Mr. Issa has been a fierce critic of the health care law, which was passed without any Republican votes.
The notes indicate that by Oct. 8, one week after the exchange opened, administration officials had begun to realize that its problems were widespread and could not be easily fixed. No sooner was one problem solved than others popped up. The documents show that officials were focused on addressing individual bugs, rather than the larger issue: The website was not working properly from Day 1.
Users were blocked at the first step, creating accounts, because their identities could not be verified. The “fix is taking longer than expected and the website is shut down to carry it out,” the notes for Oct. 8 say. Technicians “are not promising a time on the website anymore.”
A day later, about 30 percent of applicants could not enter crucial information about income, address and citizenship. The application process on the website simply skipped over these items, the notes say.
AARP Sends a Thank-You to Caregivers
By JANE L. LEVERE
AARP and the Advertising Council are beginning a new advertising and social media campaign this week designed to illustrate the many roles caregivers play and to thank them for this assistance.
Timed to coincide with November’s National Family Caregivers Month — an annual commemoration, sponsored by the Caregiver Action Network, to honor the 42 million Americans who care for a loved one with a chronic condition, disability or the frailties of old age — the campaign is the second time AARP and the Ad Council have collaborated on this issue.
In August 2012, they introduced advertising directed at female baby boomer caregivers, aged 40 to 60, that illustrated the physical, emotional and mental strains they experience. The ads, by Butler, Shine, Stern and Partners, based in Sausalito, Calif., also directed caregivers to a website, www.aarp.org/caregiving, operated by AARP, that offers tools, advice and other assistance.
The campaign reflects research conducted by AARP in June 2013 of people who consider themselves caregivers, which found that although 52 percent said they were “proud” to provide such assistance, almost three in 10 said their lives had changed from caregiving, while more than one in five said their weight, exercise or social life had suffered from it.
AARP also found that one in three caregivers surveyed felt sad or depressed and 44 percent said they bottled up these feelings. Almost 40 percent said they slept less since becoming a caregiver, while one-third avoided making decisions or isolated themselves, and almost one-quarter ate more.
“Family, friends and neighbors who support a loved one rarely see themselves as a caregiver, and they almost never ask for help. But at some point in their lives, most people will be a caregiver or need support. Our campaign is here to remind caregivers that they aren’t alone and there is help,” said Debra Whitman, AARP executive vice president for policy, strategy and international affairs.
New advertising — which has been created in television, radio, print, outdoor and digital executions, in English and Spanish — is meant to “start a broader cultural conversation about the challenges” caregivers face, said David Jenkins, president of Taxi, a Toronto-based unit of WPP, whose New York office worked on the campaign. Distribution of the advertising will begin Thursday.
Sirota: The single-payer signal in the Obamacare noise
Whenever scandal arises in Washington, D.C., the fight between the two parties typically ends up being a competition to identify a concise message in the chaos — or, as scientists might say, a signal in all the noise. This week confirms that truism, as glitches plagued the new Obamacare website and as insurance companies canceled policies for many customers on the individual market.
Amid the subsequent noise of congressional debate and cable TV outrage, Republicans argued that the signal is about government — more specifically, they claim the controversies validate their age-old assertions that government can’t do anything right. Democrats countered that the signal in the noise is about universal health care — Obamacare is a big undertaking, they argue, and so there will be bumps in the road as the program works to provide better health services to all Americans.
This back and forth is creating an even more confusing cacophony — and further obscuring the signal that neither the two parties nor their health industry financiers want to discuss. That signal is about the need for single-payer health care — otherwise known as Medicare for all.
One way to detect this signal is to consider the White House guest list.
In trying to show that he was successfully managing the Obamacare roll out, the president last week staged a high-profile White House meeting with private health insurance executives — aka Obamacare’s middlemen. The spectacle of a president begging these middlemen for help was a reminder that Obamacare did not limit the power of the insurance companies as a single-payer system would. The new law instead cemented the industry’s profit-extracting role in the larger health system — and it still leaves millions without insurance.
Obama is bubble-wrapped
By Dana Milbank,
Near the end of his new book, “Days of Fire,” my friend and former colleague Peter Baker recounts a moment in the White House Situation Room in 2008 when President George W. Bush was uncharacteristically reflective.“The president looked at [Defense Secretary] Robert Gates and Admiral Mike Mullen, who had succeeded Peter Pace as chairman of the Joint Chiefs of Staff, and harked back to the critical days in 2003 before he launched the war that had become so problematic. ‘You know,’ he recalled, ‘when I made the decision on Iraq, I went around the room to everybody at that table, every principal. “You in? Any doubts?” Nothing from anybody.’ ”
As President Obama sifts through the wreckage of his health-care rollout, let’s hope he’s having similar reflections about why he didn’t know the launch of his presidency’s signature policy would be so ugly.
In one account of what even administration officials acknowledge is a debacle, the Wall Street Journal reported that Obama’s policy advisers were aware long ago that the president’s promise that “if you like your insurance plan, you will keep it” wouldn’t hold up. “White House policy advisers objected to the breadth of Mr. Obama’s ‘keep your plan’ promise,” the Journal reported, citing a former senior administration official. “They were overruled by political aides, the former official said. The White House said it was unaware of the objections.”
Obama, to borrow Bush’s phrase, heard “nothing from anybody.”
No, the Obamacare pratfall is not Obama’s Iraq: The magnitude is entirely different, and the problems — Web site malfunctions and a wave of policy cancellations — are fixable. But the decision-making is disturbingly similar: In both cases, insular administrations, staffed by loyalists and obsessed with secrecy, participated in group-think and let the president hear only what they thought he wanted to hear.
In a damning account of the Obamacare implementation, my Post colleagues Amy Goldstein and Juliet Eilperin described how Obama rejected pleas from outside experts and even some of his own advisers to bring in people with the expertise to handle the mammoth task; he instead left the project in the care of in-house loyalists. “Three and a half years later, such insularity — in that decision and others that would follow — has emerged as a central factor in the disastrous rollout,” Goldstein and Eilperin reported.
Their report is based in part on a prescient memo sent to the White House in May 2010 by Harvard professor David Cutler, an outside adviser on health-care reform. “I am concerned that the personnel and processes you have in place are not up to the task, and that health reform will be unsuccessful as a result,” he wrote. “My general view is that the early implementation efforts are far short of what it will take to implement reform successfully. . . . I do not believe the relevant members of the administration understand the president’s vision or have the capability to carry it out.”
Cutler identified many of the problems that would later plague the Obamacare rollout: The perception of secrecy, the lack of qualified personnel and the likelihood that “if you cannot find a way to work with hesitant states and insurers, reform will blow up.”
Instead, Obama followed a different governing philosophy: Dance with the one that brung ya. He figured that those who helped him enact the health-care law should be the ones to implement it.
The sin of omission in Obamacare
By Kathleen Parker,
Among the many rules I grew up with, two stand out. The first was to never call someone a liar, which was considered the worst character indictment one could issue. The accuser had best be prepared to fight or be fleet of foot.The other was a dictum so oft- repeated that it is permanently tattooed on my brain: “If you’ll lie by omission, you’ll lie by commission.”
This first rule sheds light on why it was so shocking when in 2009 Rep. Joe Wilson (R-S.C.) shouted, “You lie,” as President Obama was addressing Congress. Beyond an insult to decorum, it was widely viewed as another tipping point in our descent into incivility.
Now that the Affordable Care Act (ACA), popularly known as Obamacare, has been released upon the land — sort of — Wilson is beingregaled in Republican quarters as the voice of Cassandra, though his outburst was prompted by Obama’s saying the ACA wouldn’t insure illegal immigrants.
“The big lie,” as the president’s broken Obamacare promise is now known, was that everyone could keep his or her doctor and insurance policy under the ACA. No one, Americans were justified in inferring, would be remotely inconvenienced by Obamacare. Instead, the reality is well-known: Millions are expected to lose their insurance policies, while others will see their premiums skyrocket.
It is still jarring to my adult psyche to impugn another, especially the president of the United States, as a liar, so I won’t. But it is not possible to pretend that the American people have been told the truth. Nor is it possible to pretend that Barack Obama has been completely honest.
The question is, how much dishonesty from a president is tolerable? How can a dishonest president lead a nation? The truth is, if the president were not immune from such things, the American people could file a class-action suit on grounds that they were sold a product under false pretenses. In the private sector, we call that fraud.
Now the White House tells us that Obama always meant you could keep the insurance policy you like if it met the standards of the ACA. Apparently, plenty of people involved with the law, including the House minority
http://www.washingtonpost.com/opinions/kathleen-parker-the-sin-of-omission-in-obamacare/2013/11/05/ad45eb2e-464a-11e3-bf0c-cebf37c6f484_print.html
MaineCare dentists hit with massive fines for minor clerical errors, they say
Some clinics face more than $200,000 in penalties under a new audit system that threatens to wipe out services for kids.
By Joe Lawlor jlawlor@pressherald.com
Staff Writer
Staff Writer
Dentists who treat low-income patients under the state’s MaineCare program say they are getting hit with major fines for minor clerical errors in their reimbursement claims under a new auditing system adopted by the state to comply with the federal Affordable Care Act.
The new system gives auditors, who work for a private contractor, financial incentives to find small errors by paying them more for each mistake they discover.
“It’s almost to the level of ‘You forgot a comma,’ ” said Michael Dowling, co-owner of Falmouth Pediatric Dentistry. He would not say Tuesday how much his practice has been fined, but described it as a “substantial” amount.
“This is not finding fraud and abuse,” he said. “This is a clawback. They (state officials) are trying to take back money that we billed them legitimately.”
Some dentists indicated that they will have to stop treating MaineCare patients, or sharply reduce their services, if the fines are upheld on appeal. Dentists met with state Department of Health and Human Services officials to contest the fines.
Officials in the DHHS, which administers MaineCare programs, did not respond to several requests for comment.
Rep. Richard Farnsworth, D-Portland, co-chairman of the Legislature’s Health and Human Services Committee, said fines totaling about $800,000 have been levied statewide, with some clinics fined more than $200,000.
“The more flyspecks (contractors) find, the more they get paid,” he said.
Health law clock is ticking for sickest patients
Hundreds of thousands of people across the country with pre-existing chronic conditions such as cancer, heart failure or kidney disease who are covered through high risk-insurance pools will see their coverage dissolve by year’s end.
By Gosia Wozniacka
The Associated Press
The Associated Press
PORTLAND, Ore. — With federal and state online health care marketplaces experiencing glitches a month into implementation, concern is mounting for a vulnerable group of people who were supposed to be among the health law’s earliest beneficiaries.
Hundreds of thousands of people across the country with pre-existing chronic conditions such as cancer, heart failure or kidney disease who are covered through high risk-insurance pools will see their coverage dissolve by year’s end.
They are supposed to gain regular coverage under the Affordable Care Act, which requires insurers to cover those with severe medical problems. But many of them have had trouble signing up for health insurance through the exchanges and could find themselves without coverage in January if they don’t meet a Dec. 15 deadline to enroll.
Administration officials say the federal exchange, which covers more than half the states, won’t be working probably until the end of November, leaving people just two weeks to sign up if they want coverage by Jan. 1.
“These individuals can’t be without coverage for even a month,” said Tanya Case, chairwoman of the National Association of State Comprehensive Health Insurance Plans, which represents the nation’s high-risk pools. “It’s a matter of life or death.”
Sebelius faces lawmakers anew on health care law
Republicans are on the attack about the millions of Americans whose health insurers have told them their current policies are being canceled.
By Alan Fram
The Associated Press
The Associated Press
WASHINGTON — Health and Human Services Secretary Kathleen Sebelius is returning to Capitol Hill for a fresh interrogation on the health care law, this time from senators with growing concerns about President Barack Obama’s crowning legislative achievement.
Sebelius was due to face questions Wednesday from the Senate Finance Committee, whose chairman, Sen. Max Baucus, D-Mont., was a chief author of the 2010 law and remains a vocal defender. Yet in a measure of its troubled rollout, even he has concerns about the problem-plagued HealthCare.gov website and the potential security risks it poses for consumers’ private information.
“I want it all to work, and security is one factor, one component. It has to be secure,” Baucus told reporters Tuesday.
To the chagrin of increasingly nervous Democrats, Republicans are also on the attack about the millions of Americans whose health insurers have told them their current policies are being canceled. Obama has said that people who liked their coverage would be able to keep it.
“The American people are tired of all the broken promises from the Obama administration — from the millions who’ve had their insurance dropped, to the increase in the cost of their health plans and that many won’t be able to keep the doctors they’ve come to trust,” Sen. Orrin Hatch of Utah, top Republican on the Finance panel, said Tuesday.
Sebelius testified a week ago to the Republican-run House Energy and Commerce Committee.
At that confrontational session, she apologized for the troubles dogging the website where uninsured Americans and those buying coverage privately are supposed to be able to purchase health insurance. The secretary, who numerous Republicans have said should resign, has promised the site would be fixed by the end of this month and says it is secure.
Insurers are sending cancellation notices to customers whose current policies lack enough coverage to meet the law’s more demanding standards — at least 3.5 million Americans, according to an Associated Press survey of states
Report: 77,000 Mainers eligible for Obamacare tax credits
Posted Nov. 05, 2013, at 11:43 a.m.
About 77,000 Maine residents who are uninsured or buy their own health insurance will qualify for tax credits next year to help them afford coverage under Obamacare, according to a new analysis released Tuesday.
Those Mainers represent just over 60 percent of the 122,000 residents who could potentially shop for health insurance through new online marketplaces created by the president’s health care overhaul, the Kaiser Family Foundation analysis found.
The tax credits are one of two types of federal financial assistance available through the marketplaces. The credits will help low- and moderate-income people to afford health insurance by offsetting some of the cost of their monthly premium. Subsidies are also available to lower consumers’ out of pocket costs, including deductibles and co-payments.
Both types of assistance depend on income and family size. To qualify for tax credits, consumers must earn between 100 and 400 percent of the poverty level (between $23,550 and $94,200 annually for a family of four). The “cost-sharing subsidies” are available to those with incomes of up to 250 percent of the poverty level ($58,875 for a family of four).
Nationally, 29 million Americans could potentially shop on the marketplaces under the Affordable Care Act, the Kaiser analysis found. Sixty percent, or 17 million, will be eligible for tax credits.
The number of people who actually sign up for insurance through the marketplaces is expected to be far lower in the first year, however. The Congressional Budget Office projects that 7 million people will use the marketplaces in 2014, with 6 million qualifying for tax credits.
The marketplaces launched on Oct. 1, but the botched rollout of healthcare.gov, the federal website to the marketplaces in Maine and more than 30 other states, has stymied many consumers hoping to sign up for insurance.
The marketplaces are geared toward uninsured people and those who buy private health insurance on their own, rather than get coverage through an employer. Individuals who have insurance through work or government programs such as Medicaid and Medicare don’t need to use the marketplaces.
Those who earn more than 400 percent of the poverty level will pay full price for their health policies through the marketplaces. People earning less than the poverty level also won’t qualify for financial help in states including Maine that opted against expanding Medicaid under the Affordable Care Act. Here, about 25,000 poor and uninsured people fall into that “coverage gap,” earning too much to qualify for the existing Medicaid program, called MaineCare, but too little to qualify for assistance buying a plan in the new marketplace, a previous Kaiser analysis found.
The Obamacare Rollout––Week Five
Enrollments continue to trickle in. Health plans, with the kind of market share that would have to sign-up 100,000 to 200,000 people for the administration to hit its goal of 7 million people, are generally reporting they have enrolled only about 100 - 200 people over the first 35 days via Healthcare.gov.
Does this mean no one wants to sign-up? No. People can argue about whether we will see the administration hit their goal of seven million or we will end up getting two or three million relatively sicker people for all of the problems Obamacare has faced. But, undoubtedly millions of people, including all of those people who just got cancellation notices, do want to see what they can get for what cost and make a decision about signing up. But they can't because they aren't able get through the entire Healthcare.gov website.
As I have said before, Healthcare.gov, because of its many problems, is in de facto shutdown because virtually no one is able to really use it.
Why doesn't the administration just tell people the site is still too frustrating for people to waste their time on until it is fixed? Instead, the administration says it is getting better and people should keep trying to make it through the gauntlet. More, they are telling them to call the 800 number to fill out a paper application.
If it is better, it is still not better enough for more than a very small trickle to make it through each day.
Many states have literally dozens of complex health plan choices on the federal exchange––each insurance company on the various exchanges is likely offering the four different plans. I find it hard to understand how a consumer can get any real sense of the options over the phone much more be able to understand which plans cover which doctors and hospitals. People really need to see the options on their computer or on the computer of a navigator or an insurance agent to understand what is available and how it fits their needs.
Does this mean no one wants to sign-up? No. People can argue about whether we will see the administration hit their goal of seven million or we will end up getting two or three million relatively sicker people for all of the problems Obamacare has faced. But, undoubtedly millions of people, including all of those people who just got cancellation notices, do want to see what they can get for what cost and make a decision about signing up. But they can't because they aren't able get through the entire Healthcare.gov website.
As I have said before, Healthcare.gov, because of its many problems, is in de facto shutdown because virtually no one is able to really use it.
Why doesn't the administration just tell people the site is still too frustrating for people to waste their time on until it is fixed? Instead, the administration says it is getting better and people should keep trying to make it through the gauntlet. More, they are telling them to call the 800 number to fill out a paper application.
If it is better, it is still not better enough for more than a very small trickle to make it through each day.
Many states have literally dozens of complex health plan choices on the federal exchange––each insurance company on the various exchanges is likely offering the four different plans. I find it hard to understand how a consumer can get any real sense of the options over the phone much more be able to understand which plans cover which doctors and hospitals. People really need to see the options on their computer or on the computer of a navigator or an insurance agent to understand what is available and how it fits their needs.
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