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HealthCare.gov’s Date with Destiny
Posted By Arnold Ahlert On November 26, 2013 @ 12:30 am In Daily Mailer,FrontPage | 2 Comments
By now, most Americans probably know that the Obama administration has promised to fix the HealthCare.gov website by November 30. It is equally likely that a majority of Americans know this administration’s definition of “fixed” is as elastic as the president’s promise regarding one’s ability to keep one’s current insurance plan and/or doctors. Unfortunately for millions of angry and confused Americans, the current prediction it is likely to be as hollow — if not more so — than the last one.
We begin with Health and Human Services (HHS) Secretary Kathleen Sebelius’s latest readjustment of reality, announced last Tuesday. “The 30th of November is not a magic go, no go date,” Sebelius told the Associated Press. “It is a work of constant improvement. We have some very specific things we know we need to complete by the 30th and that punch list is getting knocked out every week.”
Even the AP wasn’t buying it, noting that the administration’s contention the website will be properly functioning for the “vast majority of users” by the due date “has morphed in the past few weeks.” They recounted a statement by Sebelius at an October 30 Congressional hearing that an “optimally functioning website” would be in place by the end of November. On Nov. 5, Marilyn Tavenner, administrator of the Centers for Medicare and Medicaid Services, upped it to “fully functioning.” Last week, the president used the words “marked and noticeable” to describe the website improvements that will ostensibly be in place four days from now.
For those unfamiliar with the Obama administration’s definition of words such as “fully functioning,” or “marked and noticeable” improvements, it should be noted that they will consider HealthCare.gov optimally functional if 80 percent of its users can buy healthcare online. Thus, what Washington Post describes as the “first concrete performance standard in the 31/2 years since the government began to design the health exchange” will leave one-in-five Americans searching for their government-mandated insurance policies twisting in the wind–even as it is deemed a success for doing so.
Yet while Sebelius was out pitching her latest hooey in Orlando and Miami, a panel of ObamaCare computer technicians was delivering more inconvenient truths at a House Energy and Commerce Oversight and Investigations subcommittee hearing. Deputy Chief Information Officer Henry Chao of the Centers for Medicare & Medicaid Services admitted that as much as 40 percent of the IT systems supporting the healthcare exchange have yet to be built. “It’s not that it’s not working,” Chao told lawmakers. “It’s still being developed and tested.”
The most prominent part of what is being developed and tested is the ability to process and deliver payments to the insurance companies. An HHS source clarified that a bit for Politico, contending that customer payments can be delivered, but the government subsidies that accompany them cannot. Without this “reconciliation” process functioning properly, insurers cannot enroll customers in the proper plans. An unnamed insurance industry source illuminated the potential pitfalls. “If people are enrolling, but the back-end systems are not working, their coverage could ultimately be disrupted,” the source noted. “They may think they’re enrolled in a plan and they’re not. They may show up at the doctor’s office and not be covered.”
This particular aspect of Chao’s testimony is stunning, in that it came a full week after the Obama administration revealed that 106,185 people nationwide had “selected,” rather than actually “paid for” an ObamaCare health insurance plan. That number included 26,794 people who had used the federal website. If Chao’s testimony is accurate, it seems possible that no one who has used the federal website could have a policy that has been fully processed. The only thing more remarkable is that no one thought to ask if that was the case.
And that’s the good news. when pressed on the issue of security, Chao insisted the website was safe. But once again, words mattered. Chao noted that the federal data hub, which verifies one’s eligibility to use the exchange, does not store information. He further explained that the website has a dedicated security team to monitor progress.
Yet Politico noted that contractors tasked with security who spoke to the committee “distanced themselves from any responsibility for overall security.” Jason Providakes, senior vice president and general manager at MITRE’s Center for Connected Government, a federally funded nonprofit, revealed the “nuances” in Chao’s remarks. He explained that while his organization was responsible for six different security assessments, they had “no view on the overall safety or security status of HealthCare.gov,” and no role in end-to-end security testing. MITRE tested only “specific parts of HealthCare.gov within specific parameters established by CMS and in almost all cases we succeeded,” Providakes said.
Whether success in almost all cases on part of a security system is supposed to reassure Americans is anyone’s guess.
Far less reassuring was the testimony of David Kennedy, head of TrustedSec, a company that offers to hack into private systems to determine their vulnerabilities. He contended that a cursory look at the site revealed numerous “exposures” that put it at “critical risk.”
Kennedy was one of four experts, including two academics and two private sector tech researchers, who testified that day. All four of them said the website was not secure, and three-out-of-four believed it should be shut down entirely until it is. In an interview following the meeting, Morgan Wright, CEO of Crowd Sourced Investigations, described the size of the code base needed to run the site as “indefensible.” Avi Rubin, director of the Information Security Institute at Johns Hopkins University, said he wouldn’t use the site at all, because of the bugs he has learned about.
The administration’s response? “I feel like it’s safe. Absolutely,” said Sebelius, adding, “when there have been issues identified or flagged, it’s immediately fixed.” White House spokesman Jay Carney sounded even more clueless. “The privacy and security of consumers’ personal information are a top priority,” he said.
Yet once again, one is left to wonder whether that “top priority” is part of the November 30 deadline for fixing the website. Last Friday, another evolution occurred. “There will not be a magic moment around the end of the month when our work will be complete,” said Jeffrey Zients, a management consultant brought in by the administration to straighten out the website. He was speaking shortly after the Obama administration announced yet another “fix,” namely the addition of eight extra days to sign up for healthcare. The previous cutoff date of December 15 was moved to December 23. If one signs up by then, one can still get insurance by January 1, 2014, provided they are paid up by December 31–which depends on Chao and company reconciling the reconciliation process as noted above.
Note that all of the above is about the website. On Saturday, another empty promise was exposed. A analysis done by CNN reveals that “in the largest city in nearly every state, many low-income younger Americans won’t get any subsidy at all.” Low-income is defined as anyone making less than $45,960 per year (four times the poverty level of $11,490). Because the actual cost of insurance is lower than what the Obama administration calculated it would be, many Americans with incomes far below that level will get no help buying their mandated insurance policy.
This contradicts testimony made by the ever-present Kathleen Sebelius to a congressional sub-committee last April, when she insisted that anyone making less than $45,960 would qualify for “an upfront tax subsidy,” while someone making $25,500 would “definitely qualify for a subsidy if he or she is purchasing coverage in the individual market.” CNN cited three individuals in three different states with incomes ranging from $25,500-$28,725–all of whom will get no subsidy at all.
HHS spokeswoman Joanne Peters defended the change. “In some instances, because of the competition that the marketplace creates, premiums have come in so low that the premium is below the ceiling in the law,” she explained. “This means that, in some places, people will pay less than they would with a tax credit.”
That is true, but it ignores two salient factors. First, because premium prices increase with age, the younger, healthier Americans needed to keep ObamaCare afloat will be disproportionately affected by the subsidy elimination. Second, and far more important, the unexpected change amounts to one more instance where ObamaCare expectations fall short of ObamaCare reality.
Another arena of lowered expectations regards the president’s “fix,” theoretically allowing Americans to keep their old insurance policy for another year. The word theoretically is very apt, in that many of those policies are long gone. Moreover as of yesterday, the number of states rejecting the fix has increased from last week’s four to this week’s nine. Connecticut California, Indiana, Massachusetts, Minnesota, New York, Rhode Island, Vermont and Washington are rejecting the president’s offer, with Minnesota Democratic Gov. Mark Dayton and others suggesting that the fix would destabilize their respective markets, and raise premiums for too many residents.
Unfortunately for millions of Americans, the most destabilizing element of all has yet to be realized. And once again, the nation’s date with destiny has been readjusted. Last week the Obama administration announced that the date for next year’s open enrollment season will be pushed back one month, from October 15 to November 15–putting it past the 2014 mid-term election. It should be quite an enrollment period, since the 61 million to 108 million Americans who are currently insured by their employer will be seeing the same cancellation notices next year that have hit 5 million Americans–and counting–in the individual market this year. As Sen. Chuck Grassley (R-IA) rightly notes, this “cynical political move” is intended to prevent Americans from finding out how much insurance premiums for 2015 may spike “until after the election.”
That assumes the HealthCare.gov website is working a year from now. Unbelievably, AP reporter Ricardo Alonso-Zaldivar actually states that if it malfunctions again, “Democrats could benefit politically. If lighting strikes twice and the website sputters again during the next open enrollment season, that second act would not take place until after the voting is done.”
Perhaps Alonso-Zaldivar should interview Debra Fishericks, a woman with kidney cancer who is losing her company-sponsored insurance due to ObamaCare. Or he could interview company owner Betsy Atkinson of Atkinson Realty in Virginia Beach, who discovered that none of the plans offered in place of her current employee plan is affordable. “We were happy, we had great insurance,” Atkinson told CBS News. “We had continuing care for our employees. On June 30, 2014, I will probably not be offering company insurance for my employees. I just can’t afford it,” she added.
Another due date, another disaster. That’s the real story behind ObamaCare. And fixing a lousy website won’t change it.
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