Quotes of the day

Why do Republicans even bother trying to delay Obamacare? President Barack Obama’s doing it all by himself…

Sure, Obama’s not doing the things Republicans have suggested — push off centerpieces like the individual mandate, or even put the entire law on hold for a year. But piece by piece, the Obama administration keeps giving itself extensions on smaller parts of the law, because there’s always some piece that isn’t quite ready

There was also a tone to Thursday’s announcement that was close to pleading for help, as the administration urged insurers to cut the new customers a bit of slack — looking the other way if they sign up a few days late, and making their coverage retroactive if they pay a bit late…

“For all his attacks on our efforts, no one has done more to undermine the implementation of Obamacare than the president himself,” said Brendan Buck, a spokesman for House Speaker John Boehner.


The latest deadline delay for the Affordable Care Act could lead to even more enrollment problems and place a bigger burden on insurance companies, experts say.

The Department of Health and Human Services announced Thursday it would require insurance companies to accept premium payments for plans that start on Jan. 1 up until Dec. 31-eight days from the already once delayed date of Dec. 23.

“This will kill insurance companies,” says Devon Herrick, senior analyst at the National Center for Policy Analysis, of the latest deadline extension. “I don’t think insurance companies will be there on New Year’s Day figuring out what they owe, who they need to bill and who has legitimate coverage. You can see what a mess this is—I can’t imagine insurance companies can solve this in one day, especially when that day is a holiday.”…

“Is this possible? Yes. But is it practical? No. The challenge here is that the U.S. government is saying the transaction that happens to enroll someone is fundamentally easy, when it is fundamentally complicated.”


Enrollment records for close to 15,000 HealthCare.gov shoppers were not initially transmitted to the insurance plans they selected, according to a preliminary federal estimate released Saturday.

While these cases pose a challenge for the Obama administration, officials say they believe the situation is improving. Since early December, fewer than 1 percent of HealthCare.gov enrollments did not make their way to health insurance plans.


Insurers said that they had found many discrepancies and errors and that the government was overstating the improvements in HealthCare.gov.

In some instances, they said, the federal government reported that the home address for a new policyholder was outside an insurer’s service area. In other cases, a child was listed as the main subscriber — the person responsible for paying premiums — and parents were listed as dependents.

In some cases, children were enrolled in a policy by the federal government and parents were left off, or vice versa. In other cases, the government mixed up the members of a family: A child or spouse was listed two or three times in the same application in late November. Such errors can have financial implications, increasing the amount of premiums that a family is required to pay.

While some of the problems were discovered in the last few days, insurers said that they had previously reported many of the errors to the “help desk” at the Centers for Medicare and Medicaid Services, and that the problems remained unresolved.


Some people who picked a health plan as far back as October through the Covered California exchange say insurers are telling them they still have no record of their enrollment. As a result, bills haven’t gone out and consumers can’t pay their initial premium to ensure coverage takes effect in less than three weeks.

Thomas Gallo of Glendora signed up his wife and son on the second day of enrollment in October. After hearing nothing for weeks, he said, he was told by the state in late November that his application and some others had been lost.

Gallo reapplied over the phone, but he said he still has no confirmation from Blue Shield of California about his family’s Silver plan. Gallo, a retired accountant, has Medicare for himself.

“The back end is so backed up, and no one can give me an answer,” said Gallo, a strong supporter of President Obama’s healthcare law. “What happens if we don’t get coverage by Jan. 1? There are real problems here.”


For the second week in a row, the Washington Healthplanfinder website is down, and it’s causing problems for people who are dealing with billing issues. Some of them say the website is mistakenly debiting their accounts

The Bruners enrolled for insurance on the Washington Healthplanfinder website, last October. They say they selected the bill pay date to be December 24th. Instead the Washington Healthplanfinder drafted the 835 dollar premium Monday…

One viewer emailed KING 5 saying, “They drafted my account this morning for a second time.”…

“We’ve got to figure out how to get money to pay the bills for the next week or two until we have another check come through,” said Josh Bruner. “It’s just crazy.”


“We’re encouraging [insurers] to offer retroactive coverage,” Michael Hash, director of HHS’s office of health reform, told reporters on a Thursday afternoon conference call. “For example, to allow someone who signs up and pays on January 5 to get coverage with a retroactive start date of January the first.”

“Many insurers do retroactive coverage in the current market,” HHS policy director Chiquita Brooks-Lasure said later on the same call. But health care industry consultant Bob Laszewski says that isn’t true.

“I don’t know what the hell they’re talking about,” Laszewski tells THE WEEKLY STANDARD. “I’ve been in the health insurance business for 40 years. You sign it prospectively, not retrospectively.”

Indeed, if people could buy insurance retroactively, why would they buy it when they’re healthy? If you could get your medical bills covered from a January 3 car accident by signing up on January 10, there would be no reason to pay a premium in December.


“What’s wrong with ‘urging’ insurers to offer free care?” you might ask. “That’s not the same as forcing them to offer free care.” Except that the government is using the full force of its regulatory powers, under Obamacare, to threaten insurers if they don’t comply. All you have to do is read the menacing language in the new regulations that HHS published this week, in which HHS says it may throw otherwise qualified health plans off of the exchanges next year if they don’t comply with the government’s “requests.”…

The administration could pay insurers to cover up for its mistakes. But that would lead to criticism—as it has in other instances—that the White House is lawlessly throwing taxpayer money at insurers to, well, cover up for its mistakes. So, instead, they’re asking insurers to pay for the mistakes

[I]t will be up to insurers to sue to protect their rights. Like battered wives, they are unlikely to do so. Companies like Aetna and Humana are so terrified that the administration will run them out of business that they are more likely to do what they’re told, and quietly pass the costs on to consumers. The chaos and recriminations have made insurers like UnitedHealth, who have largely stayed out of the exchanges, look smart.


This tells us a few things, I think. The first is that the administration is deeply worried about people who had insurance they liked who are now going into January with either no insurance or with insurance that doesn’t cover doctors and treatments they’re receiving. And because the administration has access to the enrollment data, this further suggests to me that the enrollment spike we saw at the very end of November and the beginning of December has not reached a pace at which they can reasonably expect that the 5 million people who had their plans canceled will have replaced their coverage by Jan. 1. There’s no way to know for sure, of course, but if enrollment was still rapidly accelerating, they wouldn’t need to basically beg insurers to help them eke out as many December enrollments as possible.

The second thing it tells you is that the administration has reached the limits of its November strategy of using last-minute rule-making to implement on-the-fly changes to the law. Most in the latest round aren’t even rules, or even changes to rules; they’re requests. The insurers may well go along — they, too, have a big stake in Obamacare’s success. But by making the request in public, the administration has given itself room to blame insurers when people lose access to doctors, drugs or insurance. Now they can say, “Well, we asked them not to do that.”

Day by day, the administration is putting more of the onus on insurers to make this market work — voluntarily, out of the goodness of their hearts or at least out of mutual self-interest. In some ways, that may be a good thing; insurers are pretty good at delivering insurance, so giving them a freer hand may make sense. But, of course, it hands an awful lot of power to insurers that just a few months ago the administration seemed committed to taking away. It probably wouldn’t be doing that if it weren’t worried about how things are going.


Via RCP.

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