News Questions Congress should ask Sibelius.

[SteamKing]

Well, it's too bad the healthcare.gov was a no-bid contract. If it had been handled thru normal bidding channels, you could have submitted a bid.

If you haven't figured it out already, dealing with the government at its easiest is about 10 times harder than dealing with the private sector. Everybody in govt. has some form to fill out in zintuplicate or some quota to meet. It matters not a whit to the govt. functionary you are dealing with if you get served today or next year. He can't get fired from his job. If you screw up at your private sector job, you can be shown the door anytime.

A lot of promises were made about all of this when ACA was being passed. At the time, nothing existed but 2000 pages of legislation. Now, realities are setting in, the promises have turned out to be vapor, and hard deadlines for implementation of a functioning system are fast approaching. All offers of delay of the individual mandate were haughtily dismissed by the Senate democrats during the recent budget negotiations. Some senators up for re-election in 2014 are reportedly considering support for delaying the individual mandate. Congress has already cut its deals about coverage for themselves and their staffs. They will not personally get hit with penalties for lacking coverage in 2014 and beyond because they are already covered and will not need to navigate the bowels of healthcare.gov.

It has already been suggested that healthcare.gov has swallowed more money than amazon.com and several other commercial websites required to get up and running.

 

[Vic Sandler]

This is the 28th unfortunate day for the ACA website. The site was down all day yesterday and a good part of today, but it is up now. I still can't log in. I called the 1-800 number and they told me they can't access my information even though it was input using the 1-800 number, not the website. That is, the problems with the website are not the only problems with the program as a whole. This time I got to speak to a supervisor, but it didn't do me any good. However, I was told that my case was being upgraded and that I would be receiving a call within 48 hours from a problem solving team that presumably has more effective tools at its disposal. I was also told that the 48 hour promise was not to be taken seriously and I shouldn't get upset if it were to take until Friday before they contact me.

 

[Vic Sandler]

The ACA is a complex undertaking, no question about it.

Let me be clear about this. After three and a half years of preparation and $600 million cost, I can't log in. That is not because of the 2500 page law or the 12000 page regulation. I am concerned, however, that once I do log in, problems related to the page count will commence.

The 2014 subsidy is based on your 2013 income, but the IRS only has your 2012 information, so what are they using it for? If they can access my records in the IRS database in order to see if I entered my information correctly, then why do they need me to enter my information at all? If you expect your 2014 income to be substantially different from 2013, then you can use your estimate of your 2014 income instead. I know this because the woman on the 1-800 line told me so and collected both my 2013 estimate and my 2014 estimate.

 

[Locrian]

The 2014 subsidy is based on your 2013 income,

To clarify, the 2014 subsidy is based on your 2014 income (and you note this, I think, in your second paragraph). Prior years' income will be used to help estimate what your subsidy should be in 2014.

However, if the estimate is wrong, it will show up in your taxes in April of 2015.

Edit: I think the rest of your post supports this, but I still think clarification for other readers is warranted.

 

[russ_watters]

Sure they can. It just takes a while. It's just as much a mistake to think the government cannot run a complicated program effectively as it is to expect them to run it effectively from day one.

Well certainly not every program fails, and I didn't mean to imply that if you read it that way, but some programs do fail. Governments like to think that since they lack profit motive; time, money and political will are infinite resources, but they aren't. Eventually, they run out and some programs fail. For example, the FAA's Advanced Automation System of the late 1980s and early 1990s:
https://www.google.com/url?sa=t&rct...nNsLL2wTsFGgMYDeA&sig2=mM2ichooQ55d2hgGcGyyYw

But it should be obvious that complexity and odds of success are inversely related to each other.

 

[Vic Sandler]

To clarify, the 2014 subsidy is based on your 2014 income.

If you want information about the ACA, you can call the 1-800 number. If you want correct information, call Locrian.

 

[Vic Sandler]

Today is unfortunate day 29, I have made no progress logging in. Here is an article that claims there was a window of opportunity for me to hack into my own account, but that the window is now closed.
http://money.cnn.com/2013/10/29/technology/obamacare-security/index.html?hpt=hp_t1

Here is an article that claims Obama knew we couldn't keep our existing insurance regardless of whether we liked it or not. His new line is that even though we can't keep the insurance we like, we will be able to replace it with insurance that he likes.
http://finance.yahoo.com/news/white-house-knew-millions-couldnt-101800242.html

 

[lisab]

Well, the ACA is quite clear that penalties (read taxes) are to be assessed for individuals who don't have coverage in calendar year 2014. <snip>

A penalty you pay for breaking the law is not the same as a tax.

You can easily avoid penalties, but no one can avoid taxes .

 

[russ_watters]

A penalty you pay for breaking the law is not the same as a tax.

You can easily avoid penalties, but no one can avoid taxes .

Sure, except for the fact that a federal penalty for not buying a commercial product/service would be unConstitutional. The administration sold it to the USSC as a tax and won on that argument:

Although the Supreme Court declared that the law could not have been upheld under an argument based on the regulatory power of Congress under the Commerce Clause, the Court declared that the legislatively-declared "penalty" was constitutional as a valid exercise of the Congressional power to tax, thus upholding the individual mandate.

http://en.wikipedia.org/wiki/Consti...on_and_Affordable_Care_Act#U.S._Supreme_Court

Personally, I agree with you.

 

[Vic Sandler]

The administration sold it to the USSC as a tax and won on that argument:

I don't know if the administration sold it in that fashion, but the next day they denied that the penalty was a tax.
http://abcnews.go.com/Politics/OTUS/white-house-roberts-obamacare-mandate-penalty-tax/story?id=16679772

White House: Sorry, Roberts, Obamacare mandate is a penalty, not a tax

The dateline of the story is June 29, 2012, and the date of the USSC decision was June 28, 2012 according to your link.

 

[SteamKing]

People and corporations avoid taxes every day. That's why tax attorneys and tax accountants were invented (and profiting quite handsomely from helping people and corporations avoid taxes).

http://bgr.com/2013/10/29/google-facebook-linkedin-tax-dodging/

People don't take trips to the Caribbean just to lay on the beach, nor do they go to Ireland just to pick up a superior piece of lace.

 

[russ_watters]

I don't know if the administration sold it in that fashion, but the next day they denied that the penalty was a tax.
http://abcnews.go.com/Politics/OTUS/white-house-roberts-obamacare-mandate-penalty-tax/story?id=16679772

The dateline of the story is June 29, 2012, and the date of the USSC decision was June 28, 2012 according to your link.

New taxes are unpopular, so they sold it to the public as a penalty.

 

[Vic Sandler]

New taxes are unpopular, so they sold it to the public as a penalty.

I don't disagree on either of these two points. In fact, my link supports your second point. However, you claimed that the administration sold it as a tax to the USSC. I can't find any link supporting that view. Can you help me out?

 

[SteamKing]

You can call any checks you send to the IRS every spring as 'birthday presents for Uncle Sam', but they're still taxes.

The old joke used to be that government wouldn't rest until it figured out a way to tax the air you breathe. They've come close: now you have to pay a tax for merely breathing.

 

[russ_watters]

I don't disagree on either of these two points. In fact, my link supports your second point. However, you claimed that the administration sold it as a tax to the USSC. I can't find any link supporting that view. Can you help me out?

If you're suggesting that the USSC ruled on that explanation without the government arguing it, I'm not sure, but it isn't a hair I'm that concerned about splitting. Maybe I'll look it up later if I get a chance.

Edit: Yes, indeed: the Obama admin argued to the court that penalty=tax.
http://www.supremecourt.gov/docket/PDFs/11-117%20BIO.pdf

 

[Locrian]

However, you claimed that the administration sold it as a tax to the USSC. I can't find any link supporting that view. Can you help me out?

I think I can.

How about this discussion of the Verrilli's arguments?

Mr. Verrilli believed that his argument that the penalty for not obtaining health insurance was a tax and not a forced purchase, even though it was a secondary point in his defense, could be the lure to bring along Justice Anthony M. Kennedy and perhaps Chief Justice Roberts as the narrowest way that the conservative justices could uphold the law.

I think he was proven right.

This article may give some background as well.

“This case presents issues of great moment, and the Anti-Injunction Act does not bar the court’s consideration of those issues,” Verrilli said.

Verrilli had to be careful, though. While he insisted that the penalty is not a tax for Anti-Injunction Act purposes, he is expected to argue as the case proceeds that Congress is within its authority to pass the health-care law in part because of its ability to tax.

“Today you are arguing that the penalty is not a tax,” said Justice Samuel A. Alito Jr. “Tomorrow you will be back and arguing that the penalty is a tax.”

And he sure did. You might technically say that he both argued that it wasn't a tax, and that it was.

 

[Vic Sandler]

Today is the 30th unfortunate day for the website. It is currently down due to problems at the data hub.
http://money.cnn.com/2013/10/29/news/economy/obamacare-site-outage/index.html?hpt=hp_t1
You can still call the 1-800 number though, so either you can call the number without purpose, or the data hub isn't completely down. Also, it seems that the website went live even though the security tests had not been completed.
http://www.cnn.com/2013/10/30/politics/obamacare-website-warning-memo/index.html?hpt=hp_t1
Sibelius claims that Obama is responsible but only after a considerable amount of blaming the questioner. Similar to what just happened on this thread I might add.

He is the President. He is responsible for government programs.

http://politicalticker.blogs.cnn.com/2013/10/30/frustrated-sebelius-to-questioner-whatever/?hpt=hp_t1

There has been one significant improvement to the website. Now I can browse marketplace insurance plans without logging in. However, the information I get is useless. There is no provision to enter the number of children or any ages, so the quoted price is just generic and not necessarily applicable to my situation. Also, while the co-pay is given, the deductible is not, so you can't really say what is being offered at the generic price. Thus you cannot compare plans. I hope that when the site is finally working and I can log in and find out what my subsidy is, I will get a different view of the marketplace than the one I am getting now. I.e. there are two views of the marketplace.

 

[Locrian]

There is no provision to enter the number of children or any ages, so the quoted price is just generic and not necessarily applicable to my situation. Also, while the co-pay is given, the deductible is not, so you can't really say what is being offered at the generic price. Thus you cannot compare plans.

I assume you are talking about the "See Plans And Prices In Your Area Now" button, and I agree its functionality is really lacking. Why they didn't allow you to choose exact ages is beyond me.

For anyone who isn't familiar with individual plan pricing, the rate is the multiple of five numbers: A base rate particular to a carrier & state, an area factor, a plan factor, an age factor and tobacco factor. While these are relativities and can be normalized lots of ways, typically the base rate is a dollar figure and the factors are on the order of one (but obviously not equal to one).

The "See Plan Prices Now" button assumes no tobacco and gathers all other information - loading the age table would have required a few extra bytes of memory. Why not take that final step? Currently if you choose "just for me" it let's you choose between two different age groups. The lower just gives you the rate for a 27 year old, the higher for a 50 year old. I'm not sure what ages it's assuming for the families (I could look it up but don't feel like it).

Now insurance carriers are being bombarded with individuals who used the "See Prices Now", got one rate, logged in for real, got another rate, and then called customer service. What a goofy design choice. I hope they get rid of that button.

Not only do you not have member cost sharing*, but you don't have network size, either. As I pointed out earlier, some plans are cheaper because they cut out a large swath of providers. A user should be able to make some reasonable comparisons just by using metal levels, but the additional details will be required to make a final decision.

*Vic Sandler, you mention you do see copays, but I don't see them. Where did you find them?

 

[BobG]

You might technically say that he both argued that it wasn't a tax, and that it was.

Nothing wrong with that.

"When I use a word," Humpty Dumpty said in rather a scornful tone, "it means just what I choose it to mean -- neither more nor less."
"The question is," said Alice, "whether you can make words mean so many different things."
"The question is," said Humpty Dumpty, "which is to be master - - that's all."

 

[D H]

Today is the 30th unfortunate day for the website. It is currently down due to problems at the data hub.

This is getting very old, Vic. We all know that it the rollout was a debacle. It's going to be another month, minimum, before the website is *close* to fully functional.

Sibelius claims that Obama is responsible but only after a considerable amount of blaming the questioner.

No, she didn't. She said "whatever".

That is the perfect response to a "when did you stop beating your children" type of question. I watched some of that witch hunt. Harper's questioning was amongst the worst. The Republicans are doing themselves no favor here. I, for one, used to be a fairly solid Republican voter. Not any more. I'm a solid anti-Republican voter now.

Here's the sad thing. This rollout was a debacle, without doubt. The timing of the release was 100% politically motivated; that the product wasn't ready technologically was completely irrelevant.

Nobody is looking to the root causes. The Republicans in that hearing were looking for a scapegoat, preferably one whose last name is Obama. On the flip side, Democrats were making excuses after excuses. It was not a pretty sight.

 

[Vic Sandler]

Vic Sandler, you mention you do see copays, but I don't see them. Where did you find them?

1. From the main page click on 'See Plans Now"
2. Select "I'm looking for coverage for myself or my family", and click on Next.
3. Select "Health", and click on Next.
4. Select a state and county and click on Next
5. Select "You, your spouse, and your children" and click on Next.
6. Click on Next.
7. Click on Next.
At the top of the page it says:

Plans are put into 5 categories
These 5 categories (catastrophic, bronze, silver, gold, and platinum) are based on how you and the plan expect to share the costs for health care.

The category you choose affects how much your premium costs each month and what portion of the bill you pay for things like hospital visits or prescription drugs.

It also affects your total out-of-pocket costs - the total amount you'll spend for the year if you need lots of care.

Then it has the following chart.
CATASTROPHIC less than 60%of the total average costs of care
BRONZE 60% of the total average costs of care
SILVER 70% of the total average costs of care
GOLD 80% of the total average costs of care
PLATINUM 90% of the total average costs of care

I am not eligible for Catastrophic insurance. The thing about total out-of-pocket costs slipped my attention.

Edit: What follows is misleading. Read Locrian's post #83 below for clarification.

According to the 2500 page law, there is a cap of $6,350 per individual and $12,700 per family regardless of which metal you choose. However, according to the 12,000 page regulations, this cap will not apply until 2015. Therefore, you need to know the cap of the plan before you can evaluate its value.

In my opinion, the lack of a cap means that the insurance is by no means affordable no matter how you slice it. You can buy this insurance and still have your life savings wiped out. From now on I intend to call it the UCA.

 

[Vic Sandler]

During the recent government shutdown, there were daily reports of polls that were taken to find out if people blamed Democrats or Republicans more. Why are there no polls now to find out who people blame for the website problems?

 

[Locrian]

In my opinion, the lack of a cap means that the insurance is by no means affordable no matter how you slice it. You can buy this insurance and still have your life savings wiped out. From now on I intend to call it the UCA.

This is very misleading. The out of pocket limits are hard maximums* and are equal to or less than the values Vic Sandler noted in their post. The 1 year delay mentioned only impacts coverages where portions are carved out between separate companies. This should not occur in exchange plans.

Now if you're in a self-insured group plan with carved out drugs - which is not uncommon - then you should review your coverage. In this case it is true that you could face out of pocket costs of up to twice the ACA limit (once per carrier). However, it is very unlikely this impacts you unless your employer has made some significant and very negative changes to your plan recently (or plans to next year). If they chose to do that, it would not be related to, or required by, the ACA.

In other words, the only way you could be facting OOP costs higher than those required by the ACA is if you had multiple carriers and would have been facing those same maximums (or higher) anyways, regardless of the ACA.

*Edit: They're hard maximums for in-network services. This should go without saying. . . but I said it anyways.

 

[Locrian]

Will Insurer's be the next Obamacare dropouts?

Insurers may still be able to withdraw from the federally run exchange through this Thursday.

And why would one want to?

Lurking behind all this is another issue raised last week—the impact of sequestration on Obamacare, and on insurance companies in particular. The Congressional Research Service believes that insurance companies will personally end up footing the bill for the sequester’s cuts to Obamacare cost-sharing subsidies. Those cuts will total $286 million in the first nine months of 2014 alone.

And, as may have been mentioned, there's a potential adverse selection impact related to the problems with the exchange.

 

[Vic Sandler]

This is very misleading.

Thank you for this clarification. So if I ever successfully buy insurance through the exchange, it will have the $6,350 individual and $12,700 family out of pocket caps and therefore is not a consideration when comparing them to each other?

 

[Vic Sandler]

And, as may have been mentioned, there's a potential adverse selection impact related to the problems with the exchange.

This adverse selection business has me perplexed. It has been said that if the young and healthy opt for the cheap penalty instead of the expensive insurance while the old and sickly buy the insurance, it will sink the entire system. But how about individual companies? Is there a plan in place in case the young choose company A and the old choose company B?

 

[SteamKing]

That's a good question. In a normal market, company A would become very profitable while company B would probably wind up losing money. If this situation continued for some time, company B would probably have to exit the health care insurance business unless it was able to alter its mix of policyholders. If company B raises its rates to raise more revenue, it runs the risk not only of shedding its older customers, but it would also not be as attractive for the younger customers either.

There is no guarantee that the companies writing policies today will be the same ones doing so next year or in the future. Different states have different companies offering coverage. California has a lot of companies competing for business because of its large population. Smaller states with fewer people have much less choice.

One aspect of the health insurance market which the ACA does not address is that health insurance does not move across state lines. If you buy a policy when you are living in California and you move to North Dakota, you get to start over in obtaining coverage from one of the companies writing insurance there.

 

[Vic Sandler]

Today is the 32nd unfortunate day. It is also the 8th day I have been trying the same thing and expecting a different result.

 

[SteamKing]

Congratulations! You have met Einstein's definition of insanity.

Not to worry, though. Now the IT dudes from Oracle and Google who brought you a second Obama term have been turned loose on healthcare.gov:

http://www.businessweek.com/news/2013-10-31/google-oracle-engineers-enlisted-for-obamacare-tech-surge

The answer is probably aboard these mysterious barges which keep turning up:

http://sanfrancisco.cbslocal.com/20...barge-to-offer-high-end-showrooms-party-deck/

Nothing says luxury like a deck barge with a bunch of shipping containers on them! California, what a silly place.

 

[Vic Sandler]

Not to worry, though. Now the IT dudes from Oracle and Google who brought you a second Obama term have been turned loose on healthcare.gov

No need for the IT dudes, it will take at least a month just to get them up to speed anyway. Can they lend us their president instead.