ACA/Obamacare: The Ongoing Saga of Cyber Security and the ACA Web Site

Make special note of 3:04 to 3:39 of the video regarding the description of the pathways along which one's sensitive personal information travels.

ACA/Obamacare: The Oregon Trail to Nowhere. Meet “Cover Oregon“.

“Oregon has received the Obama administration’s approval for a 30-day extension of its Obamacare exchange’s open enrollment period, officials announced Wednesday.

State officials had requested the federal government’s approval for the extension, which has come the day after news broke that the Obama administration will be extending its own deadline for exchange enrollment for anyone who claims they began their application prior to March 31.

Oregon’s exchange, however, qualifies for an even wider extension because its marketplace has experienced possible the worst technological problems of any state. With five days left before open enrollment was supposed to close, Oregon still has no website available for individuals to enroll in health insurance online.”

“The state’s embattled exchange crashed in October and officials are still unable to get it back up and running. Officials shifted the marketplace’s focus to paper applications in November and have since been able to sign up 52,000 for private health plans, but online enrollment still isn’t possible.

A recent private investigation into how Oregon’s exchange was so severely mismanaged discovered massive internal conflict which prevented the exchange from being effectively built, including “ineffective” and “at times contentious” communications between agencies.


So far, the top tech official in charge of creating the website and two successive directors of the exchange have all been forced to resign. The website’s primary contractor, Oracle, has not yet been fired, but Cover Oregon is withholding $25.6 million of contract and has reserved the right to sue the company over payments already issued.

After requests from federal Oregon lawmakers, the General Accountability Office will audit Cover Oregon’s website operations. The exchange spent over $300 million on the website and received several early innovator grants as one of Obamacare’s first supporters.” - Oregon Obamacare exchange gets month-long enrollment delay, daily caller.com, 03/26/2014

Link to entire article appears below:

http://dailycaller.com/2014/03/26/oregon-obamacare-exchange-gets-month-long-enrollment-delay/










    

ACA: The Informed and Web Savvy Consumer Purchases Health Insurance?

The Affordable Care Act was supposedly aimed at insuring the previously uninsured. Unfortunately a woefully low percentage of previous uninsured are attracted to ACA whereas the vast majority of applicants are the previously insured merely looking for a tax credit to lower rates [subsidy]. (1)

Moreover, regarding the uninsured or the previous insured seeking subsidy, an implicit assumption by the central planners of ACA is that potential health insurance consumers are web savvy and informed consumers of health insurance. Maybe not so much regarding the uninsured which is the supposed target market of ACA.

Lower middle income and lower income people, making up a large segment of the previously uninsured, are not exactly the segment of the population with computers, computer skills and web savvy. Hence the central plan designers of the ACA have designed a delivery system known as the market place exchange web site that does not match the target market’s access point and skill set.

The same population that makes up the uninsured market, if they manage to find a computer, acquire computer skills and navigate the web site, are further assumed to be informed consumers by the central planners. Would an uninsured person or an insured person be more informed regarding health insurance? Would a person consistently uninsured in the realm of health insurance over long periods, in the main, be familiar and informed regarding health insurance?

One ends with a mismatched delivery system regarding its target market with the target market being additionally populated with uninformed market participants. Central planning at its zenith!

What are the results? Abysmal. However, highlighting two of the uninformed results may be of interest:

(a) when comparing seemingly like-kind insurance plans on the ACA web site the consumer defaults to lower price. Unfortunately the lower price many times means the consumer has purchased the ultra-narrow or narrow provider network. Hence when the time comes to use the insurance the consumer finds few takers. One might call this procedure being “informed” the hard way, (2)

(b) the supposed informed consumer will realize, without any doubt, that once his or her policy is issued they will need to request a HIPPA Release Authorization Form from their insurer, sign such form, and return it post-haste. Huh? Without the form only the named insured can access insurance information, claims paid or pending information, etc. A single person without a HIPPA Release Authorization Form filed will find no outside person can help. If a spouse is involved, sorry no information unless the form is on hand. Yes, one spouse is considered the named insured and the other spouse can only gain access if the named insured submits the HIPPA Release Authorization Form. Of course the model informed consumer of the central planner surely knows this information without a second thought. (3) (4) (5)

The plans differ; the planners are all alike... - Frédéric Bastiat


　

Notes:

(1) Aetna could be forced out of Obamacare: CEO, CNBC, 01/22/2014

http://www.cnbc.com/id/101354183



　

　
(2) Marketplace Plans’ Networks Are Very Small, Study Finds. Kaiser Health News, 12/12/2013


http://capsules.kaiserhealthnews.org/index.php/2013/12/marketplace-plans-networks-are-very-small-study-finds/?referrer=search


(3) Authorization Use and Disclosure FAQs

http://www.hhs.gov/hipaafaq/use/index.html



　
(4) HIPAA Release Form

http://www.healthcare-information-guide.com/HIPAA.html



　
(5) HIPPA Release Authorization Form

http://www.healthcare-information-guide.com/support-files/hipaa-release-form.pdf

Obamacare Provider Networks: The Networks Look Like Medicaid Networks? One has Signed Up for “Medicaid Plus“?

‘Many plans being offered now on the new insurance exchanges sharply limit the number of hospitals where services are covered, according to a new McKinsey & Co. report. Insurers are making a bet that price is more important to consumers than choice, and limiting the number of hospitals and doctors allows them to keep the cost of a plan as low as possible. Many of the new plans offered still are more expensive than current plans because they offer more benefits.’

‘According to the McKinsey report, which looked at federal and state-run insurance exchanges in 20 cities including Los Angeles, Atlanta and Houston, about 60% of health plans offer coverage at a smaller number of hospitals than comparable current individual plans. McKinsey identified 120 health plans in those markets by examining federal and state exchange filings, as well as provider information listed on individual insurer and hospital websites. Some of these new plans limit coverage to one or two large hospitals.

The number of hospitals accepting insurance from a consumer who buys coverage on the exchange could be 60% lower than the number of hospitals in current individual plans, according to the McKinsey report, which included the 20 largest hospitals in each market that it measured.

Consumers can still buy plans on the exchanges that offer coverage at a wide network of hospitals, but they cost significantly more, McKinsey said. In a market where the same insurer offers two separate plans—one with broad hospital access, one with limited options—the more comprehensive coverage costs 26% more, McKinsey said.’

‘Leading research and teaching hospitals, such as Cedars-Sinai, the University of Chicago Medical Center and MD Anderson Cancer Center in Houston, are cut out of most plans sold in their home states. That move "is built on the premise that hospitals are commodities," said Thomas M. Priselac, CEO of Cedars-Sinai Health System, which is available on just one of seven middle-tier plans sold in Los Angeles. "That's just not true."‘

‘Consumers who need complex procedures like heart transplants will still be able to get them because their insurers will contract with hospitals that offer them.

Still, "when you need an organ transplant, it's a matter of life or death—do you want your insurance company calling us, working out a deal?" asked David T. Feinberg, CEO of the UCLA Hospital system, which includes Ronald Reagan. The hospital is included in just two of seven middle-tier health plans sold in the Los Angeles market.’ - Shrinking Hospital Networks Greet Health-Care Shoppers on Exchanges, WSJ, 12/13/2013

Link to entire article appears below:

http://online.wsj.com/news/articles/SB10001424052702304202204579256621005722460


　

　

　

　

　

　

　


　

ACA Web Site Debacle (You Can’t Make this Stuff Up!): Fixing the Site Using the Same Company that Developed the Most Troubled Components of the Site? Huh?

“The Obama administration said Friday that it would fix problems in the federal health insurance marketplace by Nov. 30, just two weeks before the deadline to sign up for coverage to replace health insurance policies being canceled because they do not meet new federal standards.”

“Jeffrey D. Zients, President Obama’s troubleshooter on the project, said the general contractor, Quality Software Services Inc., a unit of the UnitedHealth Group, would now “manage the overall effort,” like a general contractor on a home improvement project. Notably, that company had a role in developing one of the most troubled components of the marketplace, which helped verify the identities of those registering.” - Promised Fix for Health Site Could Squeeze Some Users, NYT, 10/25/2013

Link to entire article appears below:

http://www.nytimes.com/2013/10/26/us/politics/general-contractor-named-to-fix-health-web-site.html?pagewanted=all&_r=0

Welcome to the ACA: Hundreds of Thousands Receive Health Insurance Cancellation Letters. No Way! Way!

“Health plans are sending hundreds of thousands of cancellation letters to people who buy their own coverage, frustrating some consumers who want to keep what they have and forcing others to buy more costly policies.”

“But the cancellation notices, which began arriving in August, have shocked many consumers in light of President Barack Obama’s promise that people could keep their plans if they liked them.

“I don’t feel like I need to change, but I have to,” said Jeff Learned, a television editor in Los Angeles, who must find a new plan for his teenage daughter, who has a health condition that has required multiple surgeries.

An estimated 14 million people purchase their own coverage because they don’t get it through their jobs. Calls to insurers in several states showed that many have sent notices.

Florida Blue, for example, is terminating about 300,000 policies, about 80 percent of its individual policies in the state. Kaiser Permanente in California has sent notices to 160,000 people – about half of its individual business in the state. Insurer Highmark in Pittsburgh is dropping about 20 percent of its individual market customers, while Independence Blue Cross, the major insurer in Philadelphia, is dropping about 45 percent.” - Thousands Of Consumers Get Insurance Cancellation Notices Due To Health Law Changes, Kaiser Health News, 10/21/2013


Update 10/26/2013

“Hundreds of thousands of Americans who purchase their own health insurance have received cancellation notices since
August because the plans do not meet Obamacare's requirements.

 The number of cancellation notices greatly exceed the number of Obamacare enrollees.”


“Several states have released Obamacare enrollment data, however, revealing extremely low rates. South Dakota reported that only 23 people enrolled in the exchanges, a mere 0.0000276 percent of that state’s population. North Dakota enrolled only 20 residents.

Alaska, meanwhile, comes in at seven total enrollees, or 0.000957 percent of Alaskans.” - Health insurance cancellation notices soar above Obamacare enrollment rates, The Daily Caller, 10/24/2013 

Observation:

The prior individual plans would all be "private" plans hence one would expect such plans to have a rather wide negotiated network of providers. If one receives the letter and buys "off exchange" from the same insurer (assuming the insurer sells off exchange policies), meaning one is purchasing another private plan, then the network would be rather wide as it is the same negotiated network of the same insurer.

If one dumped the current insurer and purchased from another insurer, in an off-exchange situation, one would need to examine the network but more than likely it is the particular insurer's negotiated network they have been cultivating for years.

However, say one receives the cancellation letter and goes to the ACA exchange and buys. Those networks are much more narrow as supposedly, according to insurers, the narrower network lowers price. Here is a situation that is bound to happen and one may do one's self a disservice:

(1) cancel letter arrives,

(2) one has an income that precludes a subsidy,

(3) however, rather than going off-exchange one merely goes through the ACA exchange. No subsidy is forthcoming but anyone can use the exchange regardless of subsidy or no subsidy,

(4) one applies and is approved,

(5) one has just been approved for a narrow network rather than the broader network available in the "off-exchange" world.

　

　
The entire Kaiser Health News article and Daily Caller articles appear in the links below:

http://www.kaiserhealthnews.org/Stories/2013/October/21/cancellation-notices-health-insurance.aspx

http://dailycaller.com/2013/10/24/health-insurance-cancellation-notices-soar-above-obamacare-enrollment-rates/


Updated 11/05/2013

Flowchart of President Obama’s “You can keep your plan, period” defenses - Keith Hennessey, 11/04/2013

 

http://keithhennessey.com/2013/11/04/argument-flowchart/

ACA Web Based Application Becomes the Old School Paper Application. No Way! Way!

“Up first, the law's administrators are resorting to an anachronism, paper applications, in a desperate attempt to enroll consumers. Obamacare's exchanges were breathlessly billed as -- ahem, "simple and user-friendly" -- Travelocity-style websites for healthcare. Amid the endless shinola-storm of glitches and technical meltdowns, here we stand:


The dead-tree version of health insurance enrollment is turning out to be surprisingly popular. Unable to use new government insurance Web sites that have been plagued by technological problems, those tasked with helping the uninsured sign up for health coverage are bypassing the sites altogether, relying instead on old-fashioned paper applications. It is a slow and labor-intensive substitute for what was supposed to be a snappy online application, similar to Amazon or Travelocity. But faced with a flood of people eager to get health benefits for the first time, what had been considered Plan B has become the plan — at least until the sites are operating more reliably, according to consumer guides and community groups. It is one way the frustrating, persistent glitches on some state Web sites as well as the main federal portal serving 36 states have had a ripple effect around the country.

Er, the only reason old-fashioned paper is "surprisingly popular" is because the entire web system, which the government had three-plus years to prepare, is hopelessly broken. The Post story goes on to reveal that those who "sign up" the old-school way...aren't actually enrolled. I'll let Allahpundit explain why:

"Solution” suggests that people are now being successfully enrolled via paper applications. Not so. Turns out that the info on those applications needs to be input into the same wheezing, error-riddled computer system that’s forced website users into using paper in the first place. The “solution,” in other words, is simply to create a paper backlog that will need to be manually entered into the ObamaCare database by the insurance companies themselves if/when the system ever becomes stable enough to let them do that.“ - Trainwreck: Obamacare Officials Now Resorting to Paper Applications As New Flaws Emerge, Townhall.com, 10/14/2013


　Link to the entire article appears below:

http://townhall.com/tipsheet/guybenson/2013/10/14/trainwreck-obamacare-officials-now-resorting-to-paper-applications-new-flaws-emerge-n1723509?utm_source=thdailypm&utm_medium=email&utm_campaign=nl_pm