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Tags: Maryland

Healthcare.gov Begins Its Final Day of Enrollment . . . Closed for Maintenance



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From the first Morning Jolt of the week:

Happy Obamacare Deadline-ish Day. CNN’s Jim Acosta logs on to Healthcare.gov this morning and finds:

Perfect. Old traditions die hard, huh? At least, a lot harder than Healthcare.gov.

Health Care’s Cost Curve Is Turning Into a Squiggly Line, Mostly Upward

May 2013: Health care’s “cost curve” is bending down! Credit Obamacare!

“National health spending grew by 3.9 percent each year from 2009 to 2011, the lowest rate of growth since the federal government began keeping such statistics in 1960,” reports the Kaiser Family Foundation. Early data suggest that the numbers held into 2012. So the curve hasn’t just bent; it has bent more than ever.

September 2013: Health care’s “cost curve” is bending back up again! Blame Obamacare!

Last week, the Obama administration’s Centers for Medicare and Medicaid Services issued a rather different prediction: that “the [Affordable Care Act] is projected to . . . increase cumulative spending by roughly $621 billion” from 2014 to 2022. To be clear, that’s spending on top of the normal health-care inflation that would have happened if Obamacare had not been passed. So much for “bending down the cost curve,” as the president often liked to say his law would do.

November 2013: No, no, health care’s “cost curve” is bending down again! Credit Obamacare!

The White House issued a 29-page report that says, among other things, the once out-of-control health spending trends in the U.S. have been tamed to the point where medical inflation is just over 1%.

Health spending growth is the lowest on record, the report contends, up an average annual rate of 1.3% over the past three years. That’s less than one-third the historical average dating back to 1965.

Today: Health care’s “cost curve” is bending back up again! Blame Obamacare!

Health care spending rose at the fastest pace in 10 years last quarter, a development that could foreshadow higher costs for consumers this year.

Expenses for health care rose at a 5.6% annual rate in the fourth quarter, the Bureau of Economic Analysis said last week. The jump triggered a sharp upward revision in the government’s estimate of consumer spending overall and accounted for nearly a quarter of the economy’s 2.6% annualized growth in the last three months of 2013.

Driving the increase was an $8 billion rise in hospital revenue — more than the previous four quarters combined, according to the Census Bureau and Royal Bank of Scotland. RBS economist Omair Sharif says the increase in hospitals’ income was puzzling because the number of inpatient days dipped 1% during the fourth quarter.

Fewer patients, staying in the hospital less time, and paying more.

In the meantime, thank you, Obamacare.

U.S seniors — those aged 65 and older — have moved from a reliably Democratic group to a reliably Republican one over the past two decades. From 1992 through 2006, seniors had been solidly Democratic and significantly more Democratic than younger Americans. Over the last seven years, seniors have become less Democratic, and have shown an outright preference for the Republican Party since 2010.

Gee, do you think it has anything to do with the fact that Obamacare is cutting Medicare?

Finally, way to go, Maryland:

On Tuesday, Maryland will begin the process of replacing its troubled exchange, which has had so many problems since its launch on Oct. 1 that officials have decided it would be better to start anew. Maryland had more than two years to create its first exchange, which has cost $125.5 million to build and operate, according to the exchange’s spokeswoman.

Tags: Healthcare.gov , Obamacare , Barack Obama , Maryland

The Week So Far: A Dagwood Sandwich of Bad News for Obamacare



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Today’s Morning Jolt is just a Dagwood sandwich of bad news for Obamacare, piled higher and higher:

A Bad Day, Even by the Standards of Obamacare’s Bad Days

President Obama probably can’t wait to get away on that 17–day vacation. Because Obamacare just continues to careen from “success” to “success”:

Some frustrated consumers are sending premium payments to insurers who have never heard of them. Others say they will pass up federal subsidies and pay full price through insurers, while still others have given up altogether on the promise of health insurance by Jan. 1.

Consternation and confusion over applications sent through the federal HealthCare.gov website continue into the last seven days before the Dec. 23 enrollment deadline. Consumers with health issues are particularly nervous about the prospect of not having insurance at the start of the new year. Federal assurances last week about a “special enrollment period” for people whose applications have been hung up on the site are little comfort as neither insurers nor consumers have any idea how this will work and who will qualify.

The Department of Health and Human Services recommends people call its help line with questions and concerns about applications on HealthCare.gov. But that suggestion is also proving less than helpful for many.

. . . “Logic tells you I’m the target population for the law,” said Nelson, a Lombard, Ill., resident and Affordable Care Act supporter. But when people seek help from the call center, “you’re just being shuffled back and forth nobody owns the callers.”

Experts are divided on another possible solution for those hanging in the balance: sending premium payments before bills arrive from insurers.

Sentara Health, which offers the Optima health insurance plans for Virginia on HealthCare,gov, is hanging onto payments it can’t match with new customers yet. But Aetna warns that consumers should wait until they get a bill in the mail before writing any checks.

That’s a heck of a strategy for getting insurance: “Pay and pray.”

Oh, hey, more bad information on the sites, too:

In the latest round of difficulties with Obamacare in Wisconsin, plans offered by at least three insurers temporarily disappeared from the online insurance marketplace last week.

Before they came off the federal HealthCare.gov website for about a day, some of the plans from one company posted incorrect information about deductibles, according to the insurer.

Oh, hey, more sudden resignations of state directors:

MNsure’s top official resigned Tuesday following a Watchdog Minnesota Bureau report that she took a two-week Costa Rica vacation in late November, during the rocky rollout of the state $150 million health insurance exchange.

April Todd-Malmlov‘s abrupt resignation came during a closed emergency session of the agency’s board of directors. Subsequent reports revealed that Todd-Malmlov was accompanied on her tropical getaway by Jim Golden, Minnesota’s Medicaid director, raising possible conflict of interest and other concerns.

Oh, hey, more broken promises of imminent fixes:

Private health insurance exchanges still are not able to directly enroll consumers in subsidized health plans offered through Obamacare even though the government has said problems doing so should have been cleared up weeks ago.

Executives from three online health exchanges that contract with both insurance companies and government agencies to enroll consumers eligible for federal subsidies in marketplace plans say the process still isn’t ready to go and that more work remains.

This despite several promises from government officials that technical fixes have been made to allow for business to be conducted on those sites, which are alternatives to the troubled HealthCare.gov website and health exchanges sites run by states.

And Maryland may have to scrap its state exchange entirely:

The pace of enrollments is still far too low. If the exchange is able to replicate its best weekday and weekend performance during every one of the 104 days between now and the end of the open enrollment period on March 31, Maryland will still only achieve about three-quarters of its goal of signing up 150,000 people with private coverage. The site may be better, but better isn’t good enough.

Under those circumstances, the question raised by Rep. John Delaney, a Montgomery County Democrat, about whether it would be better for Maryland to scrap its effort to build its own exchange and instead join the federal one has merit. Indeed, Gov. Martin O’Malley acknowledged on Monday that the option — and all others — remain on the table.

That’s a hard possibility for Governor O’Malley to acknowledge. Under his leadership, Maryland was one of the most aggressive states in the effort to build out its own exchange — a strategic decision that appears in retrospect to have involved no small amount of hubris and political ambition. Walking away now from all that effort and tens of millions in expenditures would be particularly embarrassing.

But other than all that, Obamacare had an okay Tuesday.

Nah, I’m just kidding. There’s more bad news.

Tags: Obamacare , Maryland , Minnesota

Faith-Based Discussion of the State Exchanges



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Since October, the defensive cry of the beleaguered Obamacare defender has been, “but the states are doing a much better job!”

Some are. But plenty aren’t. The post below spotlights the grand scale of failure in Oregon. Beyond their troubles . . . 

In Washington, the exchange has been down for parts of the past five days.

In Hawaii, just 574 have signed up for insurance through the state exchange so far. This is after the federal government provided the state with $200 million to set it up; the state plan requires 100,000 people to purchase insurance through the exchange to become financially stable.

Maryland:

Just over 3,700 people have signed up for private plans on the exchange and more than 97,000 are expected to be added to the Medicaid rolls through the exchange by Jan. 1, according to the latest figures. About 800,000 residents are uninsured in the state, and they are supposed to be able to buy coverage on the exchange. But the exchange crashed on Oct. 1, the day it launched, and has not provided consistent help for users since.

Vermont:

State officials were hoping that the exchange would be fully operational at the beginning of December but the online payment program still hasn’t been put into place. Some individuals and small businesses are concerned that time is running out for them to purchase policies through the exchange in order to have coverage beginning in January.

Finally, exchanges in Minnesota, Hawaii, Nevada, Colorado, New Mexico, New York, Maryland, and the District of Columbia are vulnerable to a type of Wi-Fi attack that can allow hackers to intercept usernames and passwords.

Tags: Obamacare , Vermont , Washington , Hawaii , Maryland

But Other Than All That, Obamacare Had a Good Weekend!



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From the first Morning Jolt of an icy December week:

You Know the Latest News on Obamacare Is Bad. But You Don’t Know How It’s Bad.

The threat that Obamacare could end up shutting down volunteer firehouses, the site not working again, the administrators demanding bonuses and raises . . . rough end of the week for Obamacare. But things had to get better this weekend, right?

Nope.

Behold, members of Congress and their staff, unable to purchase insurance through the exchanges. I’ll give you a moment to stop laughing at the hardships of other people.

Congress itself is now having so much trouble signing up for the Obamacare exchanges that late Friday the top administrator in the House of Representatives laid out a backup plan in case lawmakers and staff can’t get through the process by the time their enrollment ends Monday.

The red flags started reaching critical mass Thursday and Friday, when some staff and members of Congress told House administrators they were having trouble enrolling through the Washington health exchange, known as DC Health Link. The D.C. exchange is the official signup portal for Congress, where members must go to get health care through their job.

Then the state of California decided that they could do whatever they wanted with the personal information that insurance shoppers typed into the site:

Raising concerns about consumer privacy, California’s health exchange has given insurance agents the names and contact information for tens of thousands of people who went online to check out coverage but didn’t ask to be contacted.

The Covered California exchange said it started handing out this consumer information this week as part of a pilot program to help people enroll ahead of a Dec. 23 deadline to have health insurance in place by Jan. 1.

State officials said they are only trying to help potential customers find insurance and sign up in time. But some insurance brokers and consumers who were contacted said they were astonished by the state’s move.

“I’m shocked and dumbfounded,” said Sam Smith, an Encino insurance broker and president of the California Assn. of Health Underwriters, an industry group.

Smith said he was under the impression from the exchange that these consumers had requested assistance. He received the names of two consumers this week but has not yet contacted them.

And they wonder why people don’t trust the government!

Then we learned the implementation in Maryland was even worse than anyone imagined:

Although state officials have provided the public scant detail about the troubled launch of Maryland’s version of Obamacare, emails and documents show that the project was beset behind the scenes for months by an array of technical issues, warring contractors and other problems.

Since Maryland’s online health exchange opened Oct. 1 for people to buy insurance under the Affordable Care Act — and immediately crashed — the two main companies in charge of the website have taken their fight to court, a corporate project manager was replaced and a high-powered consulting firm was quietly brought in to restore order. Though state officials initially said the crash of the online exchange was an unexpected and fixable problem, emails and documents obtained by The Baltimore Sun through state open-records laws outline serious issues before and after the launch.

The revelations came just days before Rebecca Pearce, the head of the exchange, resigned. State officials announced that move Friday night and pulled Carolyn Quattrocki from the governor’s health reform office to serve as an interim replacement.

Just two weeks before the launch, Pearce visited the prime contractor’s Linthicum headquarters and found a room of empty seats. She fired off an email questioning the company’s commitment to resolve problems and reminding the contractors of what was at stake: “Tonight, I am begging. I don’t know how else to say it: we have got to make this a reality.”

Finally, remember all of those administration officials telling the public to use paper applications if the web site wasn’t working? Well, now they’re not so sure there’s time to process all of those:

Federal health officials, after encouraging alternate sign-up methods amid the fumbled rollout of their online insurance website, began quietly urging counselors around the country this week to stop using paper applications to enroll people in health insurance because of concerns those applications would not be processed in time.

Interviews with enrollment counselors, insurance brokers and a government official who works with navigators in Illinois reveal the latest change in direction by the Obama administration, which had been encouraging paper applications and other means because of all the problems with the federal website. Consumers must sign up for insurance under the federal health overhaul by Dec. 23 in order for coverage to start in January.

“We received guidance from the feds recommending that folks apply online as opposed to paper,” said Mike Claffey, spokesman for the Illinois Department of Insurance.

After a conference call earlier this week with federal health officials, Illinois health officials sent a memo Thursday to their roughly 1,600 navigators saying there is no way to complete marketplace enrollment through a paper application. The memo, which Claffey said was based on guidance from federal officials, said paper applications should be used only if other means aren’t available.

So . . . yeah, it was as bad a weekend for Washington-run health care as it was for the Washington Redskins.

Tags: Obamacare , Maryland , Congress

California: We Won’t Reveal Enrollment Numbers Until Mid-November



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The exchanges and navigators aren’t failing everywhere . . . but there are enough places where the rollout is simply disastrous. Here’s Minnesota:

Southside community worker, Miguel Rivera, who MNsure certified to provide help as a so-called “navigator” only last week said that confusion about the Affordable Care Act championed by the president is common among the people he sees.

As a MNsure navigator, Rivera can help if they can’t manage alone. But when the five-hour clinic ended, he hadn’t signed up anyone for a plan on MNsure.

. . . and here’s Maryland:

Four weeks since it began selling health insurance on the state’s new marketplace for the uninsured, Evergreen Health Cooperative Inc. has signed up only five people.

That’s a long way from the nonprofit health insurance provider’s first-year goal of 15,000 people, so Evergreen is already shifting focus.

. . . and here’s California, suddenly announcing the state won’t reveal the number of enrollees at the end of the month, as many expected:

Peter Lee, the head of the state’s new health insurance exchange, said Monday that he will not reveal how many Californians have enrolled in health plans until mid-November.

Tags: Obamacare , Minnesota , Maryland , California

New Polls Show Battleground Dems Falling Behind



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With barely a month until Election Day, a new round of polling sponsored by the NRCC paints a troubling picture for incumbent Democrats in battleground districts in Florida, Maryland and Virginia.

  • FL-24: Rep. Suzanne Kosmas (D) trails state Rep. Sandy Adams (R) by 10 percentage points — 39 to 49 — among likely voters.
  • MD-1: Rep. Frank Kravotil (D) trails state Sen. Andy Harris (R) by 4 points — 39 to 43 — among likely voters, with 3 percent going to third party candidates.
  • VA-2: Rep. Glenn Nye (D) trails Scott Rigell (R) be 5 points — 40 to 45 — among likely voters.

All three seats are in the top 15 of NBC First Read’s “Field of 64” list of the 64 House seats most likely to change hands in November.

Tags: Florida , Maryland , Virginia

GOP Challenger Leading Democratic Incumbent in Maryland



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A Republican polling firm, Public Opinion Strategies, finds GOP challenger Andy Harris ahead of incumbent Democrat Frank Kratovil by 3 percent in Maryland’s 1st congressional district.

The health-care bill is polling at 35 percent favor, 58 percent oppose in this district; only 30 percent say the stimulus is working, while 65 percent say it was “just a government spending program that did not create enough new jobs for the money.”

This is not that surprising, as this is Maryland’s reddest district, and Kratovil’s 2008 win looks like a bit of a fluke, helped along by deep divisions in the local GOP that year.

Tags: Andy Harris , Frank Kratovil , Maryland

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