The administration is claiming a limited victory by saying the number of those enrolled in ObamaCare has now hit 5 million with two weeks to go until the March 31 deadline. If accurate, the number does represent a steep increase over the 4.2 million that were said to have signed up at the beginning of the month. At this rate, administration cheerleaders reason, the goal of 7 million enrolled in the Affordable Care Act may yet be reached at some point in the near future, if not quite on time. This burst of enrollments is seen as a vindication of President Obama’s all-out push to promote the law including such questionable activities as appearing on the “Between Two Ferns” web show where he traded barbs with comedian Zach Galifianakis.
But before the president and his team start popping the champagne corks to celebrate their achievement and their faux hipness, it’s time once again to point out that the administration’s Potemkin enrollment figures should be read with a truckload of salt. As the New York Times reported last month, as much as 20 percent of all those enrolled had not actually paid their premiums, meaning they were not covered by the program. While Secretary of Health and Human Services Kathleen Sebelius told Congress she had no idea what the numbers of unpaid enrollees were, more states are reporting these figures and, as CNBC reported last week, the results are literally all over the map. While some states report high pay rates, others like Maryland say only 54 percent have paid.
All this calls in to question not only the effectiveness of the sales job done by the president and celebrity supporters such as Lebron James. It also means that the odds that this system can sustain itself without mandating vast increases in rates for those who do pay are getting slimmer every day.
For months we’ve been told by the administration that the only problem with ObamaCare was a “glitchy” website that had since been fixed. But what has since become clear is that the effort to convince young and healthy Americans to sign up for insurance that is both expensive and not something they may need is a failure. Though many of those who clearly benefit from the new health law, such as the poor and those with pre-existing conditions, have signed up, the scheme requires large numbers of those who won’t need the coverage as often in order to be economically viable. That problem will be exacerbated by the failure of much larger percentages of customers to pay for their insurance.
As we’ve noted previously, the non-payment of the premium is not a technicality. Many of those purchasing the insurance may be first-time buyers and not understand that they must pay their bill before coverage starts rather than long after the fact, as they can with a credit card transaction. Or it may be that some enrolled with no intention of paying or thinking that the hype about the glories of ObamaCare they’ve heard in the mainstream media and from the president absolved them of the obligation to pay for it. But either way, the large number of non-payments renders the enrollment figures meaningless and ensures that the rates for those who do pay are going up next year by percentages that will shock them.
The president claimed that the number of enrollees has already reached the point where the law will work rather than collapse from lack of participation. But even if we accept his premise that falling millions of customers short of the announced goal of seven million is no big deal, the fact that hundreds of thousands of those being counted in the pool of those he’s counting are not covered because of non-payment of premiums makes his assertion a colossal fraud.
The president may think that a March madness ad blitz during the NCAA basketball tournament may save ObamaCare. But if the past pattern holds, any further surge in enrollment will provide the scheme with a false sense of security. Until we get a full accounting not only of those who signed up on a website but completed the process by paying for the plan they chose, we’ll have no idea how many people truly are enrolled. Seen in that light, the president’s enrollment promises may well turn out to be no different from other pledges he has made about the ACA in the last few years: completely untrue.
The hospital bills are hitting Larry Basich’s mailbox.
That would be OK if Basich had health insurance. But he doesn’t.
Thing is, he should be covered. Basich, 62, bought a plan through the state’s Nevada Health Link insurance exchange in the fall. He’s been paying monthly premiums since November.
Yet the Las Vegan is stranded in a no-man’s-land where no carrier claims him, and his tab is mounting: Basich owes $407,000 for care received in January and February, when his policy was supposed to be in effect. Instead, he’s covered only for March and beyond.
Basich has begged for weeks for help from the exchange and its contractor, Xerox. But Basich’s insurance broker said Xerox seems more interested in lawyering up and covering its hide than in working out Basich’s problems. Nor is Basich the only client facing plan-selection errors through the exchange, she added.
Xerox, meanwhile, said it’s working every day to fix Basich’s problem, and its legal counsel is routine.
In the rollout of the Affordable Care Act and its insurance exchanges, you can find a success story for every failure. But Basich’s case is extreme.
Basich said he began trying to enroll on Oct. 1, the day the exchange website went live. Like many consumers, he fought technical flaws during multiple sign-up attempts. In mid-November he finally got through and chose his plan: UnitedHealthcare’s MyHPNSilver1.
“It was like reaching the third level of Doom,” Basich said of the torturous sign-up process.
Basich paid his first premium on Nov. 21, and within days the exchange withdrew the $160.77 payment from his money-market savings account. Because Basich paid a month before the Dec. 23 deadline, his coverage was to begin Jan. 1.
Weeks ticked by, but Basich received nothing to confirm he had insurance. Nevada Health Link kept telling him he was enrolled, but UnitedHealthcare said he wasn’t in their system.
Basich’s predicament went critical on Dec. 31, when he had a heart attack. His treatment, which included a triple bypass on Jan. 3, resulted in $407,000 in medical bills in January and February that no insurer is covering.
Basich and his insurance broker, Tamar Burch of Branch Benefits Consultants, said the issue appears to be confusion at the state exchange. Xerox’s system says Basich chose a plan from another insurer, Nevada Health CO-OP, even though Basich has paperwork that shows he selected MyHPNSilver1. In short, Xerox can’t seem to decide where Basich belongs, Burch said.
So the exchange is trying to compromise, putting Basich with Nevada Health CO-OP for January and February, when he incurred his bills, and with UnitedHealthcare from this month on. But CO-OP officials say Basich is not their member.
Nevada Health CO-OP CEO Tom Zumtobel told the exchange board on Feb. 27 that the nonprofit carrier spent seven days with Xerox determining Basich’s eligibility, only to find that Basich hadn’t chosen the group’s coverage.
“If he had picked our health plan, we would be advocating for a solution. But he didn’t pick us,” Zumtobel said. “We need someone on the board to advocate for him.”
Why have four months passed without a resolution?
“Xerox is truly out of their league. They need to understand they are an administrator, they are not an insurance company,” Burch said. “They need to understand their boundaries. They don’t understand this world. Everybody is at the mercy of Xerox, and they are not doing this right.”
Xerox representatives responded that they’re working hard to make it right.
“Mr. Basich’s issue is complex, and we’re working on it every day. We are in touch with Mr. Basich, his broker, the carriers, (Silver State Health Insurance Exchange) leadership, and the Division of Insurance to sort it out,” said spokeswoman Jennifer Wasmer.
The help didn’t come fast enough, said Basich, who blames his back-and-forth with the exchange in December at least in part for stress that caused his heart attack. That stress has turned up a few notches now that Basich is getting the bills. He fretted in the exchange board’s Thursday meeting about what will happen to his credit rating – and his ability to qualify for a mortgage – if the bills are not covered.
“All I wanted to do when I moved here was buy a house, get a dog and go to some spring training games for the Dodgers,” said Basich, who moved to Las Vegas from Hawaii in 2012.
Meanwhile, the exchange sent Basich premium invoices for January and February. He paid them both.
WHO CAN HELP?
Basich has sought help at virtually every level of the system, from the Xerox customer-service reps who answer the phones at the exchange’s Henderson call center all the way to Gov. Brian Sandoval and Senate Majority Leader Harry Reid. Both Sandoval’s and Reid’s offices have told him they want to help, Basich said, but there’s been no resolution so far.
Even Reid, who took flak for his Feb. 26 statement that “all” Obamacare “horror stories” are “untrue,” is trying to help. Reid spokeswoman Kristen Orthman said one of the senator’s health-care legislative aides has been on the phone with Basich almost daily, “but at this point it’s in the hands of Xerox to see what can be done.”
Sandoval spokesman Mac Bybee said the office “regularly engages” the exchange and Xerox on behalf of any consumer who reaches out with concerns about Nevada Health Link.
Officials with the Nevada Division of Insurance said they’re also watching the situation.
“Mr. Basich’s concerns are certainly on our radar. We have discussed them with our partners at the Silver State Health Insurance Exchange, and we feel confident that his concerns will soon be resolved appropriately,” division spokesman Jake Sunderland said.
But there hasn’t been much action. What’s more, when Burch discussed Basich’s case with Xerox executives on March 11, they said they couldn’t tell her much because the company had hired legal counsel. That’s even though Basich has no interest in suing and has not retained a lawyer. He said he merely wants the exchange to keep the promise it made when it withdrew three premium payments from his savings account.
Xerox seems to be spending inordinate time documenting Basich’s phone calls, website access and emails, Burch said. She said a Xerox executive tried to throw blame on Basich for writing four different applications with four separate sets of information.
“I said, ‘Larry’s not the only one who did that. Lots of people have created multiple applications. Nothing is concrete until people pay. If you have a problem with multiple applications, then you’ll have to come to our office and take back hundreds of cases,’” Burch said.
“I believe Xerox is covering themselves because of a huge system error. They don’t want the accountability of saying, ‘Yes, we did mess this up, and here’s the plan you selected.’ It’s like, ‘What did he pay for?’ That’s it. They are making this more complicated than it has to be,” she added.
Wasmer said there was nothing unusual about bringing in Xerox’s attorneys.
“Our internal counsel is part of the extended Xerox team looking into the situation,” she said. “It’s regular practice for a corporation to tap experts across its organization to best understand complicated issues like this one. We’ll continue to keep the goal of resolving Mr. Basich’s issue front and center as we work through its complexities.”
Though Basich’s problem is exceptional for its dollar value, his situation is not unusual, Burch said. She estimates that of nearly 200 Branch Benefits Consultants client sign ups via Nevada Health Link, only 5 percent have gone through problem-free. More than 20 customers have the same plan-selection issue as Basich. One gave up trying to fix it and is sticking with the plan the exchange put her in.
With the March 31 enrollment deadline looming, Burch said she still sees other widespread enrollment problems, including frequent website error messages; inaccurate federal subsidy calculations; payments missing in the system despite clients’ canceled checks; and wrong effective coverage dates. One client chose an effective coverage date of March 1. Her insurance card showed an effective date of Jan. 1. Burch said that when she called to fix the issue, a customer-service rep told her the system showed a start date of April 1.
Burch said her brokerage supports the Affordable Care Act and launched a department to sell exchange plans. But she said the experience is not what she or her clients hoped for.
“We think it’s a great concept for those who need insurance. It’s just unfortunate, with all of the roadblocks we’re dealing with right now,” Burch said. “The bottom line is, we’re talking about people. It’s not a system, it’s people. I think, somehow, Xerox forgot that.”
The state of Massachusetts – touted by President Obama as the model for national health-care reform – is firing the company that designed both its failed state Obamacare enrollment website and also the Obama administration’s federal enrollment site.
Massachusetts is firing Canadian company CGI, which holds a $69 million contract to run the state’s Obamacare site. The state has already paid the company approximately $15.9 million. CGI was previously fired by the federal government in January.
“We have made the decision that we are going to be parting ways with CGI,” said Sarah Iselin, who serves as Governor Deval Patrick’s special assistant on the state’s Obamacare website fix, at a Monday board of directors meeting for the Massachusetts Obamacare exchange.
CGI’s incompetence is costing the state $10 million per month in unforeseen enrollment costs and preventing Massachusetts from having a fully working enrollment website until October 2014, according to an estimate.
But while CGI’s relationship with the Bay State is over, the company is still on good terms with the federal government.
The Daily Caller reported that CGI received six additional contracts from the Obama administration’s Centers for Medicare and Medicaid Services after the disastrous launch of the federal government’s Obamacare enrollment site. The six contracts were awarded between October 1 – when the over $600 million Obamacare website launched – through January 2014.
CGI Federal is the U.S. arm of the Canadian company CGI Group, and was formed in 2009 to bring CGI into the federal contracting business. The company employs Michelle Obama’s Princeton classmate, and 2010 White House Christmas guest, Toni Townes-Whitley as a top executive.
CGI, which received the Obamacare website contract in Obama’s first term, was fired from its role as prime contractor on the federal government website in January. But the company still holds numerous government contracts, including a $6 billion contract with the Department of Homeland Security awarded less than a month before the failed Obamacare site went live and a prime contract on the Army’s much-maligned Human Terrain System, a failed program that sends academics into war zones to help soldiers understand local populations.
Massachusetts’ capital city of Boston now has the longest wait times to see a doctor of any of the 15 major U.S. cities. Bostonians wait an average of 45.5 days for an appointment with a family physician, dermatologist, orthopedic surgeon, or cardiologist.
“And it’s because you guys had a proven model that we built the Affordable Care Act on… Your law was the model for the nation’s law,” Obama said in an October 30 speech at Boston’s Fanueil Hall.
Americans buying health insurance outside the new Obamacare exchanges are being forced to swallow premiums up to 56 percent higher than before the health law took effect because insurers have jumped the cost to cover all the added features of the new Affordable Care Act.
According to a cost report from eHealthInsurance, a nationwide online private insurance exchange, families are paying an average of $663 a month and singles $274 a month, far more than before Obamacare kicked in. What’s more, to save money, most buyers are choosing the lowest level of coverage, the so-called “bronze” plans.
The firm provided the costs to Secrets through their new online price index, which gives the averages of what people are paying for insurance sold through their system. In California, for example, some families are paying a high of $2,604 a month and in New York, $1,845.
The shocking surge in prices show what Americans not in Obamacare or covered by their employer are paying as they seek lower premiums. Typically, they are not eligible for the subsidies Obamacare offers those with low incomes.
“Premiums are increasing primarily because of the new required provisions for 2014 Affordable Care Act compliant plans, including guaranteed issue, essential health benefits, modified community rating and minimum actuarial values,” said Brian Mast, spokesman for eHealthInsurance. “It is also likely that health insurance companies expected additional risk in the risk pool, because people with pre-existing conditions could no longer be denied coverage, and may have priced their plans higher to accommodate for this risk,” said Mast.
His firm’s price index also gives an average age for singles buying plans, and the results are worrying for insurers and the Obama administration. That’s because the average age is 36, older than the administration had hoped for.
Explaining the higher costs, Mast said, “There are likely other factors, but what is important is that moving forward, there needs to be a collective effort to enroll as many people as possible and create a broad and diverse risk pool to keep premiums in check. eHealth can help in that effort by enrolling consumers off-exchange and is pushing to be able to enroll people in subsidy-eligible plans as well.”
There is a hint of good news, though, in firm’s the price index. While the current costs for insurance are higher than before Obamacare, they have come down over the past several months.
Below is a cost summary provided by eHealthInsurance:
– Premiums have increased by 39 percent to 56 percent, compared to pre-Obamacare coverage. As of Feb. 24, the average premium for an individual health plan selected through eHealth without a subsidy was $274 per month, a 39 percent increase over the average individual premium for pre-Obamacare coverage.
– The most recent average premium for plans without a subsidy chosen by families was $663 per month, a 56 percent increase over the average family premium in Feb. 2013, which was $426 per month.
– For both individual and family applicants, bronze plans have been the most popular plan type chosen since the beginning of open enrollment.
– Shoppers chose less expensive plans as open enrollment progressed
A pastor recently diagnosed with cancer, and who is covered under Obamacare, tells a local Iowa reporter that there’s “no compassion in the Affordable Care Act.”
“Back in January, Pastor Angran was diagnosed with stage three cancer of the esophagus. He had insurance, but because of a previous heart condition, it did not cover the treatments he needed for his cancer. He found that out just minutes before receiving life-saving chemo,” says the local reporter.
The pastor says, “One of the workers came and said let me talk to you. And so I went to talk to her. She says that we found out that your insurance does not include chemo.”
“Over the past two months, the Angrans have emptied their savings account and racked up $50,000 in debt. They signed up for the Affordable Care Act,” says the local reporter, “but found it to be anything but affordable. It will cost the couple more than $800 per month, money they just don’t have.”
The reporter adds, “As a pastor, Angran has devoted his life to helping others, to being compassionate. He says, ‘There’s no compassion in the Affordable Care Act.'”
The newest Obamacare promotion has the official White House website imitating a March Madness-style bracket featuring gifs of twerking girls, cats and “YOLO” to convince coveted young millennials to sign up.
While President Obama’s campaigns were noted for their successful youth outreach, he has been unable to attract young people to sign up for insurance under Obamacare so far. Last week, Obama tried to up youth exchange enrollment with an appearance on “Between Two Ferns” with the often foul-mouthed star Zack Galifianakis.
Now the White House has moved onto gifs with “The 16 Sweetest Reasons to Get Covered.”
White House advertising experts spent taxpayer dollars putting together a bracket of new Obamacare benefits, intended to attract young viewers. People are encouraged to vote for their favorite benefit, with an accompanying gif that paints a picture of what Obamacare supposedly does for you.
One features young girl attempting to twerk on a countertop in a public bathroom and failing catastrophically – “because accidents happen.”
Twerk girl’s moves are set against Michelle Obama dunking a mini-basketball – because “women can’t be charged more than men,” despite women’s higher usage of health care services.
White House Deputy Director of Online Engagement Erin Lindsay already weighed in on the most pressing question facing the Obama administration – whether the girl in the gif is successfully twerking. Though she’s not a “twerk expert,” Lindsay admitted in a tweet Monday afternoon, “I certainly think she’s trying.”
“Birth control is free,’ one bracket proclaims, alongside a gif of several ducks that reads “I’m so excited.” Regulations directly hitting insurance companies are illustrated by cats – one decked out in a blazer with cash splashed about in front of it.
The benefits are illustrated with dogs, cats, pandas, even an over-excited Elmo. But the best might be a waving proclamation that “You only YOLO once,” “So don’t gamble with your health.”
Though the Obama administration predicted it would need at least 39 percent of exchange customers to fall between the ages of 18 and 35 in order for the marketplaces to remain afloat, they’ve currently topped out at 25 percent with just a few weeks left.