Ready For Another Obamacare Price Hike? (David Catron)

Ready For Another Obamacare Price Hike? – David Catron

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In July of 2009, as the Obamacare debate was heating up, Gallup published a survey indicating that 83 percent of Americans wanted health care reform to make their health insurance more affordable. Now, more than five years after the President’s “signature domestic achievement” was passed, health insurance premiums are higher than ever. And it’s obvious that Obamacare is a major driver of the increase. The Wall Street Journal reports that insurers are proposing rate increases ranging from 25 to 51 percent for 2016. Why? “All of them cite high medical costs incurred by people newly enrolled under the Affordable Care Act.”

Obamacare apologists suggest different causes, of course. Jonathan Cohn writes, “One reason could be the normal and predictable competition among insurance plans jostling for market share.” Cohn’s grasp of economics is so tenuous that he doesn’t know insurers compete for market share by reducing premiums. He also connects the increases to anxiety about that bête noire of Obamacarians everywhere, King v. Burwell: “If the court rules in favor of the plaintiffs… millions will drop their coverage because they will no longer be able to afford it.” Cohn evidently thinks insurers will respond by making insurance even less affordable.

The real reason for the proposed increases is that insurers now have real data on real Obamacare enrollees rather than implausible projections from the Obama administration. And this new information makes it clear that they’ll lose their shirts if they sell coverage at anything resembling 2015 rates. Many young, healthy individuals have refused to buy pricy Obamacare coverage, leaving insurance carriers with sluggish premium streams out of which to pay the large dollar claims coming in from seriously ill patients willing to buy coverage regardless of cost. This dynamic has already caused a number of health insurers to incur huge losses.

Obviously, not even an evil insurance company can stay in business if it consistently loses large amounts of money. Earlier this month, Assurant Health announced that losses related to Obamacare are causing it to close its doors. Western Journalism reports, “The company and industry watchers blamed its losses directly on the impact of Obamacare… Assurant lost $63.7 million in 2014. The insurer raised its rates by 20 percent in 2015, in hopes of returning to profitability, but lost between $80 to $90 million during the first quarter of this year.” The company has been in business for 123 years and provides coverage for 1 million people.

Assurant is based in Wisconsin, but insurers all across the country are attempting to survive the same perverse incentives that finally undid that venerable company. The Journal lists proposed increases by companies offering plans through exchanges in Connecticut, Indiana, Maryland, Michigan, New Mexico, Oregon, Tennessee, Vermont, Virginia, and Washington state. And many of these companies are already losing huge amounts of money: “BlueCross BlueShield of Tennessee… lost $141 million from exchange-sold plans, stemming largely from a small number of sick enrollees.” It is asking for a 36.3 percent rate increase.

All of which suggests that the “premium stabilization” safeguards ostensibly meant to prevent Obamacare from sending the health insurance industry into a death spiral aren’t working. The “reinsurance program,” as Philip Klein explains at the Washington Examiner, “slaps fees on insurance policies and uses the revenue to funnel payments to insurers to compensate them for taking on individuals with a high-risk profile.” “Risk corridors” are a corporate redistribution scheme whereby the government uses the profits of some insurers to offset the losses of others. But, as Klein points out, both programs will be gone after 2016.

If disasters like Assurant and BlueCross BlueShield of Tennessee are occurring while these programs remain in place, what will happen when they’re gone? Well, we’ll have more insurers proposing hair-raising rate increases in order to avoid the fate of Assurant. But, not to worry, says Charles Gaba at HealthInsurance.org, upon whom the erstwhile “Citizen Cohn” rather desperately relies upon as the voice of reason: “These requested rate changes are being submitted to the state insurance commissioner’s office… and in most states either the commissioner or some other regulatory body has to either approve the requests or deny them.”

In other words, some state bureaucrat may simply deny the insurance company’s rate request and impose a more “appropriate” premium. This means that, in New Mexico, Health Care Service Corp. may get a mere 25 percent increase rather than the 51 percent it has proposed. In Tennessee, Blue Cross may get only 20 percent rather than the requested 36.3 percent increase. In Maryland, the state bureaucrats may decide that, instead of a 30.4 percent increase, Blue Shield may only get 18 percent. All of these outcomes have one thing in common: The rate goes up by double digits. That means you pay a higher premium no matter how it turns out.

In other words, in the best case scenario, the your health insurance premiums are going up. And this is not simply because Obamacare has been unable to accomplish the main thing most Americans wanted from health reform in first place – more affordable medical care. Barack Obama’s “signature domestic achievement” is actually making health care less affordable. Good job, Mr. President. Please use the rest of your term perfecting your chip shot.

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Thanks Barack… U.S. Welfare Rolls Explode Under Obamacare

U.S. Welfare Rolls Explode Under Obamacare – WorldNetDaily

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The Affordable Care Act, or Obamacare, has created more dependency on government and perverted the capitalist foundations of America, according to a top surgeon.

“You just can’t keep giving everything away to people without them working for it,” said Dr. Lee Hieb, former president of the Association of American Physicians and Surgeons. “It’s not capitalism when you let people who are able-bodied not contribute to society but take the spoils. I mean, that’s just not capitalism. We have too many people that don’t work to eat.”

Obamacare appears to be worsening America’s dependency issue. The Associated Press reported food-stamp enrollment increased in 11 states between January 2013 and the end of 2014, the period during which Obamacare went into effect.

Ten of those 11 states expanded Medicaid under the ACA, and six of them used new online enrollment systems that made it easy for customers to sign up for both Medicaid and food stamps at the same time. Such streamlined application systems were built specifically for the health-care overhaul.

In total, nearly 632,000 people were added to the food-stamp rolls in those 11 states during that period, at an estimated cost of almost $79 million a month to the Supplemental Nutrition Assistance Program, the food-stamp program also known as SNAP. This came at a time when the national economy was improving and food-stamp enrollment declined nationwide.

Dr. Jane Orient, executive director of the Association of American Physicians and Surgeons, sees the phenomenon as part of a government attempt to place more Americans under its thumb.

“Self-reliant Americans are being crushed by taxation and regulation, directly and indirectly, and turned into government dependents,” Orient said. “How can you resist if government can cut off your food and medicine?”

In almost all of the 16 states that didn’t expand Medicaid, food-stamp rolls have been decreasing as the economy improves.

Hieb, author of “Surviving the Medical Meltdown: Your Guide to Living Through the Disaster of Obamacare,” said Obamacare’s Medicaid expansion damaged the American medical system by dropping people from their private insurance and putting them on Medicaid.

“People think that all these people getting on Medicaid through Obamacare were uninsured,” Hieb said. “That’s not true. A number of those people had private insurance, but now, because they qualify under these new guidelines, why not have somebody else pay for your health insurance? So instead of paying for health insurance, they’re taking Medicaid.”

She continued, “So you’ve turned paying patients into nonpaying patients. It’s absolutely, clearly a failing economic model, and I don’t understand how smart people believe it. I just don’t understand how they do not see that point.”

Hieb, an orthopedic surgeon, has observed firsthand the damage Medicaid expansion has done to hospitals. She recently reached the end of a contract to perform surgery two-and-a-half days a week at a small hospital, and she is now looking for a similar arrangement. However, she says she’s found hospitals are running scared from orthopedic surgeons like her because they fear they won’t make enough money to pay the surgeons’ salaries.

According to Hieb, the hospitals are struggling to bring in money because of the increase in Medicaid patients and corresponding decrease in private-pay patients. Medicaid does not reimburse hospitals as much as private insurance does. Hospitals have also struggled to cope with Medicare provider payment cuts and increased administrative paperwork.

But while Medicaid expansion has hurt hospitals, it has been a boon to health-care consumers. In states that expand Medicaid, adults with incomes up to 138 percent of the federal poverty level must qualify, and states are allowed to set even higher thresholds. Before the ACA took effect, the median Medicaid eligibility limit for parents was 106 percent of the federal poverty level. Medicaid expansion also made adults without dependent children eligible for the first time.

Hieb said she believes Americans are smart enough to act in their own financial self-interest, and, for many who hover just above the poverty level, that involves taking advantage of the welfare system. Hieb lives among the patients she serves in rural Iowa, and she says they know how to look out for themselves.

“It’s a mistake to think that all these poor people are children who cannot navigate this very complex medical system,” Hieb asserted. “These are the people who have figured out if you don’t make $35,000 a year working, it’s not worth working because you can do that well if you know how to work the system of welfare.”

If people can cobble together enough disability payments, unemployment payments and food stamps to earn a halfway decent living, Hieb argued, they are smart enough to hitch themselves to Medicaid, even if they might be able to afford health insurance on their own.

“People act in their own economic self-interest,” Hieb said. “If you can get things for free, why pay for them?”

She answered her own question: “One, because that’s ethical, and two, medical providers cannot be in business unless somebody actually pays the bill.”

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Leftist Nightmare Update: Hawaii Shutting Down $205 Million Obamacare Exchange (Video)

Hawaii’s $205 Million Obamacare Exchange Shutting Down – TPNN

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Hawaii’s state legislature rejected legislation giving a $28-million cash infusion to its troubled Obamacare insurance exchange, making it impossible for the website to operate after this year.

The exchange will stop taking new enrollees on Friday.

Hawaii’s Connector Exchange released a statement saying:

“Now that it is clear that the state will not provide sufficient support for the Hawaii Health Connector’s operations through fiscal year 2016 (ending June 30, 2016), the Connector can no longer operate in a manner that would cause it to incur additional debts or other obligations for which it is unable to pay.”

“Staff reductions will commence immediately, with the executive director ( Jeff Kissel) exiting once the bulk of operational activities end.” The statement continued saying: “If the state cannot facilitate an orderly transition, the Connector’s operations will abruptly end, as the Connector does not have the resources to continue operations.”

According to Americanthinker, more states, including: Minnesota, Maryland, Massachusetts, Vermont, and Oregon – are having massive problems with their Obamacare websites, and are expected to close also. The cost? Almost a Billion dollars more of our money flushed down the drain.

Can any state exchanges continue to exist? With 36 states refusing to open their own exchanges and the Supreme Court ready to deal the death blow to subsidies, the future of the Obamacare exchanges appears uncertain at best.

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How Rand Paul And A Few Other RINO Douchebags Let Congress Keep Its Fraudulent Obamacare Subsidies

How Five Republicans Let Congress Keep Its Fraudulent Obamacare Subsidies – National Review

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The rumors began trickling in about a week before the scheduled vote on April 23: Republican leadership was quietly pushing senators to pull support for subpoenaing Congress’s fraudulent application to the District of Columbia’s health exchange – the document that facilitated Congress’s “exemption” from Obamacare by allowing lawmakers and staffers to keep their employer subsidies.

The application said Congress employed just 45 people. Names were faked; one employee was listed as “First Last,” another simply as “Congress.” To Small Business Committee chairman David Vitter, who has fought for years against the Obamacare exemption, it was clear that someone in Congress had falsified the document in order to make lawmakers and their staff eligible for taxpayer subsidies provided under the exchange for small-business employees.

But until Vitter got a green light from the Small Business Committee to subpoena the unredacted application from the District of Columbia health exchange, it would be impossible to determine who in Congress gave it a stamp of approval. When Vitter asked Republicans on his committee to approve the subpoena, however, he was unexpectedly stonewalled.

With nine Democrats on the committee lined up against the proposal, the chairman needed the support of all ten Republicans to issue the subpoena. But, though it seems an issue tailor-made for the tea-party star and Republican presidential candidate, Senator Rand Paul (R., Ky.) refused to lend his support. And when the Louisiana senator set a public vote for April 23, Majority Leader Mitch McConnell and his allies got involved.

“For whatever reason, leadership decided they wanted that vote to be 5-5, all Republicans, to give Senator Paul cover,” one high-ranking committee staffer tells National Review. “So they worked at a member level to change the votes of otherwise supportive senators.” Four Republicans – senators Mike Enzi, James Risch, Kelly Ayotte, and Deb Fischer – had promised to support Vitter, but that would soon change.

Senate staffers, according to a top committee aide, reported seeing Missouri senator Roy Blunt make calls to at least two Republican committee members, lobbying them, at McConnell’s behest, to vote no on subpoenaing the exchange. By the time the committee was called to quorum, Enzi, Risch, Ayotte, and Fischer voted no.

To many observers, it was curious that any Republican would move to put the brakes on an investigation into Obamacare fraud, and particularly curious that they would pull back in an instance where the federal government was actually defrauding itself, one that so clearly illustrates Obamacare’s flaws by exposing the bureaucratic jujitsu and outright dishonesty required of federal employees themselves to navigate the law.

Conservative health-care experts can’t understand the reasoning behind the GOP senators’ opposition. They see politics and self-interest at play, and they allege that Republican leaders are as invested as their Democratic counterparts in maintaining their subsidies, fraudulently obtained, while avoiding scrutiny from an overwhelmingly disapproving American public.

“We deserve to know who signed that application, because they are robbing taxpayers,” says Michael Cannon, director of health-policy studies at the libertarian Cato Institute. The staffers who signed the fraudulent application, he says, “know who was directing them to do this. And so we have to follow the trail of breadcrumbs. This is the next breadcrumb, and whoever is farther up the trail wants to stop Vitter right here.”

The story of the ill-fated subpoena can be traced back to the debate over the Affordable Care Act, when Senator Chuck Grassley (R., Iowa) insisted that lawmakers and congressional staff join a health-care exchange set up under the bill. For government employees, that meant giving up government-subsidized health-care contributions of between $5,000 and $10,000 per person. The White House scrambled to find a way to allow congressional employees to keep those subsidies. In Washington, D.C., only the small-business exchange allowed them to do so. After secret meetings with House speaker John Boehner in 2013, President Obama instructed the Office of Personnel Management to allow Congress to file for classification as a small business, despite the fact that the law defines a small business as having no more than 50 employees and the House and Senate together employ tens of thousands.

When Vitter’s staffers tracked down the application and discovered obvious signs of fraud, Vitter requested approval to subpoena an unredacted copy of the application. The value of that document, says Cannon, is that it would reveal the name of the person who filed it. “Now you’ve got someone to call to testify,” he says, predicting that testimony would precipitate a congressional vote on whether to end the congressional exemption altogether.

“I think it makes sense to find out what happened,” says Yuval Levin, the editor of National Affairs, a noted conservative health-care voice and a National Review contributor. “It would be pretty interesting to see whose name is on the forms,” he says. “It has to go beyond mid-level staffers.”

But some congressional Republicans, it seems, are also resistant to getting to the bottom of the mystery – or, at the very least, they are content to let sleeping dogs lie.

Committee rules for a subpoena require either the consent of the ranking member or a majority of the group’s 19 senators. Because Democrats quickly made their opposition clear, Vitter needed the approval of all ten Republicans. Nine of them quickly consented via e-mail; one senator was strangely unresponsive.

Senior committee aides say that Rand Paul’s staff didn’t immediately reply to an e-mail requesting the senator’s consent and, when they did, they refused to provide it. When Vitter attempted to set up a member-to-member meeting, his overtures were ignored or put off. Paul’s policy staff refused to take a meeting. When Vitter tried to confront Paul on the Senate floor, they say, the Kentucky senator skirted the issue.

It wasn’t until after the vote that Paul shared his reasoning. “Senator Paul opposes allowing Congress to exempt themselves from any legislation,” an aide told the Conservative Review. “To that end, yesterday, he reintroduced his proposed constitutional amendment to prohibit Congress from passing any law that exempts themselves. Senator Paul prefers this option over a partisan cross-examination of Congressional staff.”

But a constitutional amendment is a longshot that would take years, and it hardly precluded an investigation of congressional corruption here and now.

“That’s absurd,” says Robert Moffit, the director of the Center for Health Policy Studies at the conservative Heritage Foundation. “You don’t need a constitutional amendment to get a subpoena… I don’t know where he’s coming from.”

“The answers he has given do not make sense,” Cannon says of Paul. “And when someone with his principles does something that is so obviously against his principles, and does not give an adequate explanation, you begin to think that politics is afoot. It would have to be someone very powerful that made him a powerful pitch – or threat – to keep him from doing this.”

Paul’s press secretary tells National Review that the senator “examines every opportunity to [oppose Obamacare] individually, and does not base his vote on requests made by other senators, including the majority leader.”

Asked whether McConnell pushed Paul or any other senator on the subpoena, a spokesman for McConnell says the majority leader “didn’t make any announcements when that committee voted.”

The flip-flopping Republicans justified their change of heart. Risch said in the April 23 committee meeting that legal wrangling with the D.C. exchange could take time away from the committee’s small-business work. Enzi said he saw little wrong with the application as is.

“Each of us has our own budget, each of us has our own staff,” he said. “I don’t know about everybody else, but I’m way under 50 [employees]. So my staff qualifies as a small business.”

Enzi was one of the original sponsors of Vitter’s 2013 amendment to end the congressional Obamacare exemption, but his press secretary tells National Review he felt the probe “could inadvertently target staff who simply completed paperwork as part of their job.” He insists that Enzi “made up his own mind.” Risch, Ayotte, and Fischer declined to comment.

A spokesman for South Carolina senator Tim Scott, who voted for the subpoena, says that nobody lobbied him one way or the other, while a spokesman for Florida senator Marco Rubio, who also voted in favor of the measure, declined to comment.

Health-care experts dismiss Enzi’s claim that each member’s office is its own small business, and not just because the health exchange application was filed for Congress as a whole. “These congressional offices that think they’re small businesses, are they LLCs?” Cannon asks. “Are they S-Corps? Are they shareholder-owned? Are they privately held? What is the ownership structure of this small business that you’re running, senator? It’s just utterly ridiculous.”

“They’re transparently absurd,” says Moffit of Senate Republicans claiming small-business status. “Who made the determination that Congress is a small business and is therefore eligible for subsidies that do not legally exist? How did that happen?”

No one quite knows what’s behind leadership’s apparent push to kill the subpoena. The move baffled some committee staffers. “The amount of blood that McConnell and Paul spilled to prevent [the subpoena] from happening makes me wonder [if] maybe that isn’t all that there is to it,” the high-ranking staffer says. “Maybe other people signed it… They’re clearly afraid of something bigger than a person’s name getting out there.”

Others, however, think the motives behind GOP leadership’s apparent obfuscation are clear. “If there’s one thing that absolutely drives Americans fundamentally crazy, it’s the idea that Congress can set one set of rules for themselves and another for everybody else,” says Moffit. “That’s political poison, and that’s why they have been so desperate to avoid the issue.”

“The most powerful interest group in Washington D.C., is not the Chamber or the unions or anyone else,” Cannon says. “It is members of Congress and their staffs. And when it comes to their benefits, they are all members of the same party.”

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Contrary To Democrats’ Promises, Emergency Room Visits Surge Under Obamacare

Contrary To Goals, ER Visits Rise Under Obamacare – USA Today

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Three-quarters of emergency physicians say they’ve seen ER patient visits surge since Obamacare took effect – just the opposite of what many Americans expected would happen.

A poll released today by the American College of Emergency Physicians shows that 28% of 2,099 doctors surveyed nationally saw large increases in volume, while 47% saw slight increases. By contrast, fewer than half of doctors reported any increases last year in the early days of the Affordable Care Act.

Such hikes run counter to one of the goals of the health care overhaul, which is to reduce pressure on emergency rooms by getting more people insured through Medicaid or subsidized private coverage and providing better access to primary care.

A major reason that hasn’t happened is there simply aren’t enough primary care physicians to handle all the newly insured patients, says ACEP President Mike Gerardi, an emergency physician in New Jersey.

“They don’t have anywhere to go but the emergency room,” he says. “This is what we predicted. We know people come because they have to.”

Experts cite many root causes. In addition to the nation’s long-standing shortage of primary care doctors – projected by the federal government to exceed 20,000 doctors by 2020 – some physicians won’t accept Medicaid because of its low reimbursement rates. That leaves many patients who can’t find a primary care doctor to turn to the ER – 56% of doctors in the ACEP poll reported increases in Medicaid patients.

Emergency room usage is bound to increase if there’s a shortage of primary care doctors who accept Medicaid patients and “no financial penalty or economic incentive” to move people away from ERs, says Avik Roy, a health care policy expert with the free market Manhattan Institute.

“It goes to the false promise of the ACA,” Roy says, that Medicaid recipients are “given a card that says they have health insurance, but they can’t have access to physicians.”

Complicating matters, low-income patients face many obstacles to care. They often can’t take time off from work when most primary care offices are open, while ERs operate around the clock and by law must at least stabilize patients. Waits for appointments at primary care offices can stretch for weeks, while ERs must see patients almost immediately.

“Nobody wants to turn anyone away,” says Maggie Gill, CEO of Memorial University Medical Center in Savannah, Ga. “But there’s no business in this country that provides resource-intensive anything and can’t even ask if you’re going to be able to pay.”

Some people who have been uninsured for years don’t have regular doctors and are accustomed to using ERs, even though they are much more expensive. A 2013 report from the Robert Wood Johnson Foundation says going to an ER when a primary care visit would suffice costs $580 more for each visit.

Damian Alagia, chief physician executive for KentuckyOne Health, says he’s seen the trend play out in his large hospital system. There are more than a half-million people in the state newly insured through Obamacare. Many who put off care in the past now seek it in the place they know — the ER. “We’re seeing an uptick pretty much across the system in our ERs,” he says, calling the rise “significant” in both urban and rural hospitals.

Gerardi acknowledges that some people come to the ER for problems that would be better handled in a primary or urgent care office. But he says the ER is the right place for patients with vague but potentially life-threatening symptoms, such as chest pain, which could be anything from a heart attack to indigestion.

ER volumes are likely to keep climbing, and hospitals are working to adapt. Alagia says his ERs have care management professionals who connect patients with primary care physicians if they don’t already have them. Gill says her Georgia hospital has a “whole staff in the emergency room dedicated to recidivism,” who follow up with patients to see whether they’ve found a primary care doctor, are taking their medications or need help with transportation to get to doctors.

Still, seven in 10 doctors say their emergency departments aren’t ready for continuing, and potentially significant, increases in volume. Although the numbers should level off as people get care to keep their illnesses under control, Alagia says, “the patient demand will outstrip the supply of physicians for a while.”

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Shocker! California’s Obamacare Exchange Plagued By Incompetence, Mismanagement

Incompetence, Mismanagement Plague California’s Obamacare Insurance Exchange – Daily Signal

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California’s health insurance exchange, established under the Affordable Care Act, has been held out as a national model for Obamacare. In some ways – not all of them good – it is. Whether it’s falling far short of 2015 enrollment goals or sending out 100,000 inaccurate tax forms, Covered California is struggling with its share of challenges.

Now, several senior-level officials integral to the launch of Covered California – who enthusiastically support the Affordable Care Act – are speaking about what they view as gross incompetence and mismanagement involving some of the $1 billion federal tax dollars poured into the state effort.

‘Somebody Must Have Been Smoking Something’

Consultant Aiden Hill became a “foxhole convert” to Obamacare in July of 2010 when he lost his insurance, had a serious medical issue and couldn’t get a new policy.

“I lived through a health care nightmare. That’s one reason why I took a cut in my pay rate to work for Covered California.”

In March 2013, Hill was hired as project manager over Covered California’s massive $120 million call center effort. In just six short months, it would face an avalanche of customers seeking insurance mandated under the new law.

But five months on the job converted Hill from avid supporter to disenchanted whistleblower. He says the secretive and dysfunctional culture was more interested in cheerleading than real results. After he persistently raised concerns, Covered California abruptly terminated his contract. He says the experience drove him to raise allegations about waste and cover ups at a Covered California board meeting.

Covered California quietly launched an independent investigation into Hill’s grievances. Nine months later, the results were summarized in four sentences stating that evidence did “not support” Hill’s complaints. Hill calls the probe a sham and says the inquiry didn’t include interviews with many witnesses he suggested.

Today, Hill describes himself as disgusted by the process – and soured on Obamacare.

“I really believe that we’ve created a monster – and it’s an unaccountable monster,” Hill told The Daily Signal.

Covered California declined comment on Hill’s allegations.

Other officials integral to Covered California’s efforts concur with Hill’s assessment. One of them headed the largest call center.

“They started this way too late for what they needed to do,” says the official who was hired in April 2013, five months before the website’s launch. He has since left that position and asked not to be named to protect his current job status.

“This program had to touch 58 counties, 11 federal agencies, all medical carriers and all advocates. To have a system that would be integrated seamlessly – somebody must have been smoking something if they thought that was going to happen.”

Disappointing Enrollment

It’s against that backdrop that Covered California finds itself now grappling with a big disappointment: low enrollment growth. California ranked near the bottom in overall growth, with a scant 1 percent increase over last year.

“It’s a tiny fraction of the growth they were expecting,” says an official who helped implement the Affordable Care Act and examined California’s numbers.

As recently as last fall, the official says, California hoped to increase enrollment by 500,000 this year. But only an additional 7,098 have “selected a plan” for 2015.

“Their total enrollment is a step in the right direction but nowhere near what anyone thought it would be for the largest state in the country.”

Covered California would not answer our questions about enrollment figures.

Another telling statistic is Covered California’s poor retention rate. Even though people are required by law to have health insurance, only 65 percent of Covered California’s 2014 customers reenrolled in 2015. The rest dropped off.

Covered California would not address our questions about lackluster retention and growth.

Last month, the agency issued a press release touting a younger and more diverse mix of customers.

“New enrollment for 2015 coverage is strong and has brought in consumers who our marketing and outreach targeted,” said Covered California Executive Director Peter Lee, overlooking the fact that his organization’s retention of last year’s customers was among the lowest in the country.

Hoping for a bump, California followed the lead of the federal HealthCare.gov effort and repeatedly extended this year’s enrollment deadline. The Feb. 15 cutoff was pushed back to Feb. 20 and then Feb. 22. Now, it’s been extended to the end of this month.

“I lived through a health care nightmare. That’s one reason why I took a cut in my pay rate to work for Covered California.”

In March 2013, Hill was hired as project manager over Covered California’s massive $120 million call center effort. In just six short months, it would face an avalanche of customers seeking insurance mandated under the new law.

But five months on the job converted Hill from avid supporter to disenchanted whistleblower. He says the secretive and dysfunctional culture was more interested in cheerleading than real results. After he persistently raised concerns, Covered California abruptly terminated his contract. He says the experience drove him to raise allegations about waste and cover ups at a Covered California board meeting.

Covered California quietly launched an independent investigation into Hill’s grievances. Nine months later, the results were summarized in four sentences stating that evidence did “not support” Hill’s complaints. Hill calls the probe a sham and says the inquiry didn’t include interviews with many witnesses he suggested.

Today, Hill describes himself as disgusted by the process – and soured on Obamacare.

“I really believe that we’ve created a monster – and it’s an unaccountable monster,” Hill told The Daily Signal.

Covered California declined comment on Hill’s allegations.

Other officials integral to Covered California’s efforts concur with Hill’s assessment. One of them headed the largest call center.

“They started this way too late for what they needed to do,” says the official who was hired in April 2013, five months before the website’s launch. He has since left that position and asked not to be named to protect his current job status.

“This program had to touch 58 counties, 11 federal agencies, all medical carriers and all advocates. To have a system that would be integrated seamlessly – somebody must have been smoking something if they thought that was going to happen.”

Disappointing Enrollment

It’s against that backdrop that Covered California finds itself now grappling with a big disappointment: low enrollment growth. California ranked near the bottom in overall growth, with a scant 1 percent increase over last year.

“It’s a tiny fraction of the growth they were expecting,” says an official who helped implement the Affordable Care Act and examined California’s numbers.

As recently as last fall, the official says, California hoped to increase enrollment by 500,000 this year. But only an additional 7,098 have “selected a plan” for 2015.

“Their total enrollment is a step in the right direction but nowhere near what anyone thought it would be for the largest state in the country.”

Covered California would not answer our questions about enrollment figures.

Another telling statistic is Covered California’s poor retention rate. Even though people are required by law to have health insurance, only 65 percent of Covered California’s 2014 customers reenrolled in 2015. The rest dropped off.

Covered California would not address our questions about lackluster retention and growth.

Last month, the agency issued a press release touting a younger and more diverse mix of customers.

“New enrollment for 2015 coverage is strong and has brought in consumers who our marketing and outreach targeted,” said Covered California Executive Director Peter Lee, overlooking the fact that his organization’s retention of last year’s customers was among the lowest in the country.

Hoping for a bump, California followed the lead of the federal HealthCare.gov effort and repeatedly extended this year’s enrollment deadline. The Feb. 15 cutoff was pushed back to Feb. 20 and then Feb. 22. Now, it’s been extended to the end of this month.

Call Center Chaos

The devastating crash of Covered California’s website and call centers on Oct. 1, 2013 was “the canary in the coalmine, an early warning of deep dysfunction,” according to Hill.

Pre-launch testing had proven disastrous. As with the national HealthCare.gov website, “it was breaking at the first click of the button,” says the former call center manager who worked under Hill. “Behind the scenes, states were worried. I know we were worried.”

Covered California contractors projected 10,000 calls the first day. The call center manager says he knew they were way off. “I and my training manager, who had launched call centers before, projected 20,000. We had 21,000 on day one. Our contractors were wrong.”

The HealthCare.gov website was on a parallel trajectory. It, too, suffered under hasty development and failed performance tests days before launch – all while the Obama administration put on a positive public face.

“Everybody knew it wasn’t going to function,” says a third Covered California official. “Calls start coming in and within the first hour, the entire system went down – phone and web.”

“The train was coming off the rails,” adds Hill. “The call center was going into meltdown.”

The meltdown lasted for months and fixes proved costly. Covered California would not provide a tally of expenses, but the agency ended up asking the federal government for an extra $155 million. That put the cost of Covered California at more than $1.06 billion federal tax dollars.

Enrollment Exaggeration?

Covered California’s disastrous debut triggered a house of cards. When the website crashed, consumers were directed to fill out paper applications; they were 33 pages long and took at least an hour to complete. What’s more, they couldn’t be coordinated with the electronic version because of a major design flaw. The forms didn’t match.

But Covered California counted duplicate applications as if they were enrollments, giving the impression that more people had successfully signed up. (The Obama administration did the same with national HealthCare.gov applications.)

For example, Covered California’s Lee publicly touted 30,000 successful enrollments for the first month. Hill says the actual number was closer to 4,000.

“A lot of the information that came out of Covered California was misleading or outright lies,” Hill insists.

Another Covered California official agrees.

“There’s no way he didn’t know he wasn’t telling the truth,” says an official, who still works at the agency and asked not to be identified. “We were fully aware that those numbers were inflated. It was horrible… morale busting. Things were being said that were blatantly untrue.”

The Daily Signal asked for Lee’s side of the story, but Covered California declined to make him available.

Hill says misinformation was aided and abetted by an uninformed press. In the midst of Covered California’s fiasco, he was stunned to read a New York Times article claiming the Golden State was an Obamacare utopia: the crown jewel of the health care reform effort.

On Nov. 24, 2013, Paul Krugman of The New York Times gushed:

What would happen if we unveiled a program that looked like Obamacare, in a place that looked like America, but with competent project management that produced a working website? Well, your wish is granted. Ladies and gentlemen, I give you California… The California authorities have been especially forthcoming with data tracking the progress of enrollment. And the numbers are increasingly encouraging.

That assessment was far from the reality, say the Covered California officials who spoke to The Daily Signal.

Covered California declined to respond to our questions but issued this statement:

Covered California is proud that it has been the portal for nearly four million people to find coverage through one of our participating health plans or through low cost/no cost Medi-Cal; is helping more than a million people access financial assistance to lower their monthly health insurance premiums; through the Affordable Care Act has reduced the number of uninsured in California by half.

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FL Governor: Obama Resorting To Extortion In Attempt To Force State Further Into Obamacare

Fla. Gov. Suing Administration For Trying To ‘Force Our State Further Into Obamacare’ – CNS

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“It is appalling that President Obama would cut off federal healthcare dollars to Florida in an effort to force our state further into Obamacare,” a furious Florida Gov. Rick Scott (R) said Thursday as he announced that he plans to sue the Obama administration.

“It’s outrageous,” Scott told Fox News Thursday night.”The federal government started a program in our state in 2006. It’s called the Low Income Pool. It’s (health care) for low income families,” Scott explained. “Now, what they are saying is they are not going to keep that program going unless the state expands Obamacare (Medicaid). So this, first off, is horrible.”

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“It sounds like extortion,” Fox News’s Kimberly Guilfoyle told Scott.

“Absolutely,” the governor agreed. “First off, you think about the families in our state that are relying on this. Second, (Supreme Court Chief) Justice Roberts said…that it’s not lawful for the federal government, for the Obama administration, to use coercion tactics, basically held a gun to our head, if we don’t expand Obamacare. They say they can’t do that.”

The Supreme Court in 2012 upheld Obamacare’s individual mandate, but it also said the federal government could not compel the states to expand Medicaid coverage for low-income people. As of this writing, 28 states and the District of Columbia have ageed to expand Medicaid. The federal government has agreed to pay 100 percent of the expansion costs through 2016, but after that, the states must pick up a larger share of the costs, and that’s what worries Scott and other governors.

In July 2012, shortly after the Supreme Court ruling, Gov. Scott announced that Florida would “opt out of spending approximately $1.9 billion more taxpayer dollars required to implement a massive entitlement expansion of the Medicaid program.”

“Floridians are interested in jobs and economic growth, a quality education for their children, and keeping the cost of living low,” Governor Scott said at the time. “Neither of these major provisions in Obamacare will achieve those goals, and since Florida is legally allowed to opt out, that’s the right decision for our citizens.”

He also noted that “Florida already has health care safety net programs for those with the greatest need.”

Scott told Fox News on Thursday that he and his attorney general are working on a lawsuit right now.

He questioned whether President Obama really cares about the low-income families in Florida for whom the federal government created the LIP program in the first place.

“And doesn’t everybody now understand that this is an administration that’s going to use coercion tactics, and when it’s appropriate, they’ll cut back funding if you don’t do another program they want?”

“One, they don’t care about the low income families because they are willing to walk away from a program. And then, two, they are using bully – this is a Sopranos. They are using bullying tactics to attack our state. It’s wrong. It’s outrageous just that they’re doing this.”

A White House spokesman, asked for his reaction to the anticipated Florida lawsuit, said he hadn’t seen “specific details.”

“But what is true is that expanding Medicaid in the State of Florida would ensure that 800,000 Floridians would get access to quality health-care coverage,” Josh Earnest said on Thursday.

Earnest noted that under Obamacare, the federal government picks up the full cost of expanding Medicaid through 2016.

“So there’s not a good reason why anybody in Florida would be in a situation of trying to block a policy that would benefit 800,000 Floridians. In fact, they would have a positive impact on the finances in the State of Florida.

“And it’s difficult to explain why somebody would think that their political situation and their political interest is somehow more important than the livelihood and health of 800,000 people that they were elected to lead.”

In a message on his website Thursday, Scott said the Centers for Medicare and Medicaid Services (CMS) sent him a letter this week, saying that “the furture of LIP’ and “Medicaid expansion are linked.”

“We will fight to protect the healthcare of Floridians, and their right to be free from federal overreach,” Scott said. “Our citizens already pay federal taxes that go into the federal LIP program. Now, President Obama has decided that the state must take on a larger Medicaid program, forcing our taxpayers to pay even more to government, before they get their own federal tax dollars back. This is outrageous, and specifically what the Supreme Court warned against.”

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