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Thread: Obamacare ... the Unintended Consequences

  1. #121
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    Here's something curious. The Republicans in the House were joined by 67 Democrats to pass a bill that says if the Federal exchange were to be hacked, the Feds have 2 business days to inform the folks whose data was stolen. It is expected that Senator Reid won't even bring it up and if he does, the President will veto it. Why on earth? What is to be gained by refusing to notify consumers of data theft ... especially when DOJ has launched an investigation of Target?
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  2. #122
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    Quote Originally Posted by Eric Johnson View Post
    Here's something curious. The Republicans in the House were joined by 67 Democrats to pass a bill that says if the Federal exchange were to be hacked, the Feds have 2 business days to inform the folks whose data was stolen. It is expected that Senator Reid won't even bring it up and if he does, the President will veto it. Why on earth? What is to be gained by refusing to notify consumers of data theft ... especially when DOJ has launched an investigation of Target?
    It's probably already been hacked and they don't want to admit it.
    Bill Davis

  3. #123
    Senior Member Gerry Clinchy's Avatar
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    Here's the story about the MD website
    http://www.washingtonpost.com/local/...tml?ctab=all_&

    $100 million of govt funds + more added to try and fix it.

    While a website is different from handling the health care issues themselves, the latter are even more complex. If we look at Medicare, a simple eye exam (my own), of which Medicare covers only a small portion, it took Medicare about 2 months to render its reply to the bill submitted. We know that the VA gets backed up as well. I have no experience with how well the govt handles Medicaid claims.

    The big issue with the govt handling of its responsibilities seems to have been a poor job of selecting the contractor(s) who could get the job done right; the involvement of govt employees failing to have clear project planning. When we look at agencies of govt that don't even know what programs they have for given problems (see the article mentioned above), it appears that govt employees really never have any accountability for their errors and failures. I'm not a Christie fan, but at least he fired SOMEbody. None of these govt fiascos seem to have resulted in ANYbody getting fired. In fact, Sebelius failed at the same job (setting up a website for a govt function) in her own state ... and she ends up with an even, bigger job with O-care, and fails there, too ... and is still collecting her regular paycheck AND also not participating in O-care! Lois Lerner got a paid vacation and happy retirement, while her cohort got a promotion. There seems to be no accountability in govt bureaucracy.
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  4. #124
    Senior Member Gerry Clinchy's Avatar
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    The Obama administration announced Tuesday that it was again extending the ObamaCare enrollment deadline for people with pre-existing conditions.


    The administration said it would extend the Pre-Existing Conditions Insurance Plan (PCIP), slated to end Jan. 31, until March 15.

    Read more: http://thehill.com/blogs/healthwatch...#ixzz2qVUfHdUF

    The $5 billion PCIP program was intended as bridge health coverage to sick patients waiting for the full implementation of ObamaCare. The administration says 135,000 have used the program at some point.


    An HHS official told The Hill there are less than 30,000 people still enrolled.
    $5 billion/135,000 = $37,000/individual that has used the program
    I can't recall how long that program has been in effect, but I think it started a year or two before ACA went into effect. Presumably, at least some of the individuals paid some premium themselves as well. Wonder if that is why only 30,000 remain enrolled in the program, i.e. if the individual premiums were still unaffordable? It's also possible that some of the 135,000 have died in the interim if they were very ill when they first enrolled.
    HHS stopped accepting new applicants early last year over fears the program didn’t have enough money to cover those who had signed up.
    Maybe the program was not an insurance plan, but the govt paid the medical bills directly?


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  5. #125
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    It occurs to me ... why do they have to extend the high-risk program when O-care accepts pre-existing conditions? Is it because the website still isn't working? These individuals could have signed up just like any other person, whether for private insurance or on the exchanges.
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  6. #126
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    Quote Originally Posted by Gerry Clinchy View Post
    It occurs to me ... why do they have to extend the high-risk program when O-care accepts pre-existing conditions? Is it because the website still isn't working? These individuals could have signed up just like any other person, whether for private insurance or on the exchanges.

    It occurs to me that a slew of republican governors did not expand medicaid. Maybe their incomes are not low enough to qualify for the "old medicaid" but don't earn enough to qualify to buy health insurance on the exchange with subsidies? Would you guess that having that program go away might put them in a pinch?
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  7. #127
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    Quote Originally Posted by Buzz View Post
    It occurs to me that a slew of republican governors did not expand medicaid. Maybe their incomes are not low enough to qualify for the "old medicaid" but don't earn enough to qualify to buy health insurance on the exchange with subsidies? Since the high-risk people now pay the same premium as anyone else, and they'd be eligible for subsidies up to $62,000/year in income they would be pinched only the same as anyone else earning just under that income amount. As I understand it, the high risk pools, in many instances still had fairly high premiums. In theory, their premiums should be lower with ACA than in the high-risk pools. The deductibles might be the killer though.


    Would you guess that having that program go away might put them in a pinch?

    The 30,000 figure is the # who are presently enrolled in the Fed high risk pool ... down from the 135,000 over the course of the existence of the program, which hasn't ended yet, but was to transition over into ACA just as the individual policies were doing. The citations don't tell us whether the decrease in participation has happened gradually or suddenly. It might also be possible that some of the "missing" 105,000 have already enrolled in ACA, but they are not counted separately from the total enrollment figures? They only seem to know that there are 30,000 still in the high-risk program who have not yet enrolled for ACA plans.


    Previously many states had high risk pools, but those somehow were required to shut down due to the ACA, as I understand it. I'm not clear on whether those state-run high risk pools had to close down if the state expanded Medicaid, or had to shut down even if the state did not participate in the Medicaid expansion.

    WRT Medicaid, each state had different programs. I don't know how accurate it is, but Corbett here in PA gave as a reason for not expanding PA Medicaid the fact that the PA Medicaid program was already more expansive than programs in some other states. I don't know if that referred to the benefits paid or the qualifications. Conforming to ACA requirements would have become prohibitively expensive when Fed contributions diminished.

    PA also had a program for "working poor" adults at one point, but it ran out of money. Participants only had to pay $10/mo. Perhaps the experience data with that program gave an idea of what it would ultimately cost to conform with the Medicaid expansion of ACA?
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  8. #128
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    http://www.foxbusiness.com/personal-...her-aca-delay/
    Although this is a Fox Business source, they are quoting the NY Times

    The IRS is not yet enforcing a provision to level the playing field in employer insurance for high-income v. low-income employees. The law anticipated this provision would be in force within 6 mos of the law's signing ... which was over 2 yrs ago ... but the provision cannot be enforced in 2014 since the IRS has not written the required regulation yet.

    We have seen that there are many ways the IRS can be used to have political impact ... and ACA has opened up some more of those ways. Suppose they might have those regs ready by mid-Nov. 2014?

    And if the mid-terms don't go the way the incumbents would like, is there any chance that the IRS might just dole out some "punishment" ? Such "punishment" would make life difficult for the punishees for 2015 and 2016. And does Congress even have the ability to un-do regulations of agencies if the IRS chooses a draconian interpretation of the law in those ACA regs? Why is it taking them over 2 years to write them in the first place?
    G.Clinchy@gmail.com
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  9. #129
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    http://www.washingtonpost.com/nation...132_story.html

    The website can sign people up, but if there is an error, there is no way to fix it. The law specifies due process for appeals in timely fashion ... but the part of the system that's supposed to do that isn't built yet.
    The Obama administration has not made public the fact that the appeals system for the online marketplace is not working. In recent weeks, legal advocates have been pressing administration officials, pointing out that rules for the online marketplace, created by the 2010 Affordable Care Act, guarantee due-process rights to timely hearings for Americans who think they have been improperly denied insurance or subsidies.
    But at the moment, “there is no indication that infrastructure . . . necessary for conducting informal reviews and fair hearings has even been created, let alone become operational,” attorneys at the National Health Law Program said in a late-December letter to leaders of the Centers for Medicare and Medicaid Services (CMS), the agency that oversees HealthCare.gov. The attorneys, who have been trying to exert leverage quietly behind the scenes, did not provide the letter to The Post but confirmed that they had sent it.
    A failure to compute a subsidy is among a variety of mistakes the computer system has made. Another involves what some CMS and state Medicaid officials refer to as “loopers.” These are people who applied for coverage on HealthCare.gov and were told that their income was low enough to qualify for Medicaid. But when they went to their state Medicaid agency, they were told they were not eligible after all, and should get a private health plan through the marketplace. So they have “looped” back to the federal system, which is unable to fix the mistake.
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  10. #130
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    U.S. intelligence agencies last week urged the Obama administration to check its new health care network for malicious software after learning that developers linked to the Belarus government helped produce the website, raising fresh concerns that private data posted by millions of Americans will be compromised.


    The intelligence agencies notified the Department of Health and Human Services, the agency in charge of the HealthCare.gov network, about their concerns.


    Specifically, officials warned that programmers in Belarus, a former Soviet republic closely allied with Russia, were suspected of inserting malicious code that could be used for cyber attacks, according to U.S. officials familiar with the concerns.


    The software links the millions of Americans who signed up for ObamaCare to the federal government and more than 300 medical institutions and health care providers.


    “The U.S. Affordable Care Act software was written in part in Belarus by software developers under state control, and that makes the software a potential target for cyber attacks,” one official said.
    Fits into the "you've-got-to-be-kidding" category. Why would we need Belarus to help us write a software program?
    Security officials urged HHS to immediately conduct inspections of the network software for malicious code.


    The software currently is used in all medical facilities and insurance companies in the United States.


    The officials also recommended that HHS use security specialists not related to software vendors for the inspections to reduce further risks.


    Officials disclosed the potential software compromise last week after the discovery in early January of statements by Belarusian official Valery Tsepkalo, director of the government-backed High-Technology Park (HTP) in Minsk.


    Tsepkalo told a Russian radio station in an interview broadcast last summer that HHS is “one of our clients,” and that “we are helping Obama complete his insurance reform.”
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