Heeeeeeere's Obamacare!

[MattusMaximus]

Health Care Exchange Is Vastly Improved, Users Say

After two months of false starts, error messages and pleas for patience from the once-hobbled federal online health care exchange, Karen Egozi, the chief executive of the Epilepsy Foundation of Florida, watched on Monday as counselors navigated the website’s pages with relative ease.

Click. Next page. Click. Next page. The website, HealthCare.gov, was working so well that Ms. Egozi, who oversees the 45 navigators in eight locations who help consumers enroll in health plans, said her team gave the system an 8 on a scale of 1 to 10, meaning that most people got as far as selecting a plan or taking home information to select a plan. It felt like a champagne moment. ...

... A little over a week after the deadline that President Obama gave for fixing the federal health care exchange, the system is definitely working better, according to consumers and navigators interviewed in several states. The technical errors that had bedeviled visitors to the site for weeks seemed to have been tamed by the patchwork of hardware and software fixes ordered by the administration, and applicants were finally selecting health care plans under the president’s new law, the Affordable Care Act. By last week, the number of applicants who dropped a plan into their virtual grocery carts was climbing at a rapid clip.

Which means we're going to see the enrollment numbers climb even higher and even faster from now on. And the Republicans said it couldn't be done. Nice to see they have such a lack of faith in American know-how and stick-to-it-ness

 

[angrysoba]

Health Care Exchange Is Vastly Improved, Users Say


Which means we're going to see the enrollment numbers climb even higher and even faster from now on. And the Republicans said it couldn't be done. Nice to see they have such a lack of faith in American know-how and stick-to-it-ness

Those dummy right-wingers are going to look even dumber when they find out how satisfied they are after all.

 

[AlaskaBushPilot]

No, I'm not an apologist. I am a tell-the-truthist. I'm an actuary. I won't pander to your propaganda, and I won't jump on your bandwagon. If you want to discuss reality, and how these things actually work, I'm more than happy to do so. If you wish, however, to hyperbolize and coat things in emotive language to support an agenda, I will not engage in that.

Haw! Talk about hypocrisy. Painting the opposition as crazy is emotional manipulation 101, ie. "discuss reality". Or all of the other emotive-packed language above.

The reality is that you are playing word games, initially saying that employer provided policies were not being "cancelled in the same fashion" to then insisting they weren't being cancelled at all and instead only "modified".

You are absolutely wrong in that contention, and as an alleged actuary claiming argument from authority it is all the more delicious ignorance. Because employers that do not have plans meeting the ACA requirements can dump insurance altogether for their employees.

Here's two articles in the journal Health Affairs discussing health insurance trends and exactly where the cancellations of insurance altogether by employers is going to be the greatest:

http://content.healthaffairs.org/content/32/9/1522.full

and here:

http://content.healthaffairs.org/content/32/9/1531.full

It is common sense and basic economics that the greatest incentive to dump insurance for employees is going to be in the low wage jobs. You are going to need a new manipulative word to characterize people losing their employer-provided insurance altogether.

I don't have any hesitation whatsoever to acknowledge that there are both winners and losers under Obamacare. Some people are going to get insurance that did not have it before or get their cost lowered through subsidies.

But there are also a lot of other things changing that harm people, depending on who you are. As an actuary you ought know this, and if you don't then you are a very poor one indeed: the restrictions on providers for example are a cost-containment device that put the lie to Obama's innumerable claims about keeping your doctor.

This inability to acknowledge something so basic like this with the ACA is the hallmark of an apologist, not a truth-teller.

 

[AlaskaBushPilot]

http://www.usatoday.com/story/news/politics/2013/12/04/obama-harvard-poll-millenials/3868629/

"Although Millennials have held firm in their approval of the president in past polls, we are now seeing a sea change among this critical demographic," said Trey Grayson, director of Harvard Institute of Politics.

Among the 18- to 29-year-olds currently without health insurance, less than a third say they're likely to enroll in the exchange. Thirteen percent say they will definitely enroll, 16% say they will probably enroll, and 41% say they are split 50-50 on whether they will enroll, according to the poll."

Can Obamacare work without the Millennials?

No, and you have an alleged actuary studiously ignoring this most basic actuarial aspect of Obamacare: that it depended upon the young and healthy subsidizing the older and sick.

The rates established in the beginning here are based upon this recruitment succeeding and it will not be until next year that we see the results of the death spiral as rates have to adjust to the fact young healthy people are not so stupid as to make the bad financial decisions Obamacare requires of them.

The partisanship is just sickening here. When I was disgusted with the war criminal Bush then places like Salon had found the constitution or concern for war crimes and made excellent criticisms of Bush policies. I published myself on Antiwar.com. With Obama in office I couldn't care less that Drudge is the one re-posting an article or leading me to studies of interest on Obamacare.

When someone leaps out with poison-the-well "right wing" or "left wing" news source instead of addressing the material then there just isn't any point in discussing. It is axiomatic that Salon is going to defend democrats and Drudge is going to defend republicans.

What the partisans do with that is the democrats will not read anything they can associate with Drudge and the Republicans will not read anything they can associate with Salon. I read either one, and actually quite often it is the British press sources that google ends up sending me to.

Well this is a waste of time. I am in a tropical country and it is time to enjoy.

 

[Emily's Cat]

And that's why we love you. [Insert Smoochity-smooch-smilie here]

 

[Emily's Cat]

Haw! Talk about hypocrisy. Painting the opposition as crazy is emotional manipulation 101, ie. "discuss reality". Or all of the other emotive-packed language above.

The reality is that you are playing word games, initially saying that employer provided policies were not being "cancelled in the same fashion" to then insisting they weren't being cancelled at all and instead only "modified".

You are absolutely wrong in that contention, and as an alleged actuary claiming argument from authority it is all the more delicious ignorance. Because employers that do not have plans meeting the ACA requirements can dump insurance altogether for their employees.

Here's two articles in the journal Health Affairs discussing health insurance trends and exactly where the cancellations of insurance altogether by employers is going to be the greatest:

http://content.healthaffairs.org/content/32/9/1522.full

and here:

http://content.healthaffairs.org/content/32/9/1531.full

It is common sense and basic economics that the greatest incentive to dump insurance for employees is going to be in the low wage jobs. You are going to need a new manipulative word to characterize people losing their employer-provided insurance altogether.

I don't have any hesitation whatsoever to acknowledge that there are both winners and losers under Obamacare. Some people are going to get insurance that did not have it before or get their cost lowered through subsidies.

But there are also a lot of other things changing that harm people, depending on who you are. As an actuary you ought know this, and if you don't then you are a very poor one indeed: the restrictions on providers for example are a cost-containment device that put the lie to Obama's innumerable claims about keeping your doctor.

This inability to acknowledge something so basic like this with the ACA is the hallmark of an apologist, not a truth-teller.

Employer Dropping Coverage <> Insurer Cancelling Coverage

you fail

 

[Emily's Cat]

No, and you have an alleged actuary studiously ignoring this most basic actuarial aspect of Obamacare: that it depended upon the young and healthy subsidizing the older and sick.

Please provide evidence of me ignoring this aspect of ALL health insurance. Otherwise, kindly rescind your baseless accusation and character attack.

The rates established in the beginning here are based upon this recruitment succeeding and it will not be until next year that we see the results of the death spiral as rates have to adjust to the fact young healthy people are not so stupid as to make the bad financial decisions Obamacare requires of them.

Well, actually, the rates set by sensible and intelligent companies assumed a higher level of uptake among sicker and older people (who are effectively more heavily subsidized by the government under ACA) than by the young and healthy (who would bear more burden and face a relatively small penalty for failure to buy insurance). The rates were set based on that rational assumption, and with consideration given to the impact of risk adjustment in a zero-sum market transfer scenario, and with reinsurance and risk corridors as well. Because actuaries are usually pretty good at their job, and don't usually make stupid assumptions that rely on people being just outright dumb.

The partisanship is just sickening here.

Well. Yes, there is some partisanship, as one expects with any large group of people with diverse opinions. But with all honesty, you seem to have brought most of it in the door with you.

 

[Silly Green Monkey]

I got my Medicare card today! I still don't know what to do with it.

 

[Drysdale]

Please provide evidence of me ignoring this aspect of ALL health insurance. Otherwise, kindly rescind your baseless accusation and character attack.


Well, actually, the rates set by sensible and intelligent companies assumed a higher level of uptake among sicker and older people (who are effectively more heavily subsidized by the government under ACA) than by the young and healthy (who would bear more burden and face a relatively small penalty for failure to buy insurance). The rates were set based on that rational assumption, and with consideration given to the impact of risk adjustment in a zero-sum market transfer scenario, and with reinsurance and risk corridors as well. Because actuaries are usually pretty good at their job, and don't usually make stupid assumptions that rely on people being just outright dumb.


Well. Yes, there is some partisanship, as one expects with any large group of people with diverse opinions. But with all honesty, you seem to have brought most of it in the door with you.

I'm lost. What exactly is your point here? If the younger generation isn't paying into it there's not enough funds to cover the total costs correct?

Or is that inaccurate and how?

 

[Unabogie]

I was watching today's hearing (at least I think it was today) and Sebelius was being questioned about healthcare.gov again. She was asked some stupid questions, but at least GOP question was appreciated. I'll paraphrase the question and answer:

Q. Now that people are enrolling, if the payment system to the carriers isn't working at all, then are people even really insured? What's to stop people from enrolling and then going to a doctor on Jan 4th. and finding out that they aren't really covered? And if they are covered, are the insurance companies screwed?

A. No. There are several things going on. Regarding the "834s", they are going through each one by hand and verifying with the insurance companies that the people are correctly enrolled. So that if a person finished their enrollment they will be genuinely enrolled. Regarding the payment system to carriers, they worked out an alternate payment system with the insurers, so that while the automatic system isn't working, they'll just cut checks as needed by hand. There's only 200 companies involved, so [ed: my best guess] they will pay them monthly in a lump sum.

Sorry, no link, all wording mine.

 

[MattusMaximus]

I got my Medicare card today! I still don't know what to do with it.

Quick, get sick!

 

[Emily's Cat]

I'm lost. What exactly is your point here? If the younger generation isn't paying into it there's not enough funds to cover the total costs correct?

Or is that inaccurate and how?

It's not that cut and dry. Not all young people are going to participate. We know that, and we've always known that. It's in their best interests financially to take the penalty and not participate. The premiums will be set to reflect the total costs. If more young people participate then the average premium will be lower... because the young people will pay part of the premiums, but will essentially cost nothing (they don't really go to the doctor, for all intents and purposes). If fewer young people participate, then the average premium will need to be higher, because their are fewer young people to spread the cost to.

So we don't assume that all young people are going to participate. We make assumptions about the range of young people that we think are likely to participate, with some quantified uncertainty, and we set our prices with a contingency margin. We plan for less than full participation from the younger people, and if more than we expected actually sign up, then we're ahead of the game.

 

[plague311]

It's not that cut and dry. Not all young people are going to participate. We know that, and we've always known that. It's in their best interests financially to take the penalty and not participate. The premiums will be set to reflect the total costs. If more young people participate then the average premium will be lower... because the young people will pay part of the premiums, but will essentially cost nothing (they don't really go to the doctor, for all intents and purposes). If fewer young people participate, then the average premium will need to be higher, because their are fewer young people to spread the cost to.

So we don't assume that all young people are going to participate. We make assumptions about the range of young people that we think are likely to participate, with some quantified uncertainty, and we set our prices with a contingency margin. We plan for less than full participation from the younger people, and if more than we expected actually sign up, then we're ahead of the game.

Does this take into affect all the young adults that will be covered by their parents due to the increase in age that young adults can be covered through their parents plan? Won't that absorb some of the young people not signing up?

 

[sir drinks-a-lot]

A. No. There are several things going on. Regarding the "834s", they are going through each one by hand and verifying with the insurance companies that the people are correctly enrolled. So that if a person finished their enrollment they will be genuinely enrolled. Regarding the payment system to carriers, they worked out an alternate payment system with the insurers, so that while the automatic system isn't working, they'll just cut checks as needed by hand. There's only 200 companies involved, so [ed: my best guess] they will pay them monthly in a lump sum.

Oi vey! Might as well go back to stone tablets and chisels.

 

[plague311]

Oi vey! Might as well go back to stone tablets and chisels.

So the newest complaint is going to be that it isn't advanced enough? They're doing what they have to do to make this work, instead of standing back and letting it fail. It's a bandaid resolution while the permanent gets fixed. You've obviously never worked in a cab shack when the electricity is out.

 

[sir drinks-a-lot]

So the newest complaint is going to be that it isn't advanced enough?

I thought I was just reiterating the existing complaints about the failings of the website but, now that you mention it, I'd concur that doing all of that by hand is probably not advanced enough. And I'm sure it's expensive.

They're doing what they have to do to make this work, instead of standing back and letting it fail. It's a bandaid resolution while the permanent gets fixed.

Of course if that is the only way it can be done at present, then they should do it that way.

You've obviously never worked in a cab shack when the electricity is out.

Many times.

 

[Ziggurat]

So the newest complaint is going to be that it isn't advanced enough? They're doing what they have to do to make this work, instead of standing back and letting it fail. It's a bandaid resolution while the permanent gets fixed. You've obviously never worked in a cab shack when the electricity is out.

The problem is not that they're doing it by hand instead of doing nothing, the problem is that doing it by hand is the best that they can do. It shouldn't be necessary. Moreover, it will not suffice if they can't get the computer systems fixed, because it will not be possible to do them by hand fast enough to process everyone who is supposed to be signing up. They haven't overloaded the manual system because the numbers are so low right now, but that's not exactly encouraging.

 

[Unabogie]

Oi vey! Might as well go back to stone tablets and chisels.

Which part of my post was unclear that this was a temporary solution while the back end was being finished? There are two hundred companies involved, and by the sound of things, they agreed to pay them on something like a monthly basis. So for a month or two, they'll cut checks by hand, once a month, to two hundred companies based on the accounting set forth in the front end of the system. In a month or two the electronic payments will be working and then they'll use that instead. Your histrionics seem contrived.

 

[Unabogie]

The problem is not that they're doing it by hand instead of doing nothing, the problem is that doing it by hand is the best that they can do. It shouldn't be necessary. Moreover, it will not suffice if they can't get the computer systems fixed, because it will not be possible to do them by hand fast enough to process everyone who is supposed to be signing up. They haven't overloaded the manual system because the numbers are so low right now, but that's not exactly encouraging.

Wait, you think they'll send the government millions of individual bills instead of a single bill to be paid by a single check?

Do you ever think anything through before you hit submit?

 

[sir drinks-a-lot]

Which part of my post was unclear that this was a temporary solution while the back end was being finished?

That was clear from your post.

There are two hundred companies involved, and by the sound of things, they agreed to pay them on something like a monthly basis. So for a month or two, they'll cut checks by hand, once a month, to two hundred companies based on the accounting set forth in the front end of the system. In a month or two the electronic payments will be working and then they'll use that instead.

Says Who? Sebelius?