December 3, 2013

"And by late morning, when the number of people on [healthcare.gov] was roughly 35,000 — or 15,000 fewer than administration officials had said it could handle..."

"... some consumers encountered a 'queue,' a new feature intended for times when the site was too crowded. The feature limits the number of people on the site and notifies others by e-mail when it’s a better time to log in."

Does that mean the goal of handling 50,000 people at a time has not been reached or are we going to be told that getting treated to the new "queue" feature is one way people are getting handled? (It depends on what the meaning of "handled" is.)

Also at the link — which goes to The Washington Post — is the news that for those who have actually enrolled, there are errors in one third of the records.
The mistakes include failure to notify insurers about new customers, duplicate enrollments or cancellation notices for the same person, incorrect information about family members, and mistakes involving federal subsidies. ...

Figuring out how to clean up the backlog of errors and prevent similar ones in the future is emerging as the new imperative if the federal insurance exchange is to work as intended. 
But keep coming in, people. We need you in. If two thirds of you get through the process without your file getting screwed up, well, don't you realize that means the vast majority of people are doing quite well? An election with 66.6% of the vote would be a landslide. And:
Some of the errors in the past forms were generated by the way people were using the system, another senior official on the project said, such as clicking twice on the confirmation button or moving backward and forward on the site.
Yes, you idiots. It's your fault! User error. You double-clicked, grandma, you computer doofus!
The errors, if not corrected, mean that tens of thousands of consumers are at risk of not having coverage when the insurance goes into effect Jan. 1, because the health plans they picked do not yet have accurate information needed to send them a bill...

Of the various errors generated by the online system, a top priority for insurers is to correct what are called “orphan reports,” in which a new customer is inexplicably excluded from reports sent to each health plan early every evening listing their new enrollees from that day.
So, there are a lot of people — who don't yet know who they are — who are eventually going to be quite upset. They did what they were told to do. The machine told them they'd done it. But they had not done it. I guess everyone who thinks he's signed up needs to worry that he's one of the "orphans." Should you get upset now or wait until you discover you're one of the unlucky ones? There should be another website selling insurance against the risk of being one of those whose insurance turns out not to be insurance.

Perhaps the goal is to drive everyone nuts about insurance, so that no one wants to hear the word "insurance" again. A collective cry goes up: "Health care should just be free!" I think the main reason that doesn't happen is that too many people believe they have access to health care services that are significantly better than what would be available for everyone if the link between care and paying for it were broken and the government — over there somewhere — paid all the bills.

Yes, everyone deserves basic access to medical treatments, but I deserve more, my family deserves better. Isn't that what you think?

112 comments:

Henry said...

Garage got his. All is right with the world.

MadisonMan said...

Imagine how far Amazon would go with a limit of 35000 users at one time.

The Cracker Emcee Refulgent said...

Yes, I deserve better than someone who refuses to work for it. I deserve better than someone who expects it to be handed to them.

Eric said...

"You double-clicked, grandma, you computer doofus!"
Sometimes you can be really funny Althouse.

MadisonMan said...

From the article:

We’ve got a team of experts already working closely with issuers to make sure that every past and future 834 is accurate. We’re confident they’ll succeed,” Mc­Guin­ness said. The 834s are nightly enrollment forms sent to insurers to tell them who their new customers are.

Top. Men.

Peter said...

Perhaps it's intentionally difficult so as to discourage the old and sick?

What matters here isn't just how many can buy insurance, but who> can buy it.

Bob Boyd said...

at the healthcare orphanage:

http://www.youtube.com/watch?v=sZrgxHvNNUc

Scott M said...

I wonder if the //comments in the code call the queue structures, "cattle cars".

SGT Ted said...

They would rather tell ten lies than one truthful statement that would maybe gain them some patience from their supporters.

They are pathological in their need to always be seen as right.

Bob Boyd said...

I keep reading the part of the system where money changes hands isn't built yet.
Does anybody know if that is the case?
If so what does it mean to be enrolled?

PB said...

It shows they still don't have a good performance model of the system. what they did have led them to adjust capacity to what they thought would allow 50,000 simultaneous users. Reality is often different from the model. That's why models need to change to improve predictability.

As one moves through the web site, it performs a variety of server requests, some of which translate to database reads and writes. The model reflects expected usage patterns. Not all reads and writes are the same and writes are much more resource intensive for the database. So if the model is wrong and there are more writes than expected, or more complex, un-cached reads are performed, then the underlying database will be able to support fewer web users.

Also, as the database grows when new information in inserted, the indexes to the tables may need to be rebuild or what were fast queries/reads before become significantly less fast.

As much as the admin likes to tout their experience with "big data" and "analytics", the fact they rely on Oracle so much indicates they rely on a traditional SQL database so this lends credence to my supposition.

Of course, another real problem is likely the burden hackers are placing on them at the moment. They're likely seeing all sorts of penetration attempts and denial of service attacks, given the recognition of the poor security of the system.

Bruce Hayden said...

Just to add a bit more gas to the fire, and aimed at all the Obamabots who think that their guy has delivered the goods here: No security ever built into Obamacare site: Hacker.

Brando said...

The president must be looking at this and wondering why his glowing brilliance and world-historical significance wasn't enough to get a working website in four short years. This must be extremely puzzling for him, and unfortunately he does not know anyone else who is brilliant enough to commiserate with.

Bruce Hayden said...

PB Reader - my understanding was that their primary DB was non-SQL, and due to the structured nature of the queries, this decision was questioned. It was also supposedly a much less heavily used DB than Oracle, where there would have been much more govt and private sector experience.

Is this one of those things where the earlier information nation was wrong (like that maybe the F&F star who died was probably not drag racing after all)?

MadisonMan said...

No security ever built into Obamacare site: Hacker.

And if a Government site is hacked, and your personal data are stolen, the Government is under no obligation to reveal that to you.

At the very least, if I do enroll, I will do so from a pristine email address that is separate and will remain separate from the rest of my life.

PB said...

Okay, let's do some math. If the web site can do 35,000 concurrent users and it takes 20 minutes to do an application, then 105,000 applications can be submitted per hour, or (assuming usage in the wee hours is very low) 1.8 million per day. This means the capacity to enroll between Dec 1 and Dec 23 is 41.4M

How will this compare to actually applications processed in the month of December? What will it say when only about 500,000 enroll? 1M?

Both of these application numbers are well below previous targets, but are significantly above October and November actual applications. Likely the admin and democrats will claim a wild success of a world-class website, even though by pre-October expectations this would be considered dismal failure.

Michael said...

I only deserve what I have paid for which is probably more than most people think is enough. I have also lived well below my means and thus have accumulated more than most people think is enough.

I have a question about this law that co tinies to nag. I am told that preexisting conditions must be insured against. I am also told that if you try and game the syatem by paying the fine but get desperately ill before the next sign-up period that you are strictly out of luck.

Does this mean, then, that under the new law people who are uninsured will be denied treatment whereas currently they cannot be?

Ann Althouse said...

"If so what does it mean to be enrolled?"

As the article says, you are not enrolled until you've paid. You may think you are and find out later that you are not.

I edited some sentences out, but if you go to the link, you will see that clearly.

Wince said...

"You see what you get when you mess with the Orphans!"

test said...

Should you get upset now or wait until you discover you're one of the unlucky ones?

They should call the insurer directly and verify their enrollment.

Michael said...

"Of course, another real problem is likely the burden hackers are placing on them at the moment. They're likely seeing all sorts of penetration attempts and denial of service attacks, given the recognition of the poor security of the system."


Clearly. Who would have thought that hackers who are malicious enough to disrupt web activity just for the hell of it would want to penetrate the sacred healthcare.gov? And then there arethe hackers who are after something.

Hagar said...

I don't know what, if anything, I "deserve," but I definitely want to see a doctor that I choose, if any, and deal with an insurance company, if any, that I choose; not the government or any other third party.

Birkel said...

Michael:

You cannot be denied treatment. What it means is that you will not be able to sign up for the Obama-insurance (such as it is and calling it insurance makes me wince) until the enrollment dates come 'round.

So you'll either have postpone medical treatment, if medically possible, or pay out of pocket. Or bankruptcy is an option.

Bruce Hayden said...

Sorry - left out a critical word on my last post.

I keep reading the part of the system where money changes hands isn't built yet.
Does anybody know if that is the case?


I think in particular, the code to pay the insurance Companies the subsidies. They are apparently supposed to bill their exchange policy holders for the subsidized price, and have the feds then make up the (often substantial) difference. This is supposedly one of the missing pieces, getting the subsidy to the insurance companies. And in many cases this is going to be the bulk of the money brought in to these companies to cover their costs paying claims.

PB said...

Bruce Hayden: NoSQL doesn't mean "no sql", even the vendor states that it means "not only SQL). It's fairly common these days to mix non-structured data storage and analysis like Hadoop with structured data storage like Oracle. Plus, SQL interfaces to Hadoop are also in play.

cubanbob said...

Yes, everyone deserves basic access to medical treatments, but I deserve more, my family deserves better. Isn't that what you think?"

It would be a strange world where having money is only good for luxuries and not necessities.

tim in vermont said...

As a software requirements writer for some part of my career, the word "handled" was strictly to be avoided unless specifically defined within the context of the system in question; for the same reason that the truth evaders in the administration like it so much.

PB said...

Bruce Hayden: that was the surprising claim in November in Congressional testimony, but they since assigned at least one programmer to the task so they can claim it's being worked on.

But no, that functionality is not there.

Hagar said...

Bruce Hayden above,

So, doesn't this mean the insurance companies have to try to collect at least two billings for each medical "event"?

And this is supposed to be cheaper for them?

Plus the fact all of us who have dealt with the federal government has experienced: For the Feds, a promise to pay eventually is just as good as actually making the payment now.

Henry said...

One thing that has concerned me about this whole fiasco is that it easily could reinforce the Red/Blue chasm by giving citizens in different states completely different experiences with the botched rollout.

It is largely Blue states that have created their own exchanges, with California and New York being the largest. (Battleground states Florida, Pennsylvania, and Ohio are notable absent.)

One reason for this, outside of political party power, is that these states started with much more legal and regulatory infrastructure. New York has had community rating for 20 years. Even mismanaged little states like Rhode Island have more regulatory infrastructure in place than much larger, less regulated states to its South and West. There's nothing like moving from Rhode Island to Massachusetts and saving money on your health insurance.

The citizens of these states are used to paying more. These states align closer to ACA mandates so the disruptions will be less. And those states that decided to create their exchanges had more pieces in place to make that possible.

The result is that many Blue-state supporters of the ACA will be confirmed in their bias. It won't be as disruptive to them. Their state exchanges will work better than the Federal. Blue state activists will quickly pivot (as they have already) to blaming Red states for refusing to build their own exchanges, ignoring that these states faced much greater disruption to the legal and regulatory systems they had in place.

Out of curiosity about the possible electoral impact I indexed the 16 states with their own exchanges to population. The result will be heartwarming to Republicans. The 16 states with local exchanges (including some unexpected outliers like Idaho and Kentucky) account for roughly 33% of the population and 34% of Presidential electors.

If we add those States with partnerships and other hybrid systems (Illinois being the biggest), the "in" states still only account for 43% of the population and 44% of the presidential electors.

So perhaps the pain will be unequal. Which is good. A stalemate means disaster.

PB said...

Ann said: "Perhaps the ultimate goal is to..." There are lots of theories as to what the ultimate goal is, but it's hard to get past the simplest explanation: ignorance, incompetence, hubris, and malfeasance.

Perhaps what we should be worried about is the reality that this could be considered a true "national disaster" with people left hanging without insurance and insurance companies unable to be paid by the federal government. What is the possibility that some in the authoritarian wing of the administration will move to declare some sort of "medical martial law" as 1/6th of the economy risks being thrown into total chaos?

If you believe in ulterior motives, then you might consider:
1. There have been very surprising and a large number of senior commanders replaced in the military for what some would say are dubious reasons
2. Maybe we'll find out just why those govt agencies have been buying and stockpiling all that ammunition.

Anonymous said...

Speaking as an a veteran of complex software systems development (wall street trading systems, global telecom network controlling systems, etc.), and for those of you with a software background, you'll remember this software developer's adage fondly and swear to its validity:

The first 90% of the system takes 90% of the time. The last 10% of the system takes the other 90% of the time.

Two implications:

1. Don't believe it is "fixed" just because some talking head behind a podium or mic says it is fixed.

2. Obama is a complete dunce in this domain.

tim in vermont said...

I can't imagine what it is going to be like at the pharmacy beginning in January. It will hit there first.

khesanh0802 said...

"On Monday, Julie Bataille, a spokeswoman for CMS, recommended that insurance seekers who choose a health plan through the site contact the insurer afterward to make certain they are actually enrolled. "

Amazon asks that you do the same. Call their operators to confirm that your order has been placed. NOT!!! That would certainly be the end of Amazon.

Can you imagine having the b**ls - or the complete disconnect -to stand up and say what Bataille said? You've just spent an hour entering an order and your told: " Please give us a call to ensure that we did not f**k up."

Ann, you are getting quite harsh with these "doofuses". Only what they deserve! Are you having any trouble controlling yourself during conversation with your Madison colleagues?

Hagar said...

That did not work out right, but there would have to be two transactions where there now is one.
Either the doctor/clinic would have to bill the insurance company and the federal government, or the insurance company would have to pay the doctor/clinic the full amount and then bill the federal government to get reimbursed eventually.

jacksonjay said...


I am more concerned about the dissenters being targeted by the IRS!

garage mahal said...

Hope the website is working. Scott Walker kicked 80,000 people off BadgerCare and told them to go on ObamaCare. Sort of an odd decision?

tim in vermont said...

Hagar, I was wondering what you are talking about, but no, the govt is not going to subsidize individual claims, they are going to top off premiums for those qualifying for subsidies.

tim in vermont said...

"Sort of an odd decision?"

Yeah, it was an odd decision to trust a known liar like Obama.

test said...

What is the possibility that some in the authoritarian wing of the administration will move to declare some sort of "medical martial law" as 1/6th of the economy risks being thrown into total chaos?

1. There have been very surprising and a large number of senior commanders replaced in the military for what some would say are dubious reasons
2. Maybe we'll find out just why those govt agencies have been buying and stockpiling all that ammunition.


(a) There is a high chance the administration will transfer financial responsibility to taxpyers for expenses (premiums or claims) related to people who signed up for a plan but ended up uninsured.

(b) This has zero relationship with military replacements or ammunition stockpiling.

Beldar said...

I don't think I or my family "deserve better."

But I would like to be able to buy healthcare and health insurance (different things!) for myself and my family in a free market undistorted by government tax breaks and penalties designed to manipulate and interfere with the market.

As is, the only kind of healthcare of which that's true is — oddly enough! — the only segment of the market that's almost completely uninsured and least regulated by the government, viz: the market for cosmetic surgery and procedures, in which during the last 40 years price has plummeted, and availability and quality have soared.

Anonymous said...

PB Reader said...

As one moves through the web site, it performs a variety of server requests, some of which translate to database reads and writes. The model reflects expected usage patterns. Not all reads and writes are the same and writes are much more resource intensive for the database.


I suspect that the vast majority of the latency and lag is in the queries again the external remote legacy systems. The Read/writes against the internal DB ought to be pretty fast (except, that when you go production, you not only need to keep rebuilding indices, you need to add others, e.g. the ones you forgot)

jacksonjay said...

I think we can all agree that Republicans have sabotaged this from jump!

PB said...

Marshall: Likely you're correct about transfer of financial responsibility. However, I wouldn't discount the desire to take some sort of unprecedented executive action stretching the bounds of presidential authority.

1. disturbing trends among military leadership towards those that are strict supporters of the party line.
2. militarization of local police forces with all that free combat gear.
3. militarization of federal department security forces (Library of Congress SWAT team??)
4. All that ammo in quantities larger than the military used in Iraq or Afganistan and more lethal (hollow points are illegal for military use, but fed govt has been stockpiling).

I generally don't go for conspiracy theories, but when certain capabilities develop on their own through normal government overreach, they usually end up be used to the public's detriment.

Michael said...

Birkel. So an uninsured person in the new, good, era is in the same position as an uninsured person in the old, bad,era.

TosaGuy said...

The American government's way of putting people in line for government goods is far superior to the way the USSR did it. 'MERICA!

Hagar said...

Tim in the formerly independent state of Vermont,

So, it is not as many transactions, but the imsurance company bills me for my share of my premium, and then the government for the subsidy share with documentation as to why and how much I should get subsidized?

Or, they bill me the full amount, and it is my problem to get the federal subsidy paid to me as rembursement?

Either way, that is still a bunch of extra work and time lost that has to be paid for somehow.

Bruce Hayden said...

So, doesn't this mean the insurance companies have to try to collect at least two billings for each medical "event"?

Don't think so. Rather, as I understand it, an insurance policy may cost $1,000 a month. But the cost to the insured is supposed to be, maybe, $600, with the federal govt making up the difference with a $400 subsidy. So, the insured pays the insurance company $600 a month, and the feds send them the remaining $400 - except that they can't, because the code to do so apparently hasn't been completed.

So, what happens if this functionality isn't fully functional by the end of the year (less than a month away). Will the insurance companies have to cover these people, even if the money coming in is far short of what they have going out, thanks to the missing federal subsidies? All on the promise that they will ultimately be paid, and the govt has "top men" working on the problem? Promises made by the same Administration that promised everyone that they could keep their policies if they liked them. Period. That they could keep your doctor if you liked them. Period.

PB said...

Drill SGT: Unless you perform one of the identity verification steps (in the middle or at the end) all of the data is really simple stuff that comes from the user and only goes to the healthcare.gov website, not to any external system. Even the identity verification is simple it is merely a back-end interface to Experian (I know this because I deliberately set up a fictitious application and the first identity validation caught the non-existent name and address pairing). it's only when you complete and submit the application that the back-end processing begins.

test said...

I wouldn't discount the desire to take some sort of unprecedented executive action stretching the bounds of presidential authority.

This desire can't be discounted since it has already ocurred. But this doesn't create a link between Obamacare and replacing military officials. The military is not going to protect a domestic policy.

The other "trends" you mention predate Obamacare and in some cases Obama himself and are inevitable attempts by institutions to increase their own power. There is no link between them and Obamacare.

Anonymous said...

Hagar,

I think the more interesting question is a contract law one. Nominally, your insurance isn't in force until the firm gets your full first month's premium. So if the insured pays half and the Feds don't pay their half by Jan 1, do you have a valid policy?


PB Reader said... (hollow points are illegal for military use, but fed govt has been stockpiling).

Not disagreeing with your general angst, the HP issue could be as simple as seeking rounds for building raids where you don't want a miss to go through 3 more apartments and hits some little old lady....

Eric Jablow said...

The problem of people submitting web forms twice by accident has standard solutions. Every web framework has ways to solve that problem. One common method is to have the web page include a hidden random number. For example, <input type="hidden" name="nonce" value="867-5309">. The web site is set to ignore all but the first transaction from a user with a particular 'nonce' value.

That the web site does not implement those solutions shows that the programmers do not understand what they are doing, either on the programming side and on the human side.

Anonymous said...

PBR,

I'm talking about the read fetches to external systems for income, SSN validation, State Medicaid rolls, etc...

Me? I would have built all those needed external data fetches against an internal data warehouse, and done bulk table reloads to the DW at night from the remote external sources...

Hagar said...

How do the government agencies and the insurance companies keep track of the extent to which I am eligible for subsidies?

If I pay the "insurance" premiums monthly, does the government check my employment status, lottery winnings, possible inheritances, or whatever monthly, or just once a year with my tax return?

I think my income is so low that I don't really have to file a tax return. Then what?

Matt Sablan said...

Heh, this is the same anger that every MMO player experiences when they are told about server upgrades, only for the various sites that do MMO metrics to find out, no, there are not more concurrent users now.

Scott M said...

(b) This has zero relationship with military replacements or ammunition stockpiling.

Well, not zero, surely. It all falls under the executive branch, doesn't it?

David-2 said...

The cluelessness of journalists to really basic arithmetic facts is amazing in the way they repeat the Administration's assurances of low error rates as if they were good news. It is obvious why the Administration wants to obfuscate their failure, but I think the news media doesn't even realize it.

Two cases in point:

First, yesterday we learned the error rate on pages that didn't load was 1%. 1% on a page load means 1 out of 100 pages didn't load overall. Since a "visit" to Healthcare.gov involves many page loads that means any individual user's chance of getting through the site without a failure is lower.

(Although, actually, I suspect the true success rate is much lower than 99%. At 99%, if getting through the site requires 10 page loads, you should have a 90% chance of getting through to "register". But anecdotal evidence from news stories indicates the true success rate is much lower than this.)

Second, and much more important, we learn today from this article that your chance of of data not being generated on the "form 834" has been reduced from 3% last week to 0.5% this week. Well, that's reassuring! 0.5% is really low, right?

Well, 0.%5 is 1 in 200. That ... well that sounds a little more serious.

If only journalists weren't bottom of the barrel when it came to things like understanding arithmetic. This affects all their reporting, of course, from recall rates of automobiles to the impact of various environmental scares.

garage mahal said...

Yeah, it was an odd decision to trust a known liar like Obama.

Walker trusted Obama and ObamaCare as the best option for 80,000 people. Wow!

PB said...

Drill SGT: No matter how you or I would design the system, there are only 2 identity validation steps performed during the application process and the other stuff happens after you submit the application so they can later come back to you with your options and prices. The core of healthcare.gov is a really simple web site that registers a user, and then collects a bunch of standard data and stuffs it in a database. It's really boggling how they could have screwed up a pretty well known web/db problem.

An indicator of the programming incompetence is how they handle date input. You have to enter mm/dd/yyyy. It can't fewer digits, though it should (as any quality web site does) How many years have people been developing web sites with this requirement?

MadisonMan said...

@Eric J, but what if the person doing this is not named Jenny!!?

Diamondhead said...

Althouse, you probably eat better food than 95% of the world's population (and food as good as the remaining 5%). When you enjoy these meals, do you think that you deserve better food than everyone else? When you're driving your car, do you think that you deserve a better car than most other people? More likely you can afford what you like so you buy it without too much thought for the people who don't have the money or who choose to spend it differently.

test said...

Scott M said...
(b) This has zero relationship with military replacements or ammunition stockpiling.

Well, not zero, surely. It all falls under the executive branch, doesn't it?


In my usage a relationship exists only if one thing influences the other. Common existence, even within a common structure, is not a relationship.

Matt Sablan said...

"The problem of people submitting web forms twice by accident has standard solutions."

-- Play by post games on things like VBulletin or whatever prevent double posts by simply not accepting a response from the same user every, say, 30 seconds or so. You don't even need anything fancy to do that.

Matt Sablan said...

"First, yesterday we learned the error rate on pages that didn't load was 1%."

-- That's easy. Think of all the perfectly stable pages on the website (FAQ, home page, etc.) and how many hits they must get. That inflates your total hits on perfectly stable pages that, additionally, if they take a bit longer to load, no one notices because they don't matter. If that 1% error rate is focused nearly entirely on the registration part of the site, that 1% is more significant than if it is on the FAQ page.

Joe Schmoe said...

There should be another website selling insurance against the risk of being one of those whose insurance turns out not to be insurance.

I laughed out loud at this line until I though about the high likelihood of this happening.

Sorun said...

"Yes, everyone deserves basic access to medical treatments, but I deserve more, my family deserves better. Isn't that what you think?"

My issue has always been the corruption and incompetence of a government monopoly. That's what we're going to have, with the website a preview of things to come.

Scott M said...

Once the fail reaches this magnitude, it rises in direct proportion to "teh stoopid" burn.

Scott M said...

In my usage a relationship exists only if one thing influences the other. Common existence, even within a common structure, is not a relationship.

...and don't call me Shirley.

William said...

At what point do liberals look at a social program and say this isn't working?.......When the Soviet Union finally collapsed, it is instructive to note that 20 to 30 % of the people in France and Italy were Communists. This number included some of the best educated people in those countries.

Insufficiently Sensitive said...

Perhaps the goal is to drive everyone nuts about insurance, so that no one wants to hear the word "insurance" again.

The word 'insurance' in healthcare has been rendered useless by Obamacare - which is not insurance, but merely a prepaid health reimbursement plan which spreads the wealth around in addition to that feature.

The Obamacare mandates that 'insurance' companies pay off folks with pre-existing conditions are the negation of real insurance. They merely convert insurance companies into Government-controlled boodle-shufflers. Brought to you from the school of Chicago politics, where you get nothing unless somebody sent you.

Andy Freeman said...

> Scott Walker kicked 80,000 people off BadgerCare and told them to go on ObamaCare. Sort of an odd decision?

WI voted for Obama. Why shouldn't it get Obamacare?

Odd that Garage would complain about that. Did Heritage? (Garage keeps saying that we should like Obamacare because it is a Heritage plan. Regardless of whether it actually is, he can't expect anyone else to accept an authority that he rejects, so clearly he's on-board with everything Heritage. Of course, the rest of us are under no such obligation.)

Seeing Red said...

...So, what happens if this functionality isn't fully functional by the end of the year (less than a month away). Will the insurance companies have to cover these people, even if the money coming in is far short of what they have going out, thanks to the missing federal subsidies? All on the promise that they will ultimately be paid, ....


Illinois is $9 Billion(?) in arrears?

Of course the evil insurance companies will float it until the feds get around to paying for it. What else can the insurance companies do?

Nancy Pelosi was quite clear during the sequester, there is no more money, they've cut to the bone.

Alex said...

It's obvious that healthcare.gov is a runaway success and conservatives are just jealous of a government program that works!

garage mahal said...

(Garage keeps saying that we should like Obamacare because it is a Heritage plan

I never said that. Liberals wanted Medicare for all.

So if ObamaCare is so bad, why is Scott Walker dumping 80,000 people needlessly into ObamaCare? This income level group was never designed to be in the exchanges in the first place.

Skeptical Voter said...

You're damn right Althouse. And I'm willing to pay for it for my family.

Curious George said...

"garage mahal said...
Hope the website is working. Scott Walker kicked 80,000 people off BadgerCare and told them to go on ObamaCare. Sort of an odd decision?"

How so?

Scott M said...

This income level group was never designed to be in the exchanges in the first place.

Which group is that?

Curious George said...

"garage mahal said...
This income level group was never designed to be in the exchanges in the first place."

This is a false statement. All those being moved off BadgerCare qualify for the exchanges but not Medicaid.

Curious George said...

"garage mahal said...
So if ObamaCare is so bad, why is Scott Walker dumping 80,000 people needlessly into ObamaCare?"

Because it saves WI taxpayers tens of millions which then can be used to ensure all Wisconsinites below the poverty line are covered under Medicaid/Badgercare.

Why do you hate poor people garage? Because they are mostly black?

garage mahal said...

How so?

The success of his decision to transition people off Medicaid now rests on the success of ObamaCare. Basically, Walker is admitting the best bet for these [now] uninsured people is ObamaCare. Oh, the irony.

Curious George said...

"garage mahal said...
How so?

The success of his decision to transition people off Medicaid now rests on the success of ObamaCare. Basically, Walker is admitting the best bet for these [now] uninsured people is ObamaCare. Oh, the irony."

This doesn't even make sense.

Seeing Red said...

All those being moved off BadgerCare qualify for the exchanges but not Medicaid.

What are (some of) the requirements for "qualifying for the exchanges?"

Curious George said...

"Seeing Red said...
All those being moved off BadgerCare qualify for the exchanges but not Medicaid.

What are (some of) the requirements for "qualifying for the exchanges?"

Basically don't qualify for Medicaid or Medicare. Some limitations if you have coverage through employment.

jr565 said...

Ann Althouse wrote:
As the article says, you are not enrolled until you've paid. You may think you are and find out later that you are not.

I read how they haven't quite written the portion of the website where you actually pay for the insurance.So, does that mean no one is really enrolled yet?

jr565 said...

garage mahal wrote:

The success of his decision to transition people off Medicaid now rests on the success of ObamaCare. Basically, Walker is admitting the best bet for these [now] uninsured people is ObamaCare. Oh, the irony.



It's like being caught been the Scylla and Charybdis.

Seeing Red said...

In other words, most everybody once this Obamanation really gets going.

jr565 said...

The cutoff point where you don't qualify for the subsidy is 42,000 or so. And if you don't qualify for the subsidy you will be hit with the sticker shock of your life.
Since of course you will be paying for those who do qualify for the subsidy. And for old people.
Unless you are under 26 in which case you will be on your parents insurance.
So, basically if you're 27 and making more than 42,000 a year prepare to be gouged.

David said...

"Some of the errors in the past forms were generated by the way people were using the system, another senior official on the project said, such as clicking twice on the confirmation button or moving backward and forward on the site."

That was my favorite part, and I had the same reaction as Althouse. I thougt victim blaming was such an un lefty thing to do. But no, it's our fault. Who ever clicks twice on a confirm button? Who ever moves in reverse while surfing a web site? The fools. No insurance for you fools, fools.

jr565 said...

All that's happening with Obamacare is the increase of Medicare/Medicaid. Which will be unsupportable.
Just ask doctors how much they're getting reimbursed by doctors now for Medicare/Medicaid. It's like govt wants to do insurance on the cheap.

Anonymous said...

"The errors, if not corrected, mean that tens of thousands of consumers are at risk of not having coverage when the insurance goes into effect Jan. 1, because the health plans they picked do not yet have accurate information needed to send them a bill..."

Hmm, 1/3 of orders are screwed up. "tens of thousands" of people will be harmed. So that means, what, 60,000 have actually signed up (as opposed to having placed an insurance plan in their shopping cart)?

Or, since this is a forward looking statement, does this mean they don't expect that even 300,000 people will have actually chosen a policy through the Federal Exchange by the end of the year?

Need: 7,000,000
Expect: < 300,000

Government competence at work.

garage mahal said...

All those being moved off BadgerCare qualify for the exchanges but not Medicaid.

Walker redefined the poverty level.

By turning down Medicaid expansion, 85,000 fewer will be covered, and cost the state 119 million more.

Compared to taking the federal dollars to expand Medicaid, Walker’s plan costs state taxpayers $119 million more over the next two years to cover 85,000 fewer people with BadgerCare, according to estimates by the Legislative Fiscal Bureau. The state also will bring in $489 million less in federal taxpayer money than if Medicaid were expanded to individuals up to 133 percent of the federal poverty level.

Patrick said...

Very nice pick up Madison man.

Anonymous said...

cubanbob said...

"Yes, everyone deserves basic access to medical treatments, but I deserve more, my family deserves better. Isn't that what you think?"

It would be a strange world where having money is only good for luxuries and not necessities.

Good, but not the entire point: It is an evil world where "the best" goes, not to those with money (which has generally been earned in honest transactions with other people), but to those with "pull" (i.e. those who have political power and / or connections).

How do we decide who gets what? Is it by money? Or is it by connections? Because there's never been a ongoing situation in the history of the human race where everyone got exactly the same. What the Democrats are trying to do is crush the middle class down with the poor, and use the "excess" that they've stolen from the middle class to 1: pay off their poor supporters (a tiny little bit), and 2: use the rest to support the political class 9see e.g. Pharma campaign donations to Democrats in exchange for the high priced contraceptive mandate).

Yes, the middle class absolutely do deserve better heath care treatment than the poor get. That's the whole point of being middle class rather than poor, you get better things (food, housing, medical care, transportation, etc) than the poor get, because you've earned them.

Seeing Red said...

Obama's redefined the poverty level via Obamacare. He also redefined "rich."

Anonymous said...

Henry said...

One thing that has concerned me about this whole fiasco is that it easily could reinforce the Red/Blue chasm by giving citizens in different states completely different experiences with the botched rollout.

It is largely Blue states that have created their own exchanges, with California and New York being the largest. (Battleground states Florida, Pennsylvania, and Ohio are notable absent.)

Um, Henry, over a million people in CA lost their Health Insurance this year because of ObamaCare. Last I heard, 80,000 have signed up for new policies on the State exchange.

Oregon is doing paper enrollments. Their exchange might be up by the middle of the month. But it might not be. The head of the program just took a "medical leave of absence". The governor "had a cold", and so wasn't able to talk with the press about it.

Perhaps NY will be an actual ObamaCare success. Perhaps.

But if so, it's just about going to be the only one.

Anonymous said...

" Birkel said...
Michael:
You cannot be denied treatment."

In what universe? I go to a pharmacy, I want to buy some medicine. They look me up, I don't have any health insurance, because ObamaCare screwed up. If I have a space $2000 lying around, I can buy my medication. Otherwise? I'm SOL.

I go to the Doctor for an appointment. They ask me for my insurance information. I give it. They check with the company. The company has never heard of me (the 834 was screwed up). The Doctor will see me, but I have to pay in full for the appointment, first.

Emergency Rooms have to treat all comers. No one else does, unless they pay.

Anonymous said...

garage mahal babbled...

All those being moved off BadgerCare qualify for the exchanges but not Medicaid.

Walker redefined the poverty level.

By turning down Medicaid expansion, 85,000 fewer will be covered, and cost the state 119 million more.

1: Obama is the one who tried to redefined the poverty level, not Walker.
2: How much has Walker saved WI over the next ten years? That Medicaid expansion money runs out, then the State is stuck with the whole bill.

Henry said...

@gregq -- I'm talking levels of impact here. Clearly there is a large coterie of supporters dedicated to drumming up support for the ACA. Their job is easiest in states which fail least miserably. If any one state manages something remotely resembling success, that success will be exploited like Michael Jordon's sneakers.

If you oppose the ACA, you have to be prepared for that.

You also have to be prepared for the fact that sticker shock and network constriction will vary wildly from state to state.

Seeing Red said...

The Doctor will see me, but I have to pay in full for the appointment, first.


In Full? Why? You're going to the wrong doctor. Mine has a sign for cash 25% off.

As to meds - call the company, one never knows if one will qualify.

Nice try, tho.

Seeing Red said...

And just wait until the states have to pay for their entire Medicaid expansion.

Andy Freeman said...

>> Garage keeps saying that we should like Obamacare because it is a Heritage plan

> I never said that.

Garage has repeatedly written that conservatives/repubs/etc should be happy with Obamacare because he claims that Obamacare is a Heritage plan.

He can't argue that others must accept everything from Heritage unless he himself does. (Even then, we're not obligated to go along, but ….)

Andy Freeman said...

> So if ObamaCare is so bad, why is Scott Walker dumping 80,000 people needlessly into ObamaCare?

They voted for it, so why shouldn't they get it?

It isn't Walker's job to protect WI from every bad thing it wants.

> This income level group was never designed to be in the exchanges in the first place.

How so?

If you believe the Obama, Obamacare is cheaper for everyone, so why shouldn't those people get to take advantage of lower prices.

If you believe in subsidies, Obamacare needs lots of (relatively) rich and healthy. These people qualify.

If Obamacare is such a good idea, why is adding more people to it bad?

garage mahal said...

Garage has repeatedly written that conservatives/repubs/etc should be happy with Obamacare because he claims that Obamacare is a Heritage plan.

I've never said that one time. I said I was getting tired of defending the Heritage plan.

Bruce Hayden said...

In what universe? I go to a pharmacy, I want to buy some medicine. They look me up, I don't have any health insurance, because ObamaCare screwed up. If I have a space $2000 lying around, I can buy my medication. Otherwise? I'm SOL.

Of course, ObamaCare doesn't solve this problem either. One of the places that at least the lower cost plans cut costs is in their drug costs. Was looking at BC/BS, and was shocked by their arrogance - none of my SO's major meds were covered. Sort of thing you would expect from a socialized medical system - one size fits all, despite everyone being different. You really have to look at the insurance companies' drug policies and lists, and their provider networks. For us, we are talking almost $1,000 in meds alone for her that that BC/BS doesn't cover.

Seeing Red said...

Maybe GM should actually post the Heritage Plan so we could have a baseline. Romneycare wasn't really Romneycare after the vile Progs of MA got thru with it, either.

Seeing Red said...


Barack Milhous Obama @PresPasserby
Follow
I'm never going to be able to save you $2,500 a year if you keep insisting on expensive add-ons like website security.


7:41 AM - 3 Dec 2013

Belial said...

When people get shunted to the "waiting room" the webpage should have links to pre-2011 issues of Smithsonian or something for people to read, to replicate the actual experience of a doctor's waiting room.

Andy Freeman said...

> Romneycare wasn't really Romneycare after the vile Progs of MA got thru with it, either.

Isn't that backwards? Wasn't Romneycare an adaption of what the Progs wanted?

Note that Romneycare hasn't delivered on the "cheaper, better, more people covered" promises either.

However, you could sign up for it.

Romney could have run against Obamacare by accepting the false equivalence and then saying "it didn't work in MA, why should we take it national?"

Hagar said...

Listening to part of The Kelly Files this evening, and I think Miss Megyn may be even more confused than I am.

I think the insurance companies will have to accept you as being insured for something if they hace cashed your check or charged your credit card, either of which events you should know about, though if your application is faulty, or lost in the "cloud," or whatever, it may take a court case to establish just what was covered.

Obamacare surely is going to be a bonanza for the trial lawyers!

As for this deal they apparently have come up with, that the insurance companies will make an estimate of the Government's share (i.e. "subsidies") and the Treasury will cut them an advance check to cover it until the dust settles and they can figure out what it really should have been, I think her fears that the insurance companies will overcharge and refuse to pay it back is unfounded.

The companies already know from experience that the Obama administration will try to blame them for any problems, and they will not want to give Congress any additional handles to go after them with.

Besides, I think that what this mess is going to cost the insurance companies in any case will vastly exceed whatever money they may succeed in getting out of the Government for the estimated "subsidies."

wildswan said...

Walker moved 80,000 people who would qualify for subsidies to Obamacare and then added 73,000 new people to Badgercare. Or that was the plan. But now everyone is staying in Badgercare as requested by many including the Wisconsin Democratic Senator.

RecChief said...

so they "fixed" the front end, the part that the public can see, and who cares if they actually get insurance.

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