Minggu, 14 Oktober 2018

For Those Of You Who Yesterday Didn't Believe My Federal Exchange Enrollment Estimates And Reports Of Backroom Problems...

You need to see today's Wall Street Journal front-page story, "Health Website Woes Widen as Insurers Get Wrong Data."

Here's an excerpt:
After realizing that some applications listed up to three spouses in a single family, Blue Cross & Blue Shield of Nebraska, which has about 50 health-law enrollees, had to "stop those enrollments from going through the automated process," said Matt Leonard, the insurer's sales manager. "It takes an automated process and turns it into a manual process," he said.
The biggest health plan in Nebraska has 50 enrollees so far? A state with about 300,000 uninsured.

Then this:
Scott & White Health Plan in Temple, Texas, has received 25 enrollees from the federally run exchange so far.
Enrollment numbers this low are what I am hearing from health plans all across the 36 states where the Obama administration is running the exchanges.

I am not hearing about thousands of enrollments per health plan. Maybe a few hundred at best––from plan after plan.

And on top of a lack of enrollments, there are the backroom problems. One health plan after another is saying the same thing the Nebraska Blues plan and Medical Mutual of Ohio were willing to say on the record:
Emerging errors include duplicate enrollments, spouses reported as children, missing data fields and suspect eligibility determinations, say executives at more than a dozen health plans. Blue Cross & Blue Shield of Nebraska said it had to hire temporary workers to contact new customers directly to resolve inaccuracies in submissions. Medical Mutual of Ohio said one customer had successfully signed up for three of its plans.

Should The Administration Shut The Obamacare Computer System Down? That Depends Upon What's Going On Behind The Curtain

My sense is that the biggest reason Obamacare is now in trouble is because of the top-secret way in which the administration has handled the rollout. If they had developed the computer system in a transparent way, the marketplace would have told them long ago this would not work.

No one outside the inner circle at the Department of Health and Human Services has any idea what's really going on behind the Wizard's curtain. Hasn't for months. Doesn't now.
So any technical advice any of us could give would be, to say the least, uninformed.

If I were on the inside, and it were up to me, the first thing I would do is bring in a group of heavyweight information technology experts to tell me just what was really going on. The administration cannot trust the people who have been working on this because they told them to launch this mess on October 1 and almost three weeks in there has been no improvement on the website or in the backroom––they no longer have credibility.

I would ask those experts to very quickly answer three questions:
  1. Can this thing be fixed on the fly––as the administration appears to be trying to do?
  2. If it can't be fixed on the fly––and three weeks into this that sure looks doubtful––then can it be taken down for one or two months with a high degree of confidence it can be brought back up in time to enroll people sooner rather than later?
  3. If the first two options are not possible, just how long will the computer system have to be shutdown before Obamacare can be launched in a way that there can be confidence it will work smoothly?
Then I would take their advice.

Right now the Obama administration appears to only be looking at this through a political lens: How do they minimize the political fallout?

There are two things wrong with that perspective.

First, the politics of this can't get any worse. This is now a political joke. Republicans can make lots of snarky comments about Obamacare and they won't be able to do more damage to Obamacare than the administration is doing to itself. Any Republican reaction to taking the system down won't last more than a couple of news cycles. More, the President would never lose politically by making a decision about every American already knows he has to make.

Second, the Obama administration, by keeping this computer system up and so far not being able to fix it, is not only wasting people's time they are on their way to destroying Obamacare.

As I have repeatedly said on this blog, the real longer-term threat Obamacare faces is that not nearly enough healthy people will sign-up for coverage in order for the aktivitas to be able to pay the medical costs for the sick people who enroll.

Left as is, I have to believe that the only people willing to put up with the repeated attempts and frustration with the Obamacare website and call centers are people so sick and in need of health insurance they have no alternative.

The greatest threat to Obamacare right now is a computer system the Obama administration continues to defend. And maybe their inability to understand how much damage they are themselves doing to the President's signature domestic accomplishment.

When these computer problems are finally fixed, then we can move onto the main event: Can Obamacare work?