It’s Time for a Big, Giant Health Care Reform Roundup

I have been neglectful in posting about the continuing travails of Obamacare; real life demands mean less time for blogging. There is a lot of news to cover, and the news does remain bad for Obamacare fans.

Let’s start with what might be the next big problem for Obamacare:

Obamacare’s rollout dented the Department of Health and Human Services in just the first month. Up next year: the Internal Revenue Service.

A key piece of the health care law gives Americans making less than 400 percent of the poverty line subsidies to buy insurance. But if buyers don’t alert the insurance exchanges to big life changes throughout the year — like a divorce, promotion or new job for them or a spouse— they could wind up with sticker shock at tax time.

It’s a new responsibility for this group — many of whom are just struggling to sign up.

The IRS, for its part, must make sure consumers don’t get blindsided — or it will face a bunch of angry taxpayers who didn’t realize they would owe Uncle Sam money back, tax experts said.

“If I were the IRS, I would be very concerned that I’m going to be viewed as the villain when people have to pay back money the government gave them for health insurance,” said Chris Condeluci, who was Senate Finance Committee GOP tax counsel during drafting of the Affordable Care Act.

There is time. Potential “repayments” to the government will not come due until 2015, when recipients file next year’s taxes. But the new rule for reporting these life changes begins this January.

I fully expect this to be an issue, especially given the fact that “[r]ight now, the IRS does explain the issue on its website, but consumers would have to be looking for the information to find it.” It’s bad enough that people have been forced to give up insurance plans that they liked, and that they have lost access to doctors and hospitals that they have grown comfortable with–all despite the Obama administration’s assurances and promises that if we liked our health care plans, our doctors and our hospitals, we could keep them “period.” Now, people are likely going to have to face a third nasty surprise–tax penalties. Incidentally, for all those who believe that Democrats have suffered through the worst of the Obamacare implementation debacles, get ready to be proven wrong when taxpayers get eye-popping bills from the Internal Revenue Service.


Here comes the ObamaCare tax bill.

The cost of President Obama’s massive health-care law will hit Americans in 2014 as new taxes pile up on their insurance premiums and on their income-tax bills.

Most insurers aren’t advertising the ObamaCare taxes that are added on to premiums, opting instead to discretely pass them on to customers while quietly lobbying lawmakers for a break.

But one insurance company, Blue Cross Blue Shield of Alabama, laid bare the taxes on its bills with a separate line item for “Affordable Care Act Fees and Taxes.”

The new taxes on one customer’s bill added up to $23.14 a month, or $277.68 annually, according to Kaiser Health News. It boosted the monthly premium from $322.26 to $345.40 for that individual.

The new taxes and fees include a 2 percent levy on every health plan, which is expected to net about $8 billion for the government in 2014 and increase to $14.3 billion in 2018.

There’s also a $2 fee per policy that goes into a new medical-research trust fund called the Patient Centered Outcomes Research Institute.

Insurers pay a 3.5 percent user fee to sell medical plans on the Web site.

Avik Roy reminds us that “fact-checkers” completely fell down on the job when it came to covering Obamacare:

On December 12, the self-appointed guardians of truth and justice at PolitiFact named President Obama’s infamous promise—that “if you like your health care plan, you can keep it”—its 2013 “Lie of the Year.” An understandable choice. But in its article detailing why the President’s promise was a lie, PolitiFact neglected to mention an essential detail. In 2008, at a critical point in the presidential campaign, PolitiFact rated the “keep your plan” promise as “True.” The whole episode, and PolitiFact’s misleading behavior throughout, tells us a lot about the troubled state of “fact-checking” journalism.

Indeed it does, and there have hardly been any apologies made to those who predicted the problems that would attend the implementation of Obamacare. Meanwhile, problems with the website continue:

I tried to use the Obamacare exchange in my state, I really did. I probably spent about seven hours on the site in four or five sessions over the past few months.

Theoretically, I’m the sort of person who might benefit from the program. I don’t work for a big company that provides health insurance for its employees. We had been getting our family health insurance by paying for a “cobra” policy that extended the benefits my wife had gotten from her former job, but that has an 18-month time limit. So we need new health insurance for our family effective January 1, 2014. (A modest health reform might extend that 18-month time limit to, say, four years, but the drafters of Obamacare were not interested in modest reforms.)

In the past, I had bought health insurance through the Authors Guild. But because Obamacare outlawed individual policies of the sort that had been available through the Guild, that is no longer an option. (A modest health reform might have encouraged the purchasing or provision of health insurance through voluntary professional associations such as the Authors Guild, but the drafters of Obamacare were not interested in modest reforms.)

I live in Massachusetts, a state that had, under Governor Mitt Romney, pioneered the “individual mandate” and “universal coverage” that are at the center of Obamacare. You’d think they’d have a functioning Web site for health insurance. And they did, a year or so ago when I window-shopped for health insurance. Since then, however, to become compliant with Obamacare, the state scrapped the old RomneyCare web site and replaced it with a non-functioning Obamacare site.

By “non-functioning,” I mean, “non-functioning.” As in, it really doesn’t work.

And more:

A glitch is once again stacking up would-be health insurance shoppers on

The oft-troubled federal Web portal that is supposed to be the front door for millions of Americans to enroll in Obamacare health insurance plans started directing shoppers this morning to a “queue,” notifying them there is a problem with the site and to come back later.

“Right now, is queuing consumers,” HHS spokeswoman Joanne Peters confirmed in a statement. “This system is in place while the tech team works on fixing an error that happened during routine maintenance last night. This work started at 10 a.m. and we anticipate this could take two to three hours and that the site will be up and running again soon.”

The outage comes at a critical time as people are expected to flock to the site before a Dec. 23 deadline to enroll in order to get coverage that’s effective Jan. 1 under the Patient Protection and Affordable Care Act.

And more:

A top security officer told Congress there have been two, serious high-risk findings since the website’s launch, including one on Monday of this week, CBS News has learned.

Teresa Fryer, the chief information security officer for the Centers for Medicare and Medicaid Services (CMS), revealed the findings when she was interviewed Tuesday behind closed doors by House Oversight Committee officials. The security risks were not previously disclosed to members of Congress or the public. Obama administration officials have firmly insisted there’s no reason for any concern regarding the website’s security.

The Department of Health and Human Services (HHS) responded to questions about the security findings in a statement that said, “in one case, what was initially flagged as a high finding was proven to be false. In the other case, we identified a piece of software code that needed to be fixed and that fix is now in place. Since that time, the feature has been fully mitigated and verified by an independent security assessment, per standard practice.”

According to federal standards set by the National Institute of Standards and Technology (NIST), the potential impact of a high finding is “the loss of confidentiality, integrity, or availability could be expected to have a severe or catastrophic adverse effect on organizational operations, organizational assets, or individuals.”

Details are not being made public for security reasons but Fryer testified that one vulnerability in the system was discovered during testing last week related to an incident reported in November. She says that as a result, the government has shut down functionality in the vulnerable part of the system. Fryer said the other high-risk finding was discovered Monday.

In another security bombshell, Fryer told congressional interviewers that she explicitly recommended denial of the website’s Authority to Operate (ATO), but was overruled by her superiors. The website was rolled out amid warnings Fryer said she gave both verbally and in a briefing that disclosed “high risks” and possible exposure to “attacks”.

There are problems on the state level too:

Nearly 16,000 Iowans who tried to apply for coverage via the trouble-plagued federal health-insurance website are being told to apply separately through the state Department of Human Services.

The Friday afternoon announcement is the latest bout of bad news about the website, which is a key part of the Affordable Care Act.

The announcement affects people who entered their information into and received a notice that they might qualify for Medicaid. The federal computer system was supposed to transfer their applications to a state computer system, but that transfer has been complicated by technical problems. The timing is critical, because the new insurance coverage is supposed to take effect on New Year’s Day, which is Wednesday.

State officials say they can’t guarantee that people in this situation will have coverage if they need to see a doctor before the mess is untangled.

And more:

While Americans around the country scramble to meet the deadline to sign up for Affordable Health Care coverage to start Jan. 1, Marylanders have until Friday. The insurers in Maryland’s Health Care Exchange agreed to extend the deadline for those who want coverage in January until Dec. 27.

The Maryland Health Connection website has been a source of frustration since the launch on Oct. 1.

“With all its problems, it was like changing tires on a rolling car, but it is working a lot better and it has worked for 42,589 people,” said Governor Martin O’Malley.

Dwayne Henderson is not one of them.

“Saturday about 6 p.m. I tried the local site; the local site was not working. I went to the federal site; the federal site said I was ineligible to apply because Maryland has its own exchange,” he said.

Forty percent of Marylanders enrolled in Affordable Health Care enrolled last week, according to the governor, but many like Henderson couldn’t sign up.

“I reapplied at 11 p.m. on a Sunday, thinking that the volume should not be a problem. Unfortunately, I got the same response asking me to reapply,” he said.

Remember, the implementation of Obamacare is supposed to have “improved” after its initial disastrous start.

I guess that this story ought to surprise no one:

Even as President Obama’s health insurance website limps to recovery, at least two states that used the same contractor and are still plagued with malfunctions — Massachusetts and Vermont — are taking preliminary steps to recoup taxpayer dollars.

Massachusetts officials are reviewing legal options against CGI Group, a Montreal-based information technology company, and will make recommendations on how to seek financial redress at a Jan. 9 meeting.

So far, the state has paid $11 million of its $69 million contract with CGI. It will not pay a penny more until a functioning website has been delivered, said Jason Lefferts, spokesman for the Commonwealth Health Connector, the state’s insurance marketplace.

“CGI has consistently underperformed, which is frustrating and a serious concern,” Lefferts said. “We are holding the vendor accountable for its underperformance and will continue to apply nonstop pressure to work to fix defects and improve performance.”

Expect other states to follow suit by filing suit themselves.

Because of all of the problems associated with the implementation of Obamacare, the administration has been forced to implement a host of rules changes. For those who claimed to be worried about an imperial presidency back when George W. Bush was in the White House, now is the time for all of you to perk up:

It’s hard to come up with new ways to describe the Obama administration’s improvisational approach to the Affordable Care Act’s troubled health insurance exchanges. But last night, the White House made its most consequential announcement yet. The administration will grant a “hardship exemption” from the law’s individual mandate, requiring the purchase of health insurance, to anyone who has had their prior coverage canceled and who “believes” that Obamacare’s offerings “are unaffordable.” These exemptions will substantially alter the architecture of the law’s insurance marketplaces. Insurers are at their wits’ end, trying to make sense of what to do next.

And more:

Deadlines? Who needs ‘em? Not when it comes to Obamacare anyway. [December 23] was set to be the final day to sign up for coverage that begins on January 1 of next year. But the administration has quietly extended that deadline by an additional 24 hours. And by quietly, I mean, with no official announcement at all. News of the delay comes from two unnamed sources who confirmed the move to The Washington Post.

I am sure that this is someone’s idea of “good government,” but you will forgive me if I think otherwise.

I had planned to make this post longer, but it appears to be long enough for the moment. Not to worry; there is much more bad news to pack into a future post, and I should have the time to write one relatively soon.

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