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ObamaCare Clusterfuck: "Manual workarounds" now in project scope for CT exchange, as Obama's PR move on the 3-page form caused delay

What I have been seeing, trying to do Kreminology on ObamaCare's bizarrely secretive implementation, is project managers frantically triaging requirements to get something, anything, out the door; see Colorado, for example. Turns out, and as usual, I haven't been nearly cynical enough. Sarah Kliff does some actual reporting on how things are going with the Connecticut exchange:

At a monthly board meeting of Connecticut’s health insurance exchange, members of the standing-room-only crowd [!!] got a reminder that they, too, were behind schedule. The insurance marketplace they were working on nights and weekends won’t be completely ready on time.

“It is highly complex, it’s unprecedented and it’s not going to be smooth,” Kevin Counihan, chief executive of the state’s exchange, Access Health CT, told the group.

Just so long as it's not a "third world experience," eh? Could be deliberate lowballing, but the stories don't read like a PR campaign. Unless the crowd is made up of Obots and the site developers, it's the press and non-profits -- along, I would bet, with the crows and vultures that always circle a prostrate body.

That’s why Connecticut — like other states across the country — has lowered the bar, doing what it can in the time it has left before the health-care law’s major programs are launched Oct. 1.

Although the states are promising to provide new marketplaces for individuals to compare and buy health insurance plans, the Web portals will be a bare-bones version of what was initially envisioned.

Why do I think these "bare bones versions" are not going to be like Expedia? And do note Obama's oft-cited PR move to change to the ObamaCare submission form at the last minute butchered the schedule (and I would bet busted the budget as well):

Connecticut has made progress. It was the first state to complete an intensive technology test in which the state’s portal successfully connected to a federal data hub.

But officials have learned that good news can have a downside. The state agency spent weeks reprogramming its Web site after the federal government shrank the insurance application from 21 pages to three.

In other words, states that were most committed to ObamaCare (and, one would like to assume, their uninsured citizens) were punished the most.* [BWA-H... It hurts too much.]

And who's impacted by the delay Obama caused? Why, the gay community, since DOMA changes impact the exchanges by changing marriage status. But don't worry! There's a solution:

When the Supreme Court struck down a key element of the federal Defense of Marriage Act, Access Health CT board members cheered. Then, they remembered that it would add to the workload: The marketplace would now need to recognize same-sex marriages, a coding change unlikely to be ready for October.

“Everything continues to change all the time,” Van Loon told his staff at a meeting later that day. “We’re going to have to adjust some processes around that. If DOMA requires a manual work-around, we’ll do that.”

Oh, great. So tell me, how does the manual workaround get into the system? Gay people have to travel to whatever office is handling ObamaCare, and fill out the forms on paper? And they get to be second-class citizens again, just this time because Obama started tinkering with his own Rube Goldberg device?** And how is this like Expedia, exactly?

And most importantly of all, can somebody tell me how a "bare bones" site, partially paper-based, is going to attract those critical "young invincibles"? From back in May:

What's one thing you know about young people today, maybe the most obvious thing? That's right: They're totally wired, totally digital, totally computer-savvy. (They are also said by some to multi-task and have very short attention spans.)

So if you had an Internet product, and you wanted to turn young people off, right at the point of purchase, what would you do? That's right: You'd build a platform that was "buggy," with a "user experience" that "needs improvement," that has "glitches," and that will take three years to straighten out.

Which, my friends, is exactly what ObamaCare's exchanges are going to be like, according to Rahm Emmanuel's little brother. Yikes.

Oh, I almost forgot. Here's the headline, and Kliff's lead:

‘I wish we had one more year:’ States are struggling to launch Obamacare on time

HARTFORD, Conn. — Facing tight deadlines and daunting workloads, states across the country are scaling back ambitions for implementing the Affordable Care Act.

Well, everybody had three years (2013 - 2010) to implement ObamaCare, "the President's signature domestic initiative," which is going to cover a pitiable 7 million of the 40+ million uninsured in its first year. LBJ, let us remember, rolled out Medicare for the entire over-65 population in one year, back in the day of steam-powered mainframes that used punch cards fed to them by guys in white shirts with ties.

So what's the difference? The system architecture. Medicare for all has a simple and robust single payer architecture: You determine eligibility in one (1) jurisdiction (the United States) with one eligibility criteria for citizens: Their age. ObamaCare, by contrast, needs to determine eligibility in 50 (fifty) jurisdictions, with a complex eligibility formula that's primarily income-based, but involves systems integration from the IRS, DHS, HHS, and private credit reporting companies (at least), to throw people into the right subsidy bucket. That's called a combinatorial explosion, and even the best program and project managers -- which ObamaCare's managers clearly either are not, or have not been given the opportunity to be -- have a hard time dealing with them. Let me know how it all works out....

* * *

I should add my usual caveat that a system as large as ObamaCare is going to end up helping some people; the odds are that the lucky or the persistent are going to fight their way through the chaos and end up with a health insurance policy that if they're lucky, will cover them when they need it. (Under RomneyCare, bankruptcy claims due to medical expenses fell from 57% to 52%, which gives you an idea of how lucky they will need to be: Basically, a coin flip.) And no doubt the Obama permanent campaign apparatus (Enroll America; OFA) will do its level best to get the most telegenic of the lucky winners in front of the cameras. So there's that.

NOTE * Which is what happens to you when you trust Obama; see youth unemployment and debt, for example, or black unemployment.

NOTE ** I wonder if his techies warned him, or if they were too Koolaid-addled or afraid to speak up, or if they were even at the table at all. Ya know, I'm waiting for the "Hitler Reacts" video on ObamaCare....

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nihil obstet's picture
Submitted by nihil obstet on

By the eighties, non-computer people thought they were being cutting edge savvy envisioning computers taking all the work out of actually thinking through issues and processes. Computer people tended not to realize that issues and processes needed to be thought through. The extensive reporting on things like the various block grant programs was a major hassle for everybody, so the federal government kept offering states the opportunity to work with them on developing computer reporting. This went on for years. The states who were trusting enough to agree spent enormous amounts of person hours struggling to enter information into the federal system, but because the programs were large, complex, and flexible, the feds kept realizing that they had left out something or gotten something wrong or whatever. The trusting states suffered.

Serious problems implementing a complex system are not in themselves evidence of a conspiracy. They're evidence that you shouldn't set up complex systems unless absolutely, totally, completely necessary. Every little neuron spasm in a politician's head should not be incorporated into public policy implementation.

Right from the get-go the enormous resources that would be necessary for Obamacare were a clear indication that this turkey wasn't going to fly.

katiebird's picture
Submitted by katiebird on

Jurisdictions -- more than 50, right? At least 51 - with Washington, DC. But, what about Puerto Rico and the Virgin Islands? are there more?

And is "Bare Bones" Obama-speak for Quick and Dirty. Because my experience is that's a bad thing.

jo6pac's picture
Submitted by jo6pac on

This great news in that we should all receive #2 pencils sometime soon in the mail so we can manual fill out the form. I hope mine is bright yellow and not to sharp like aca.

It will be fun as we get closer and closer to Oct to read how 0 and his obots will defend this mess. What was wrong with Medi-Care again, oh right Main Street doesn't get screwed.

katiebird's picture
Submitted by katiebird on

Any other bill with this scope and potential impact so horrifically ill-conceived?

I'm trying to imagine how this will work and I just can't.

Now we have no requirement for Employer Reports into the Exchange. Yet the biggest criteria for admittance into the Exchange is the availability of "affordable" insurance from an employer.

Not, "your" employer - just "an" employer. If your spouse's (now including same sex spouses who didn't have to give this issue a thought 2 weeks ago) employer offers your spouse insurance that is less than 9.5% of salary AND offers plans that include you, no matter how wildly expensive it is then, oops-- you don't qualify for an exchange plan.

How can that be? How can our choices, my choices, your choices be limited by a decision made by our spouse's employer? Is there any reason to that?

And if you are a moderately normal person, would it even occur to you that this restriction existed?

It's beyond belief that anyone made this decision deliberately but it's true, they did. (I'll find a link to that fact if necessary but, we've talked about it.

Submitted by lambert on

[rimshot. laughter]

First they ignore you, then they ridicule you, then they fight you, then you win. -- Mahatma Gandhi

katiebird's picture
Submitted by katiebird on

But, really .... we've been lied into wars, suffered corrupt administrations, been spied on. These are horrible things but, the convoluted twists and turns (enhanced by the loooong sloooow roll out) of this thing --- has any major new program been so bungled? It would almost seem to be deliberate, but why the push to pass it at all?

Submitted by lambert on

I don't mean this to be "the incompetence meme" quite, since Obama is good at stuff that works when "It's good to be king!" like drone strikes or the kill list or public speaking (for those who don't want to throw stuff at the radio when they hear him, at least).

But for the rest, Obama's real "signature achievements" are negative. They involve doing nothing, like not prosecuting the banksters, or a meager minimum, like the stimulus, or being outright destructive, like HAMP or the mortgage settlement.

But he doesn't seem to be able to build, at all. I think it could be true that the fundamental critique us bitter knitters made in 2008 was correct: He simply was not tested on the national stage, and now the test results are coming in.

Obama is a big league player with a passionate following, charisma for those who can stand him, and minor league professional skills. He was a winner in a very weak field, and the staffers who made him look good have cashed in and moved on to other teams; Obama is the Tim Tebow of presidents.

Unfortunately, we can't trade him. Even more unfortunately, we can't bench him.

(This post got me thinking this way, but your question made me draw the conclusion.)

First they ignore you, then they ridicule you, then they fight you, then you win. -- Mahatma Gandhi

Alexa's picture
Submitted by Alexa on

And I don't see any "unintended consequences"--quite the opposite.

It appears to me that he is carrying out the corporatist/neoliberal agenda quite competently.

I believe that this delay is quite intentional--only a "pretend" unintended consequence (for the benefit of the so-called " base.")

Has anyone seen what Dean had to say about this? He's ecstatic.

And here's a blurb about Senator Begich lobbying for this delay.

'Obamacare' foes renew attack after employer mandate delayed

'CYNICAL PLOY'

Senator John Barrasso, a Wyoming Republican and leading critic of the health law, accused the administration of carrying out a "cynical ploy" with postponement of the employer mandate.

[I think he's spot on.]

"The public already lacks confidence in the law and it seems that now the administration is finally admitting that this law is unworkable, unaffordable and continues to be very unpopular," Barrasso said.

Among Obama's supporters, the AFL-CIO, a staunch ally of the Democratic president, said it found the decision to postpone employer-provided coverage "troubling."

AFL-CIO President Richard Trumka complained that while the White House showed willingness to provide flexibility for the business community, it appeared reluctant to make changes sought by labor.

He said he would press his concerns and hoped the administration would address them, "just as they have the concerns voiced by employers."

[More Kabuki! And what a joke--there's no bigger "puppet of the Democratic Party" than Trumka. A couple of years ago I heard Ex-Senator Alan Simpson "brag" about what close friends that he and "Rich Trumka" are.

He said this to an auditorium full of students during a townhall that aired on Sirium/XM. He added that he and Trumka "hug and kiss upon greeting."]

And the piece goes on to say,

Business groups said they welcomed the postponement but remained concerned about the employer mandate.

The U.S. Chamber of Commerce said the delay would help avoid "serious near-term economic consequences of the health law," but it wanted to work with the administration to head off other potential problems.

The National Association of Manufacturers said in a blog post that the employer mandate was a bad idea from the start and the administration's move "simply delays the inevitable."

[Does that mean that the Administration will drop the mandate altogether? Probably. Does anyone think that any Democrat really cares "what the base thinks?" I know that I don't.]

The delay complicates White House efforts to make the rollout of the health law look smooth, an already challenging task in part thanks to the continuing Republican campaign to discredit the program.

[Not really, when you "base" believes anything and everything--no matter how ridiculous--that you tell them. ;-)]

Jim Manley, a former aide to Democratic Senate Majority Leader Harry Reid, said he was worried that the delay would give Republicans "another club to beat Democrats upside the head."

"There's no denying that this is a setback for the program. The perception is pretty bad," said Manley, who was involved in the effort to pass the law.

Hey, just another Dem apparatchik trying to add to the legitimacy of the claim that this was one of those dastardly "unintended consequences,"--except this time, the "foil" is Big Business, instead of Republicans.

After seeing Dean's delight over beginning to "decouple insurance coverage from employment"--yes, you read that correctly--I came away believing that "Establishment Dems" are happy with this development, since it allows many employers to throw their employees into the Exchange in 2014, instead of offering them coverage.

And, since none of those corporations will be fined for it--they aren't likely to punish Dem "pols" in 2014 when it comes to financing their campaigns.

I'd post a video of Dean, but this computer doesn't have Flash Player on it (and I'm reluctant to download it).

I remember hearing an audio of Dennis Kucinich, saying that the Administration "got exactly what they wanted in the ACA."

Frankly, I have a feeling that this is simply another example of the Democratic Party base being "punked."

The piece goes on to say,

Several lawmakers, including some Democrats, had pressed the White House to consider a delay in the employer mandate. Among them was Senator Mark Begich, a Democrat in the Republican-leaning state of Alaska, who met with the White House last week to express his concerns about the law's implementation.

Begich has also written to top administration officials complaining that small businesses were overwhelmed and confused by complex information strewn across nearly 50 government websites.

And we all know that Begich is in one of the Dems tightest Senate races.

No, I think that just as we were led to believe for the longest time that the public option was still on-the-table, we'll "think" that their is an employer mandate, until we're already "up to our eyeballs" in the Health Exchanges--then they'll tell us, "Oh, btw, we've decided that it's best to drop the employer mandate."

Sigh . . .

[I'll try to post the Dean video when I get my own computer back. Again, when you want to hear the truth--listen to the business (finance) channels, LOL.]

Alexa

“If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

[Avatar Photo Credit: Conflagrate, jurvetson's photostream, flickr]

katiebird's picture
Submitted by katiebird on

Is he happy about the delay? And why?

Alexa's picture
Submitted by Alexa on

unintentionally ended up in the blockquotes.

Alexa

“If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

[Avatar Photo Credit: Conflagrate, jurvetson's photostream, flickr]

Alexa's picture
Submitted by Alexa on

intended to be posted to the earlier post about the "dropping of the employer mandate."

Got in a hurry. Sorry, Lambert!

Alexa

“If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

[Avatar Photo Credit: Conflagrate, jurvetson's photostream, flickr]

Alexa's picture
Submitted by Alexa on

Adobe Flash Player on this computer.

Here's a brief summary:

As I mentioned, Dean looks at this "delay" as a plus because without a "fine," many employers will NOT cover their employees under a group health plan.

As a result, many more Americans will be thrown into the Health Exchanges.

If you think about it, it would make sense from their standpoint. I suspect that this is what was intended all along.

They "sold the ACA" on the premise that "if you have insurance, you won't be affected."

But Howard Dean's obvious "delight" with the delay of the employer mandate (didn't sound like he supported one on employers, in the first place) makes me very suspicious of the entire premise of the bill.

I think that there could be several reasons for this line of thinking.

Just speculation on this part, but here one reason, IMO.

We've all read about their concerns about not getting enough young and healthy beneficiaries to participate in the Exchanges.

I'm wondering if this is not just a "back door" way toward accomplishing this.

Now, with many more Americans probably either being thrown off their employers health plans (remember--no fines for next year), I imagine that they believe that they can set up a "healthier pool" of beneficiaries.

I've read numerous articles that allude to the concern that the oldest, and poorest, and sickest Americans--many of them having been uninsured for long periods of time--will be very costly to cover--no matter what program they're in.

By delaying the employer mandate, and therefore pushing a lot of employees (who've been covered by their group health insurance plans) into the Health Exchanges, the PtB may be thinking that they can keep down the premiums costs.

As opposed to the Health Exchanges being filled with mostly individuals who've received little or no decent health care.

I've seen more than one article address this concern.

This was the reason for all of HHS running around with their "hair on fire" wanting to get as many "young invincibles" as possible enrolled in the Health Exchanges.

Again, Dean appeared very pleased, because he believes that this quicker "decouples healthcare, with employment--since more individuals will be thrown into the health exchanges now."

Hope that makes sense.

Alexa

“If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

[Avatar Photo Credit: Conflagrate, jurvetson's photostream, flickr]

Alexa's picture
Submitted by Alexa on

Dean Favors Migration From Employer-Provided Health Care

Former Democratic Vermont Gov. Howard Dean on Wednesday praised the White House's decision to delay by one year the enforcement of a rule that requires larger employees to provide health insurance for their workers. It is a key provision of President Barack Obama's health-care reform law.

"I think this is a good thing," he said on CNBC's "Squawk Box," because he prefers fewer mandates and the delay will help the Obama administration "get their house into order" to implement a very large and complex system.

In addition, Dean said, "What I think will happen, the unintended consequences for everybody ... is more people will migrate out of employer-based health insurance, into the exchanges." That refers to the planned government-run online marketplaces designed to help people buy health insurance from private health care providers.

He said migrating to insurance exchanges is good in the long run because "I've always believed that you've got to divorce employment from health insurance in this country for a large number of reasons."

I'm convinced that this is "BS"--the unintended consequence line. Funny how there are "so many" unintended consequences--and they always only affect the "average guy" negatively. Apparently he has no concern that this could increase costs to the "employees" many fold. It appears from what I'm reading that the Dem Establishment has completely sold out. Any talk of a "public option" or MFA is clearly just a pipe dream, IMO.

He goes on to say,

Dean argued that because health care has gotten "so expensive over so long—three times the rate of inflation for nearly 30 consecutive years—employers are either cutting back or reducing benefits or not giving health insurance at all,"

A long-term move away from employer-funded health care would help reduce costs and "get the monkey off the back of the business community."

Alexa

“If a dog won’t come to you after having looked you in the face, you should go home and examine your conscience.” -- Woodrow Wilson

[Avatar Photo Credit: Conflagrate, jurvetson's photostream, flickr]