ObamaCare: a riddle wrapped in mystery, inside a mousetrap

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  • 09/21/2022

How many people have paid, valid ObamaCare policies?  We still don’t know.  An official for the Centers for Medicaid and Medicare Services restated that claim to Congress just a few days ago.  In fact, he said the Administration isn’t even trying to collect a total of valid payments, but they plan to start pulling it together one of these days.


That’s a remarkably lax attitude toward one of the only two metrics for ObamaCare success that matters at all, and the other one – the percentage of healthy customers paying excessively high premiums to support the system – depends entirely upon it.  Why, you’d almost think the Administration was working very hard not to know how many valid purchases there have been, so they can keep kicking around inflated hypothetical numbers that make ObamaCare look like less of a disaster.

This is also the sort of accounting practice the government frowns upon, when private industries do it.  Millions of dollars changing hands, and no one is keeping tabs on the purchases?  You don’t need a $637 million computer system for that.  Our grandparents did a better job of it than the Obama technocracy using paper and pen.

So if that “death spiral” kicks in, and the Young Invincibles aren’t signing up fast enough to offset the cost of covering older, less healthy consumers – leading to premium hikes that in turn depress enthusiasm for ObamaCare even further, which gives the “spiral” effect – how much will it cost to bail out the insurance companies?  Nobody knows, and as the Washington Examiner points out, the Congressional Budget Office never really gave it much thought when they were pumping out the ridiculously inaccurate cost estimates for ObamaCare:

Republicans led by Sen. Marco Rubio of Florida and Rep. Tim Griffin of Arkansas have called for repealing what’s known as the risk corridors program, which has also been described as a bailout of the insurance industry. Under the program, insurers have to estimate the amount of money they expect to pay out in medical claims each year along with their premium revenue and administrative costs. Insurers who do significantly better than expected must pay HHS and those who do worse than expected receive money from HHS. But it’s remained an open question how much this could potentially cost.

The Congressional Budget Office essentially didn’t account for the cost of the program when it evaluated the health care law, as the number-crunchers assumed that the payments between insurers and the federal government would cancel each other out.

Following the botched rollout of the health care law, which has threatened insurers with a risk pool that skews toward older enrollees, it’s increasingly less likely that the provision will remain budget-neutral.

But Republicans are doubtful that the CBO would attempt to re-score the risk corridor program anytime soon.

“My understanding is that the first bit of data that they’d need to do that is not available,” Griffin said in a phone interview.

When can we get a number on that bailout estimate?  Well, the Department of Health and Human Services issued regulations that require insurance companies to submit the information no later than July 31… 2015.  You know, the year after the midterm elections.  Funny how that worked out.

The aura of impenetrable mystery surrounding ObamaCare unfortunately extends to insurance companies not being aware of their alleged customers.  Tales of people who discovered their ObamaCare data got lost somewhere in the interstellar void between the online exchanges and the doctor’s office are legion.  The problems are affecting both federal and state exchanges, as sad tale related by Fox News illustrates:

Vicki Rapoport is the face of the breakdown in state exchanges — in her case, Maryland.

“To me it’s very personal,” she says, “and it’s very frustrating because the system has failed me.”

Rapoport, who is self- employed, starting trying to sign up in early October. She eventually went to an official navigator for Howard county, called Healthy Howard, which signed her up, gave her a confirmation number and a printout of the plan she chose.

But then she hit a brick wall.

“I was told by the insurance company I selected that they have no record of me. I did go to the state navigation system and they have no record of me,” she said.

Rapoport reached out to everyone she could think of – “the governor, her representatives in Washington, and the White House, as well as the state exchanges” – but after days of effort, she got nothing except a letter from Senator Barbara Mikulski (D-MD) that said – I kid you not – “I am just as frustrated as you are about the launch of health reform.”

It’s touching to know all these Democrats are just as frustrated as we are by the failure of the system they rammed down our throats, but that’s not much help to people like Ms. Rapoport, who eventually got a call from the governor’s office saying she’d receive a manual application in a week or so, and be expected to cough up two premiums for her policy right away… even though she doesn’t know how much the premiums will be.  Isn’t this cutting-edge Information Age technocratic system wonderful?

Over in Connecticut, a woman had to put off urgently-needed surgery for lung cancer for over six weeks due to “the bureaucratic nightmare she has endured in the long days since she signed up and paid her premium,” as the Huffington Post put it.  “You know, with cancer, every day counts,” said K.C. Handler of New Canaan.  “So I am beyond frustrated.  I was very anxious that I was waiting this long, and then to have it postponed is devastating to me.”

Rest assured you’re probably not as frustrated, anxious, or devastated as Senator Mikulski and her caucus, ma’am!  Luckily, the CEO of Accesshealth CT stepped in and got things hammered out with Anthem Blue Cross/Blue Shield, so Ms. Handler’s operation will go forward next week.  “I almost feel squirrely saying that because this is not about self-aggrandizement, but clearly, I think we put a little juice under Anthem’s nose,” said CEO Kevin Counihan modestly.

So ObamaCare more or less works, eventually, if you can wait a few weeks for your operation, and you’ve got a high-powered executive ready to pump some juice under the right toes.  Smashing!

The Associated Press took a look at the other data problems insurance companies are wrestling with:

More than 1 million people have signed up through the federal insurance market that serves 36 states. Officials contend the error rate for new signups is close to zero.

Insurers, however, are less enthusiastic about the pace of the fixes. The companies also are seeing cases in which the government has assigned the same identification number to more than one person, as well as so-called “ghost” files in which the insurer has an enrollment record but the government does not.

But orphaned files — when the insurer has no record of enrollment — are particularly concerning because the companies have no automated way to identify the presumed policyholder. They say they have to manually compare the lists of enrollees the government sends them with their own records because the government never built an automated system that would do the work much faster.

“It’s an ongoing concern,” said Robert Zirkelbach, a spokesman for the industry trade group America’s Health Insurance Plans. “Health plans can’t process enrollments they haven’t received from the exchange.”

And there are fears the situation will get worse, as “insurers worry that the back-end problems will grow more acute as the process the wave of customers who signed up at the end of 2013.”  But the industry has an awful lot riding on the survival of ObamaCare, so they’ll probably bite the bullet and do whatever it takes to handle the situation with a minimum of politically damaging complaints.  The rest of us will get the bill later.

If you think having ObamaCare is a hassle, just try getting rid of it.  Lesli Hill of Missouri bought an expensive ObamaCare package, then later learned she could get a better deal outside of the exchanges.  That’s when she discovered the geniuses who designed ObamaCare don’t seem to have allowed for the possibility that anyone might want to cancel a policy.  There’s a “Terminate” button at the website, but – surprise, surprise – it doesn’t actually do anything.  Hill was forced to embark on a process that she says “consumed my whole life” and felt like “slipping into a parallel universe,” as chronicled by Fox News:

Hill first tried the HealthCare.gov help line, and “literally was on hold for several hours a day,” she said. After multiple attempts, without much luck, she tried the online chat. She was redirected back to the help line. The “script” that operators were reading from did not seem to address how someone could actually cancel a plan.

Hill continued to call the help line around the holidays, and eventually was given the impression that, at last, the plan was terminated.

But then, a $950 premium was withdrawn from her account — which she knew meant she was still enrolled.

Hill went on a blitz, breaking through to another layer at the HealthCare.gov help line. But the answer she was given was that cancellations are handled by a “special department,” the number of which could not be given out.

“He said, ‘I’m not allowed to tell you that,'” Hill told FoxNews.com. “You’ve got to be kidding me.”

She kept pressing, to no avail. Then she got angry.

Like Vicki Rapoport in Maryland, Hill fired emails off to everyone from the governor of Missouri to the state insurance department, to no avail.  She wound up driving to Kansas City and appealing to Blue Cross / Blue Shield for help.  They “worked through the federal help line with her until finally reaching someone who, despite not being pleasant about it, said the plan would be discontinued.”

Sure, you can escape from your ObamaCare policy, provided you’re willing to invest dozens of hours, maybe drive to the local insurance company office and spend the day working on it!  But all the hassle and expense are worthwhile, because the uninsured are finally getting coverage, right?

Well… no.  As a matter of fact, according to the Wall Street Journal“early signals suggest the majority of the 2.2 million people who sought to enroll in private insurance through new marketplaces through December 28 were previously covered elsewhere.”  To a degree even critics of the Affordable Care Act find surprising, ObamaCare’s meager sign-ups are coming mostly from people who already had insurance, which of course they were promised repeatedly they would be able to keep, but we all know how that worked out.

Apologists for Obama’s Big Lie claim that many of the insurance cancellations were “churn,” the normal process of insurance companies terminating old policies.  By that reckoning, most of the ObamaCare sign-ups are “churn,” too.  An awful lot of that churning involves knocking people who used to pay for insurance into the Medicaid abyss.

We spent a titanic amount of money and shredded the Constitution to impose ObamaCare, and perhaps the greatest among its many mysteries is whether it’s making a lick of difference to the people it was most urgently supposed to help.




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