Monday, December 30, 2013

Ideological Stylishness Has a Cost

“Maryland’s energy affordability gap has grown 198.8 percent between 2002 and 2011

from the National Review
Maryland would have felt lucky to get a lump of coal in its stocking this week.

Governor Martin O’Malley’s aggressive green agenda has favored expensive renewable-energy sources, driving up the cost of electricity. The 784,000 Marylanders who are living in poverty, and many more on the brink of it, have been particularly hard hit, even though sometimes the cost is offset by subsidies.

Since O’Malley assumed office in January 2007, residents’ electricity rates have increased by 43 percent, according to estimates from Change Maryland, a group chaired by Larry Hogan, a Republican who intends to run for governor. In comparison, electricity costs have risen 24 percent nationwide. Likewise, the Maryland Department of Legislative Services noted that while other states in the region saw average residential electrical rates grow by 34 to 41 percent between 1999 and 2013, in Maryland they increased by 49 percent. The average Marylander pays more than $125 a month for electricity.

Electricity has grown more expensive while incomes have remained stagnant, says Robert Strupp, the executive director of Baltimore Neighborhoods Inc., a nonprofit that helps tenants and landlords work toward fair housing. He says that residents regularly call in facing power shutoffs — and not just in the city of Baltimore. Earlier this week, a resident from affluent Howard County called in distress, he says. Though she’d already received a state voucher to help offset electricity costs, she was still struggling to keep the power on.

While myriad factors affect the price of energy, the governor’s radical environmental policies have undoubtedly contributed to its escalating expense. By 2020, O’Malley wants 18 percent of the state’s energy to be supplied from green sources, even though natural gas is at least 37 percent cheaper an energy source than onshore wind, and solar energy is at least 98 percent more expensive than conventional coal. Working toward this goal, the governor has backed several green policies, despite their impact on electricity prices.

An offshore-wind project that the Maryland legislature supported earlier this year would be among the most expensive to date. Taxpayers would fund the project, coughing up $1.73 billion in direct subsidies over the next two decades. Then they’d be forced to buy whatever wind energy the project manages to produce, at a premium; offshore wind is by far the most expensive energy source, costing at least two and a half times as much as coal or natural gas. The legislation’s fiscal and policy note estimated that offshore wind would add $1.04 billion to utility bills over the next 20 years.

Such skewed economics make sense to bureaucrats but not investors, so despite supporting legislation, the offshore wind project is unlikely to be built. While that program’s expense is currently theoretical, other green policies have been successfully implemented, driving up real energy costs.

Maryland’s Renewable Energy Portfolio Standard has created an artificial market for pricier alternative energy sources. Utility companies, forced to buy expensive energy, pass the cost along to their consumers. One analysis by the Institute for Energy Research found that in states with renewable portfolio standards, the price of electricity is almost 40 percent higher.

Maryland also participates in the Regional Greenhouse Gas Initiative, an interstate cap-and-trade program. Even the program’s advocates were forced to admit that utility companies in participating states shifted a $900 million initial cost to their consumers. Though supporters of the program claim long-term consumer savings, the argument rests in part on sticker shock that would compel households to use less energy.

That feeds nicely into other state programs, such as EmPOWER Maryland, which seeks to cut per capita electrical consumption by 15 percent by 2015. It allows utility companies to add an “implementation surcharge” to electricity bills. The law also accommodates utility companies at the expense of the consumer, ensuring that they don’t lose profits when energy use decreases. A “decoupling” policy divorces profits from sales. Practically, this creates a baseline guaranteed profit for utilities, and it often forces consumers to pay for electricity even if they didn’t use it.

The increased cost of energy isn’t just a side effect of Maryland’s environmental agenda; for radical green policymakers, it’s the point, explains Myron Ebell, the director of energy and global-warming policy at the Competitive Enterprise Institute. Already, consumption has decreased by 9.4 percent under O’Malley’s tenure, according to the Maryland Energy Administration.

“The purpose of [such green policies] is to make people poorer so they can’t use as much energy,” Ebell says. “They are making life very difficult for the lower-middle-class and working-class people and creating a greater divide between rich and poor, and despite the rhetoric that we need to reduce inequality, it’s really designed to do the opposite.”

Maryland’s poorest families could breathe easier if they were allowed to use cheaper energy sources.

The Maryland Budget & Tax Policy Institute has highlighted a “home energy affordability gap,” noting that energy is considered affordable when it costs less than 7 percent of household income. But in Maryland, people at 50 percent of the federal poverty level or below devote about 40 percent of their income to energy consumption, says Richard Doran, program director of the Fuel Fund of Maryland.

Only eight states had a bigger affordability gap, according to the Maryland Budget & Tax Policy Institute. Furthermore, it noted, “Maryland’s affordability gap has grown 198.8 percent between 2002 and 2011 (the most recent data).”

Right now, Doran says, at least 500,000 state residents are struggling to pay their utility bills. And Children’s HealthWatch, which provides nonpartisan policy analysis, reported in 2011 that 15 percent of Baltimore residents had been threatened with a shutoff and that an additional 18 percent were heating their homes with a cooking stove, had experienced a shutoff, or lived in an unheated home.

Of course, no one mentions that O’Malley’s ambitious green policy has an outsize and detrimental impact on the state’s most economically vulnerable residents. But as a long, cold winter settles in, O’Malley would do well to consider the human cost of his environmental agenda.

Sunday, December 29, 2013

Affordable Health Care Turns Out to be Unaffordable... Surpised?

from Modern Healthcare
Massachusetts, whose health care reform program was used as a template for the Patient Protection and Affordable Care Act, had the highest per capita health spending in the U.S. in 2009. According to the commission's report, the state spent $9,278 per person on health care in 2009, which was 36 percent higher than the national average of $6,815, and 11.2 percent more than the next-highest state, New York, which spent $8,341.

Tuesday, December 24, 2013

Annapolis, We STILL Have a Problem...

from the Washington Post
IF PEOPLE’S health weren’t on the line, it would be darkly funny: For weeks, uninsured Marylanders trying to get coverage through the state’s health exchange have slogged through online forms and technical glitches, only for the system to freeze just before they hit the “enroll” button. The Web site is supposed to facilitate the enrollment of 150,000 Marylanders in private health insurance. As of the middle of the month, it had signed up only 7,435 — and that is after notching its highest-volume days since its Oct. 1 launch.

Gov. Martin O’Malley (D) and Lt. Gov. Anthony Brown (D), whom Mr. O’Malley tapped to be the point man on the state’s health-care rollout, say that the site has dramatically improved over the past several days, despite a server failure last week. But the site still needs work — and Mr. Brown still needs to explain how he let this happen.

Things have been so bad that figures such as Rep. John K. Delaney (D-Md.) argue that Maryland should consider moving its enrollment systems to HealthCare.gov, the federal Web site that also failed after its Oct. 1 launch. HealthCare.gov is working better now, the argument goes, so Marylanders should have at least the access that most other Americans do.

All options should be on the table, but switching to the federal site probably isn’t advisable. Mr. O’Malley’s claim that the Maryland site is better, though not perfect, seems to be bearing out. Enrollments are increasing. Changing systems in midstream would bring with it large technical challenges; for one thing, insurance companies would have to adjust their systems to interface with that of the feds while they’re trying to process enrollments on deadline.

What is necessary is more progress. The site still seems to have formidable problems. People who created accounts before the latest overhaul have struggled to log back in. The governor says the state will contact people who might have gotten stuck on the site. Good. The repairmen must also ensure that enrollment information the site sends along to insurers — in those so-called 834 files — is coming over accurately. Otherwise, people who think they’re enrolled might not have the insurance they thought they did, or not at the price they expected.

Also needed is a thorough accounting of how the state’s site ended up failing. A recent staff shakeup suggests that process has begun, but it needs to be transparent. Mr. O’Malley approved opening the broken site on Oct. 1. Mr. Brown was supposed to be leading the rollout of health-care reform all along. By their own admission, neither knew that the state’s systems had massive problems. They should investigate, and then report, what went wrong and why.

Monday, December 23, 2013

Last Day to Sign Up...

...or PAY the Penalty of NOT having Insurance Come January 1, 2014!

from Reuters
Reuters) - For most Americans who don't have health insurance, Monday is the deadline to sign up for coverage starting on January 1 under President Barack Obama's healthcare law.

For others, it's not a deadline.

There is a "hardship" exception for some that permits them not to sign up any kind of health insurance at all without facing a penalty - the hardship being problems they've encountered with Obamacare and its malfunctioning website HealthCare.gov.

There will also be a "good faith exception" for others, according to a senior Obama administration official.

"We'll have a special enrollment period," the official said last week, for "all those who make a good faith effort to get enrolled by the deadline" but fail to do so.

The official did not say how the government would determine whether or not the effort was made in good faith.

Still others may simply get a break from insurance companies, which the administration has urged to be flexible with people who miss the deadline.

Such is the uncertain state of "Obamacare" as it approaches what was originally supposed to be a defining moment - a signup deadline that would provide the first real test of the viability of the healthcare program brought into law by the Affordable Care Act.

Adding to the confusion is the fact that the original deadline for obtaining medical coverage was December 15. That was extended to December 23 after the federal government's website, HealthCare.gov, proved dysfunctional and sometimes non-functional.

The administration has reserved the right to change the deadline again "should exceptional circumstances pose barriers to consumers" enrolling on or before Monday.

Obama said on Friday that one million people had enrolled for new insurance plans under the law through HealthCare.gov, which serves 36 states, and 14 state-run marketplaces.

Many more enrollments are a major priority for Obama's signature healthcare reform, which officials are still hoping will help millions of uninsured and under-insured Americans finally to obtain medical coverage by the end of March.

GAPS IN COVERAGE?

It is not known how many consumers may have no insurance coverage during periods of 2014 because they failed to sign up on HealthCare.gov by Monday.

Some of the 14 states running their own healthcare exchanges have extended their sign-up deadlines past December 23.

On Thursday, the administration announced that if people's old insurance plans were canceled because of new standards under the law, they can claim a "hardship" exemption to the requirement that all Americans must have coverage by March 31 or face penalties that start at $95.

So some of these people may not sign up.

The Obama administration says it is trying to be flexible, but some Republican critics of the law say the frequent delays and changes have muddied the waters and confused people.

"With no clarity as to when people should sign up and who they should pay and when, it's a virtual certainty that many consumers will find themselves uncovered for a period of time through no fault of their own," Senator Orrin Hatch, a Utah Republican, said last week.

Administration officials said on Friday there are fewer than 500,000 people who have received cancellation notices from their insurance companies and have not yet found alternatives. Some were "auto-enrolled" in other plans by their insurance companies, the officials said.

The pace of sign-ups has picked up since October and November when technical problems crippled the HealthCare.gov website. Anyone who tried the website in October and November and became stuck has been getting attention from the administration.

Officials sent more than two million emails to people who could not advance through the website. They have also made more than 600,000 phone calls to consumers and mailed notices to hundreds of thousands of people, officials said.

"We are confident that we are doing everything we can so that individuals know what their options are to get coverage, whether it is at the marketplace or seeking it through the private insurers," said the senior official.

Update from CBS Baltimore
ANNAPOLIS, Md. (AP) — Insurance carriers participating in Maryland’s health care exchange have extended the deadline for individuals and families to enroll in order to be covered Jan. 1, Gov. Martin O’Malley announced Tuesday.

State residents who enroll in a qualified health plan through Maryland Health Connection by Dec. 27 can have coverage that begins Jan. 1. The previous deadline was Dec. 23. Consumers would have until Jan. 15 to pay for their coverage.

On Monday, Carefirst announced it would extend the deadline to Dec. 27, and other insurance carriers also have agreed to the later deadline, including Kaiser Permanente, United Healthcare and Evergreen Health Co-op.

The deadline extension comes as Maryland’s exchange has had computer problems since its debut on Oct. 1. O’Malley told reporters Monday that nine major problems have been addressed, but that some computer glitches continue.

O’Malley and Lt. Gov. Anthony Brown recently changed the leadership structure for the information technology portion of the Maryland Health Benefit Exchange. Isabel FitzGerald, the secretary of the Maryland Department of Information Technology, is leading the effort.

“We know the improvements to MarylandHealthConnection.gov are making a difference because we are seeing more and more people successfully completing the process every day,” O’Malley said in a statement. “We will continue making improvements to the site, and we are pleased that all carriers have agreed to extend the deadline for coverage so that we can continue to work toward our goal of helping more Marylanders access quality, affordable coverage.”

On Monday, the O’Malley administration announced that Columbia-based Optum/QSSI has been brought in to improve the overall performance of the website.

Thursday, December 19, 2013

More Evidence that the U.S. Senate Has Been Replaced by the HAL3000

“This budget bill exemplifies what is wrong with Washington,” Cruz said in a statement. “Nothing is getting fixed. No important reforms are being addressed. The people get little in return except more debt, more taxes, and no change to the Obamacare disaster."

"The Senate majority voted to allow Sen. Reid to ignore all Republican amendments," he continued. "Over and over, this is the roughshod style of leadership that characterizes this Senate and underscores why Washington badly needs to listen to the people.”

Cruz’s point about how Senate Majority Leader Sen. Harry Reid (D-NV) did not allow any amendments, including one that would have protected veterans’ pensions, was in reference to how Reid used a procedural trick referred to in D.C. parlance as “filling the amendment tree.”

Reid introduced a series of amendments that would not substantively change the legislation so as to prevent any substantive debate on or amendments to the bill before passage. Technically, under certain Senate rules, only a specific amount of amendments are allowed to be introduced, debated, and voted on. Reid filled out the list and killed any opportunity for real amendments to be considered.

Tuesday, December 17, 2013

The Eclipse of Liberty

At the start of a meeting with tech industry CEOs on NSA surveillance, Obama quipped “I’m just wondering if [Netflix CEO Reed Hastings] brought advance copies of House of Cards,” according to a pool video camera in the room.

As the CEOs laughed and joked that Obama should make a cameo appearance in the series, the president continued to praise the series, which revolves around a power-hungry House Majority Whip played by actor Kevin Spacey.

“I wish things were that ruthlessly efficient,” Obama said in his first public remarks on the show. “It’s true. It’s like Kevin Spacey, man this guy’s getting a lot of stuff done.”

Monday, December 16, 2013

The Hidden Obamacare Death Tax

from the Seattle Times
It wasn’t the moonlight, holiday-season euphoria or family pressure that made Sofia Prins and Gary Balhorn, both 62, suddenly decide to get married.

It was the fine print
.

As fine print is wont to do, it had buried itself in a long form — Balhorn’s application for free health insurance through the expanded state Medicaid program. As the paperwork lay on the dining-room table in Port Townsend, Prins began reading.

She was shocked: If you’re 55 or over, Medicaid can come back after you’re dead and bill your estate for ordinary health-care expenses.

The way Prins saw it, that meant health insurance via Medicaid is hardly “free” for Washington residents 55 or older. It’s a loan, one whose payback requirements aren’t well advertised. And it penalizes people who, despite having a low income, have managed to keep a home or some savings they hope to pass to heirs, Prins said.

With an estimated 223,000 adults seeking health insurance headed toward Washington’s expanded Medicaid program over the next three years, the state’s estate-recovery rules, which allow collection of nearly all medical expenses, have come under fire.

Medicaid, in keeping with federal policy, has long tapped into estates. But because most low-income adults without disabilities could not qualify for typical medical coverage through Medicaid, recovery primarily involved expenses for nursing homes and other long-term care.

The federal Affordable Care Act (ACA) changed that. Now many more low-income residents will qualify for Medicaid,
called Apple Health in Washington state.

But if they qualify for Medicaid, they’re not eligible for tax credits to subsidize a private health plan under the ACA, which requires all adults to have health insurance by March 31.

Prins, an artist, and Balhorn, a retired fisherman-turned-tango instructor, separately qualified for health insurance through Medicaid based on their sole incomes.

But if they were married, they calculated, they could “just squeak by” with enough income to qualify for a subsidized health plan — and avoid any encumbrance on the home they hope to leave to Prins’ two sons.

“We’re happy to be getting married,” Prins said last week. “Unfortunately not everyone has such an elegant solution to the problem.”

For Washington state, the solution has been much more complicated.

Over the past month, as lawmakers began hearing from worried and angry constituents, state officials began exploring what it would take to fix this collision of state rules with the ACA.

Late Friday, Gov. Jay Inslee’s office and the state Medicaid office said they plan to draft an emergency rule to limit estate recovery to long-term care and related medical expenses.

They hope to be able to change the rules before coverage begins Jan. 1.

Fixing the problem will cost the state about $3 million a year, said Dr. Bob Crittenden, Inslee’s senior health-policy adviser, but it’s the right thing to do.

“There was no intent on the part of the ACA to do estate recovery on people going into Medicaid (for health insurance),” Crittenden said. “The idea was to expand coverage.”

Unpleasant surprise

People in their 50s and 60s make up about 30 percent of the adults who have signed up for health insurance through Washington’s exchange marketplace, and about 18 percent of adults who have enrolled in health insurance through Apple Health.

Some 55- to 64-year-olds, who may have taken early retirement or who were laid off during the recession, have found themselves plunged into a low-income bracket. Unlike Medicaid recipients in the past — who were required to reduce their assets to qualify — they’re more likely to have a home or other assets.

For health coverage through Medicaid, income is now the only financial requirement.

At first, Prins was pleased at the prospect of free coverage.

But the more she thought about the fine print, the more upset she got. Why was this provision only for people age 55 and older? Why should those insured by Medicaid have to pay back health expenses from their estates when people with just a bit more income who get federal subsidies don’t? Why didn’t she and Balhorn know about this before getting to the application stage?

As Prins began searching for answers, she found that even those trained to help people sign up for insurance under the ACA weren’t aware of this provision, nor were some government officials.

Around the country, the issue has sizzled away in blogs and commentaries from both right and left. The National Women’s Law Center noted the ACA and its regulations prohibit age discrimination in programs such as Medicare and Medicaid.

Dr. Jane Orient, executive director of the politically conservative Association of American Physicians and Surgeons, writing in the The Washington Times, called the recovery provision “a cash cow for states to milk the poor and the middle class.”

“People will think this is wonderful, this is free insurance,” Orient said in an interview. “They don’t realize it’s really a loan, and is secured by any property they have.”

Even states that are now limiting estate recovery, she warned, can change the rules again if budget problems become more intense.

Unclear rules

One reason this snafu has become so troublesome is that ACA rules appear to give those who qualify for Medicaid little choice but to accept the coverage.

People cannot receive a tax credit to subsidize their purchase of a private health plan if their income qualifies them for Medicaid, said Bethany Frey, spokeswoman for the Washington Health Benefit Exchange.

But they could buy a health plan without a tax credit, she added.

For someone age 55 to 64 at the Medicaid-income level — below $15,856 a year — it’s quite a jump from free Medicaid health insurance to an unsubsidized individual plan. Premiums in King County for an age 60 non-tobacco user for the most modest plan run from $451 to $859 per month.

Ball in states’ court

It’s not the first time federal and state rules have clashed, and local officials now find themselves on the hook to ensure that the new law doesn’t create hardship.

In Oregon, state officials changed estate-recovery rules last month.

Recovery will no longer apply to health benefits for those 55 and over, the Oregon Health Authority said, although the state will collect expenses for long-term care.

On Friday, Washington Medicaid Director MaryAnne Lindeblad promised to draft an emergency rule very soon. The state also must revise the plan filed with federal authorities, but Lindeblad said she doesn’t expect problems or appeals of the rule.

As for Prins and Balhorn, they’re good with their choice.

Instead of paying $577 a month apiece for an unsubsidized private plan or worrying about losing their assets after death, as a married couple they’ll pay $76 a month for a midlevel “silver” plan with a tax credit. “Since we’ve been in an established relationship and love each other, the decision to get married was pretty easy,” Prins said.

Sunday, they made a big fruit salad, dressed in tango clothing and were married in their home. Afterward, they danced to their favorite tango music and toasted each other with orange juice and a dash of cranberry.

“I’d be very happy if the governor actually makes this change possible,” Prins said late last week. “And I’m very happy to be getting married!”

Sunday, December 8, 2013

Two Month's (+)... 3,758 Enrolled in Maryland - Where's Governor O'Malley???

from the Baltimore Sun
Although state officials have provided the public scant detail about the troubled launch of Maryland's version of Obamacare, emails and documents show that the project was beset behind the scenes for months by an array of technical issues, warring contractors and other problems.

Since Maryland's online health exchange opened Oct. 1 for people to buy insurance under the Affordable Care Act — and immediately crashed — the two main companies in charge of the website have taken their fight to court, a corporate project manager was replaced and a high-powered consulting firm was quietly brought in to restore order. Though state officials initially said the crash of the online exchange was an unexpected and fixable problem, emails and documents obtained by The Baltimore Sun through state open-records laws outline serious issues before and after the launch.

The revelations came just days before Rebecca Pearce, the head of the exchange, resigned. State officials announced that move Friday night and pulled Carolyn Quattrocki from the governor's health reform office to serve as an interim replacement.

Just two weeks before the launch, Pearce visited the prime contractor's Linthicum headquarters and found a room of empty seats. She fired off an email questioning the company's commitment to resolve problems and reminding the contractors of what was at stake: "Tonight, I am begging. I don't know how else to say it: we have got to make this a reality."

Despite her proddings, in-fighting between contractor Noridian Healthcare Solutions and a key subcontractor, EngagePoint Inc., disintegrated amid finger-pointing and accusations in court papers. At one point, after Noridian severed contractual ties between the companies but continued to ask for help, EngagePoint CEO Pradeep Goel emailed Noridian officials: "Are you people on crack cocaine?"

Today, the exchange website, called the Maryland Health Connection, is still not operating properly for all users, and officials are scrambling to meet deadlines for the public to obtain coverage. The problems have triggered criticism from some political pundits and have proven embarrassing for Gov. Martin O'Malley and other state officials who touted the website before its launch.

Asked about the conflict between the project's contractors, Health Secretary Dr. Joshua Sharfstein said in an interview, "It's sort of like hiring a husband-and-wife team to do your roof and then they get divorced. The dispute did adversely affect the project. It was a distraction as we were launching the website and then working to address problems."

Lt. Gov. Anthony G. Brown, chosen by O'Malley to lead the state's reform efforts, claimed ultimate responsibility for the website problems last week after facing increased media and political pressure. But he said in a later interview that he had focused mainly on legislative and policy issues and depended on operational updates from Pearce's office. The reports noted everything was running smoothly and on track until September, when only minor problems were reported, he said.

"I certainly had the responsibility to ensure that if there were problems that required additional resources — changes in legislation or policies — that my responsibility was to make sure the exchange got what it needed," Brown said in an interview Friday. "And I relied on the reports that I received on the exchange. …But at no point was a red flag ever brought to my attention as if we have a problem here, we are not going to meet the launch date, or if we do meet the launch date we are going to significantly underperform."

Brown said the exchange was created as an independent agency with autonomy. Its board is chaired by Sharfstein and includes heads of the state's health care commission and insurance administration.

Sharfstein and other health department employees were copied on a number of emails that discussed problems with the exchange. Sharfstein and Brown are co-chairmen of the overarching Health Care Reform Coordinating Council, which is charged with implementing Obamacare in the state.

The shake-up at the health exchange began last week. O'Malley and Brown charged the state's chief technology officer with overseeing fixes and put Sharfstein in charge of operations, taking away Pearce's main responsibilities in managing the exchange. A few days later, she resigned.

Pearce, who was hired in 2011 at a salary of $175,000, declined to comment on problems surrounding the exchange or her resignation.

The emails provided by the state covered the two weeks before and after the website launch. They give only a limited behind-the-scenes view of creating and launching the exchange. Officials withheld an unknown number of emails, saying state law exempts them from disclosure because they involved the decision-making process of high-ranking executive officials.

The troubles in Maryland mirror problems faced by other state exchanges, as well as the federal portal providing insurance options to consumers in 36 states.

The exchanges' bumpy rollout has galvanized critics of the health law, including Republicans in Congress who say it was fresh evidence that the entire plan should be scrapped. In Maryland, the toughest criticism has come from website users who have struggled to buy insurance, as well as political opponents of Brown, a candidate for governor. They say he bears responsibility as the state's point man on health care reform.

O'Malley has also been a target of critics. He recently said that he wanted the website's major technical problems fixed by mid-December. That statement came a day after Sharfstein told state lawmakers it was unclear when the site would be entirely free of glitches — an answer that drew criticism from Republicans and some Democrats.

Technology experts and those involved in setting up the websites say they are among the most complex web endeavors ever undertaken. State officials say there wasn't sufficient time to test the sites after the federal government released regulations related to the Affordable Care Act, and there was no pre-launch access to federal computers used to check consumers' eligibility for subsidies.

In Maryland, Sharfstein said the complexity was compounded because of an aging state Medicaid computer system that needed to be integrated into the exchange. Officials also chose to customize existing technology that proved tougher to retrofit than expected, he said.

"Unlike buying a book online from Amazon, this process is more akin to applying for a passport, buying a home, and receiving an individually calculated tax credit all through a single web portal," O'Malley said Friday night. "We had more user glitches and user problems than we had hoped.

"A longer testing period might have allowed us to prioritize and address more of these problems before the launch date. Time and ultimate success will tell whether the decision to purchase off-the-shelf software and employ multiple contractor entities were good or bad decisions."
The companies

In early 2012, the state gave a $71 million contract to develop the website to a Noridian-led team that included Curam Software, IBM and Connecture. To save time in creating the exchange, the Maryland legislature exempted the contract from the normal procurement process, and North Dakota-based Noridian outscored three other bidders.

Sharfstein said Noridian will likely remain at work in its Linthicum offices beyond its contract's year-end expiration. The company has already been paid about $57 million but the state contract allows penalties for delays. State officials declined to comment on whether any penalties will be sought.

Noridian is ultimately responsible for delivering the system, Sharfstein said. EngagePoint, which is based in Calverton, was not included in the original contract and appeared to have been hired without the exchange's knowledge, officials said.

The state first learned of the companies' "deep strains" in the three months before the website launched, according to documents in U.S. District Court in Baltimore. The issues disputed included accounting, project management, intellectual property and payment.

Emails offer a glimpse at how their differences affected efforts to build the site and then fix post-launch problems. Pearce repeatedly questioned the contractors' commitment to the project after Gov. Martin O'Malley announced on national TV that Maryland's site would go live on time.

On Sept. 22, after Sen. Barbara Mikulski echoed the governor in publicly applauding Maryland's readiness, Pearce wrote the contractors: "It's time to get this right. Now. Period."

Noridian was also criticizing the subcontractor it hired. On Sept. 25, Noridian's project manager wrote to Goel, complaining that EngagePoint refused to perform critical work: "EngagePoint is responsible for 'designing and implementing [an exchange] system,'" the project manager wrote.

The 8 a.m. launch was supposed to allow the estimated 800,000 uninsured Marylanders to sign in and browse 45 plans from six insurers. Officials had warned of "bumps in the road," but the site crashed in minutes.

The state provided few emails from the first day. In one, contractors said they would work on the firewall; Sharfstein said later in an interview that it was eventually altered to allow more users onto the site.

Problems persisted the next day. Pearce repeatedly asked for updates, but the answers appeared unsatisfactory, emails show.

"As the executives in charge of this program, I would like to understand from you exactly what is happening with the project and what you are doing to address the issues," she wrote to the contractors at 7:56 a.m. on Oct. 2. By 4:10 p.m., she questioned why 85,000 people had hit the "get started" button, but there fewer than 500 accounts had been created.

About a half-hour later, she wrote to the contractors, "Can you please provide an update on what is going on right now? Who is on site? What has anyone learned?"

Some of the companies' emails focused on achievements rather than dwelling on worsening problems.

Noridian CEO Tom McGraw wrote to state officials on Oct. 4, "We have seen increases in all aspects of the system performance over the last several hours and anticipate that these will start showing in the next report."

But four days later McGraw notified state officials that the project manager was being replaced.

Meanwhile, Marylanders like Luke Goembel were stymied by a host of problems that included frozen screens, problems with verification and difficulty creating accounts.

When the website opened, the Baltimore scientist tried to buy insurance for his family, but got an error message. Three days later, Goembel got a message to call customer service.

Goembel tried the website again that day, but says that after entering information about his identity, the site froze. Later he got a "server error" message. And still he had no online account.
Customer service started a paper application for him on Oct. 18.

Over the next month, Goembel finally was able to create an account, but before he could buy a plan for his family of four with subsidies, he had to repeatedly call for help, enter the same information over and over online, tolerate error messages and recheck his eligibility for assistance three times.

Eventually, the family was enrolled in a plan significantly better and 40 percent cheaper than his previous coverage, with dental insurance.

Still, he's angry about the delays. "The Maryland system is severely flawed," he says. "The state was sold a bill of goods."
The dispute

Soon after the website's launch, emails among the contractors and exchange officials began to focus more on the dispute between Noridian and EngagePoint.

Chuck Milligan, who heads the state's Medicaid program, whose recipients will eventually use the exchange, complained that the contractors were too distracted by a new argument over who should be the state's prime contractor. The companies had proposed that EngagePoint take over as the prime contractor, but state officials said there was no time to consider such a shift.

"We do not have time to waste," he emailed the contractors. "We hope your email was not intended to convey that the team will not proceed with conviction while it awaits the resolution of the prime issue."

The top executive at Noridian also stepped in by mid-month, holding a meeting with contractors, state officials and consultants it hired from McKinsey & Company, a global management consulting firm. McKinsey was hired at the state's suggestion, but paid for by Noridian.

Paul von Ebers, CEO of Noridian Mutual Insurance Co., Noridian's parent company, wrote on Oct. 10 that the consultants "expressed concern with ongoing coordination issues between the Noridian and EngagePoint teams." He requested a meeting to resolve "working differences" between the companies.

This was days before Noridian fired EngagePoint, sparking the angry email exchanges and dueling lawsuits between the companies. Noridian then sought to hire EngagePoint workers; EngagePoint sued and was met with a counter-suit.

"We are expected to do piecemeal work for Noridian after contract termination because you just woke up and decided you don't know what you are doing?" Goel wrote Oct. 26. "We are not going to respond to ridiculous emails from Noridian demanding our team members show up for work after being escorted out of the office."

Noridian's McGraw declined to be interviewed but said in a statement that his company was responsible for designing and implementing the system. It is a work in progress, he added.

"The complexity of this project has led to a number of major issues beyond what was anticipated; one example is federal regulations that redefined the system's requirements during development," he said in the statement. "Noridian and subcontractors have been working to systematically identify the cause and resolve each issue."
He declined to comment on the litigation with EngagePoint.

Goel, the EngagePoint CEO, said in a telephone interview that he was never told his company's work was unsatisfactory. The conflict with Noridian at first involved the way the project was being managed, he said.

After EngagePoint's firing, the companies battled over $6 million that EngagePoint said it is owed for work, Goel said. He also said Noridian wants to hold EngagePoint responsible for certain financial obligations, such as potential state penalties for missing performance goals, even though it is no longer part of the contract.

Goel said problems with the exchange lie with the complexity of the job, connecting federal, state and insurer sites for the first time ever.

"It's not like Legos where everything is designed by the same company and fits beautifully," he said. "You're trying to get all the pieces to talk to each other."

He admits that emotions were running high immediately after the firing, but said he wants the exchange to succeed and has given Noridian information when asked.

EngagePoint also has contracts to work on exchanges in other states, including Minnesota. A spokeswoman for the Minnesota exchange said officials in that state have been happy with the company's work.

Improvements have been made to Maryland's website, officials said, including easing the firewall, increasing memory and rewriting code to reduce errors. Combined, they have made the site "far more functional" than it was on Oct. 1, Sharfstein said.

As of Friday, 3,758 people were enrolled in private insurance plans. More than 97,000 are expected to gain coverage under Medicaid. And officials maintain that their goal is to sign up 150,000 in private plans by the March 31 deadline for Americans to buy insurance or face a penalty.

Larry Burgee, an associate professor of information systems at Stevenson University, says Maryland could have avoided problems with better planning. For example, states should not have all tried to create their own sites but rather should have pooled resources, tested a few systems and all gone with the best, said Burgee, who teaches a class on the federal exchange website.

He added, "All this money was spent, and in Maryland we hear about two companies fighting. ... People at the top need to take the fall for this."

Friday, November 22, 2013

Political Damage Control - Delaying Obamacare Round II Until AFTER the 2014 Vote....

from CNN
Washington (CNN) -- After the many bumps, ruts and roadblocks the Affordable Care Act has run into, health officials in Washington have decided to delay open enrollment in Obamacare -- not this year, but a year down the road.

The Department of Health and Human Services wants to give insurers, consumers and engineers more time to avoid the first go-round's site crashes, coverage train wrecks and cost surprises.

It has moved the start of next year's open enrollment from October 15 to November 15 and extended the sign-up period from roughly seven weeks to eight, an HHS official, who spoke on condition of anonymity, told CNN.

The change will not affect this coverage year, which begins January 1, 2014.

The postponement "will give issuers the benefit of more time to evaluate their experiences during the 2014 plan year and allow them to take into account those who may enroll late, including young adults, before setting 2015 rates," the official said.

Young adults are less likely than their older counterparts to take out a health insurance policy, but even without that issue, enrollment in Obamacare has been minute overall, particularly via the federal sign-up website HealthCare.gov.

Exact numbers are hard to pin down in the 36 states using the site. But as of November 2, just 26,794 people had enrolled in the HealthCare.gov states.

CNN's current tally for this group stands at less than 45,000 enrollees, but that's based on just a handful of states that have provided updates.

In the 14 states running their own sign-up methods, the numbers look better but still dismal. At least 133,000 people had enrolled at last count.

Many more have taken advantage of the expansion of Medicaid. Sticker shock The health department hopes that the added time will encourage insurers to get coverage details right and make their plans more affordable, while consumers have more time to flush the the devil out of the details.

Some consumers were not only hit with high premiums during the rollout but also with deductibles above flood stage. People picking the bronze plan, which has the lowest premiums, will shell out about $5,000 before insurers foot the bills.

Even then, policy holders will cover plenty out of pocket, like doctor visits, lab tests and medications.

"All we ever heard about Obamacare is that it would lower our deductibles and premiums," said Jennifer Slafter, 40 of Mabel, Minn.

"That's just not what's happened." Slafter and her husband, Steve, are scrambling to find affordable care for themselves and their two children.

The exchange's Blue Cross Blue Shield plan was $1,087 a month with a $6,000 deductible, while a Medica plan was $877 a month with a $12,700 deductible.

Both are steeper than their current plan.

Battle ahead As a side effect, the enrollment delay could also give everyone more time to contend with the political battle over Obamacare and whatever changes to the Affordable Care Act that might result.

Republicans on Capitol Hill have distributed a digital playbook among their ranks to align talking points against Obamacare.

The strategy memo is titled "Because of Obamacare ... I lost my insurance," and includes propaganda videos, fliers and social media posts.

The American people are handing President Obama a beating over the many glitches in the rollout of the ACA, with his approval ratings in polls bouncing down a staircase from one low point to the next.

Obamacare is even less popular.
So that the policy cancellation notices and huge price INCREASES don't hit right before the election.

Monday, November 18, 2013

The Health Care Cavalry Has Arrived!

From the office of U.S. Rep Andy Harris and The Dagger:
Washington, D.C. – Over 73,000 Marylanders have seen their health insurance plans terminated because of the President’s health reform law. Now the President is unilaterally changing the law to try to allow them to keep their plan for an additional year. If the insurance companies in Maryland who cancelled policies decide to extend them, Congressman Andy Harris, M.D. is calling on Maryland Insurance Commissioner Therese M. Goldsmith to expedite the review of those extensions to ensure individuals will be able to keep their plans on January 1st.

Congressman Andy Harris, M.D. released the following statement:

“The President promised Americans that if they liked their plan they could keep it. The President’s proposal today is too little too late, but now the Maryland Insurance Commissioner must expedite the review of any policy extensions offered so that those who have plans and like them can keep them. I have heard from many constituents who liked their policies, but are losing them and can’t afford the dramatically higher prices of plans offered in the exchange. The Maryland Insurance Commissioner must do all she can to prevent this harm from occurring.”

Thursday, November 14, 2013

Do we Live Under the Rule of Law? Or the Rule of a Man?

Under heavy pressure by congressional Democrats to fix Obamacare, President Barack Obama announced Thursday that the administration will allow insurance companies to keep individual customers on their existing plans for an additional year, even if the plans don't meet the law's standards.

The president's plan does not require the insurance companies to take back the Americans they kicked off, but does give them the option of taking the customers back if they want. The government will inform state insurance commissioners that they have permission to allow insurers to offer the out-of-date private plans for an additional year. It's up to them whether to allow them to continue or not.

Obama has been caught between two problems of his administration’s own making: millions of cancellations of individual health care coverage despite his pledge that “if you like your plan, you can keep it” and a botched federal website that was supposed to allow Americans to buy new insurance.

"I completely get how upsetting this can be for a lot of Americans," a contrite Obama told reporters Thursday afternoon. "Americans whose plans have been cancelled can choose to enroll in the same kind of plan."

The cancellations, estimated to affect up to 7 million Americans, are due to new standards in Obamacare that insurance companies are required to meet. Those who received cancellations were expected to go onto the new federal insurance marketplace — which has been plagued by tech problems since its Oct. 1 rollout — and purchase coverage there. About 5 percent of insured Americans get their insurance on the individual market.

But it remains unclear whether insurance companies will rescind the cancellations they’ve already handed out, since the Obama administration is not requiring them to do so. And the extension is only for one year, so the fix only delays the fact that many Americans will not be able to keep their current insurance under Obamacare.

The administration argues that many of the cancelled plans were sub par and that many people can buy better insurance for cheaper on the federal marketplace. The law significantly overhauled the individual insurance market, prohibiting plans that kick people off if they become sick or hiking premiums due to illness, among other reforms.

Obama said he believes the Affordable Care Act will work, but admitted the rollout of the exchanges has been bad. "We fumbled the rollout of this health care law," he said. The president added that he was not informed that the glitches in healthcare.gov were so extensive and crippling — he believed they were minor and not systemic before Oct. 1. With his second term — and his legacy — in the balance, Obama frequently seemed deflated, almost defeated, light-years away from his soaring “audacity of hope” or the “fierce urgency of now” that powered his eager first term.

Things will get better, he promised, “if we can just get the darn website working and smooth this thing out.”

“I make no apologies for us taking this on because somebody, sooner or later, had to do it,” the president said. “I do make apologies for not having executed better over the last several months.”

And he offered worried and angry congressional Democrats — many of whom fear Obamacare will prove a potent Republican weapon in the 2014 mid-term elections — a kind of “I feel your pain” moment.

“There is no doubt that our failure to roll out the ACA smoothly has put a burden on Democrats, whether they're running or not, because they stood up and supported this effort through thick and thin, and, you know, I feel deeply responsible for making it harder for them rather than easier for them,” he said. “We’re letting them down.”

But he took more personal responsibility for the botched rollout than he has before in public.

“There have been times where I thought we, you know, got slapped around a little bit unjustly. This one's deserved, all right? It's on us,” he said.

After promising on Oct.1 that buying insurance on the federal website would work “the same way you’d shop for a plane ticket on Kayak or a TV on Amazon,” a more chastened Obama acknowledged that “buying health insurance is never going to be like buying a song on iTunes.”

He denied any deliberate attempt to mislead the public or that he was hasty in rolling out the website even as internal tests showed it would fail.

“I'm accused of a lot of things, but I don't think I'm stupid enough to go around saying, ‘this is going to be like shopping on Amazon or Travelocity,’ a week before the website opens, if I thought that it wasn't going to work,” he said.

As he closed the press conference, Obama dug for a more upbeat, combative message.

“Part of this job is, the things that go right, you guys aren't going to write about. The things that go wrong get prominent attention; that's how it's always been. That's not unique to me as president, and I'm up to the challenge,” he said.

Democrats crafted a bill that would require insurance companies to keep on the millions of customers, pressuring Obama to fix it. Sen. Mary Landrieu, the bill's sponsor, said in a statement she appreciated the president's announcement and would continue to "support legislation to fix this problem."

Republicans, meanwhile, have pounded away at Obama’s false promise and failed website to hammer home their message that the president is neither honest nor a competent manager.

"There is no way to fix this," Republican House Speaker John Boehner said. "I am highly skeptical that they can do this administratively."

Obama's statement is part of an all-out push to rescue the law. The White House was to host Senate Democrats later in the day, while chief of staff Denis McDonough was expected on Capitol Hill to reassure House Democrats.

---

Earlier this week, former President Bill Clinton advised President Obama to "honor the commitment" he made and to allow Americans to keep their health care plans, if they like them. That was a central promise Obama made when he sold Obamacare, but one that turned out not to be true when Obamacare began to be implemented last month.

"So I personally believe, even if it takes a change to the law, the president should honor the commitment the federal government made to those people and let them keep what they got," Clinton in an interview released Tuesday.

Now President Obama is taking Clinton's advice and trying to honor that commitment. In remarks today at the White House today, Obama said, "I completely get how upsetting this can be" lose insurance plans that I promised Americans would be able to keep. "To those Americans, I hear you loud and clear."

But there's a catch with president's proposed solution. The president is not proposing that the law be changed to allow all health insurance plans grandfathered into Obamacare's eligibility requirements.

No, instead the White House is saying that it will use "enforcement discretion" to allow illegal health insurance plans to be able to still be sold.
That is, the Obama administration will not enforce the penalty on individuals for not having eligible health insurance plans and they'll allow the insurance companies to still sell so-called bad plans -- plans they technically can't sell under Obamacare.

"Under the White House’s approach, the Department of Health and Human Services will notify the nation’s state insurance commissioners that they have federal permission to allow consumers who already have such insurance policies to keep them through 2014," reports the Washington Post.

He'll also be forcing insurance companies to help advertise for Obamacare by letting customers know that there's an Obamacare marketplace where they can purchase (or get subsidized) health care coverage.

Obama's proposal is an extra-legal solution to a big problem for millions of Americans around the country.

"I don't see within the law how they can do this administratively," said Speaker John Boehner in a press conference on Capitol Hill. "No one can identify anything the president could do administratively to keep his pledge that would be both legal and effective."

The proposed White House fix so that Obama can honor his commitment is also likely to create more problems and to further distrust the American people have for this administration, which makes law based on what it chooses to enforce while sidestepping the constitutional process that is in place.

Indeed, there's another problem. As Texas senator Ted Cruz says, the president cannot fix an unfixable law. "We cannot 'fix' Obamacare. The damage has been done, as millions of Americans have already been made to pay higher premiums and lose their jobs, wages, and health care plans," Cruz said today.

President Clinton famously dismissed Obama's candidacy for president of the United States by saying, "Give me a break. This whole thing is the biggest fairy tale I have ever seen."

With Obama's reliance on "enforcement discretion," it would now seem that Clinton had a point -- and that the "fairy tale" continues.

Hey Marylanders... Got Insurance?

From the Office of U.S. Rep Andy Harris and The Dagger:
Washington, D.C. – Today, the Department of Health and Human Services released the information on the number of people who have enrolled in the health insurance marketplaces. In Maryland, only 1,284 individuals have selected a plan on the health insurance marketplace between October 1 and November 2nd. That number pales in comparison to the over 73,000 people who have seen their plans terminated.

“The website sign up process has been an embarrassment, but the real train wreck of the President’s health plan is for the 73,000 families who lost their insurance,” said Rep. Andy Harris, M.D. “The President made three promises: if you liked your plan you could keep it, if you liked your doctors you could keep them, and the price for family health insurance would be $2,500 less per year. All three are turning out not to be true,”

According to an October 12, 2013, Baltimore Sun article, Maryland officials claimed 1,121 people signed up in the first 10 days. If that number was accurate, that means less than 8 people were able to sign up each day for the remainder of the reporting period. At that rate, it would take more than 295 years to sign up all of Maryland’s 800,000 uninsured.

Friday, November 8, 2013

If You Like it, You can Keep it. Period

from McClatchy DC
WASHINGTON — Even as President Barack Obama sold a new health care law in part by assuring Americans they would be able to keep their insurance plans, his administration knew that tens of millions of people actually could lose those their policies.

“If you like your private health insurance plan, you can keep your plan. Period,” Obama said as he pitched the plan, the unqualified promise he made repeatedly.

Yet advisers did say in 2010 that there were large caveats and that anyone whose insurance plan changed would lose the promised protection of being able to keep existing plans. And a report in 2010 said that as many as 69 percent of certain employer-based insurance plans would lose that protection, meaning as many as 41 million people could lose their plans even if they wanted to keep them and would be forced into other plans. Another 11 million who bought their own insurance also could lose their plans. Combined, as many as 52 million Americans could lose or have lost old insurance plans.

Some or much of that loss of favored insurance is driven by normal year-to-year changes such as employers changing plans to save money. And many people could end up with better plans. But it is not what the president pledged.

Caught in the firestorm of his broken promise, Obama on Thursday apologized.

“I am sorry that they are finding themselves in this situation based on assurances they got from me,” he told NBC News Thursday evening. “We’ve got to work hard to make sure that they know we hear them and we are going to do everything we can to deal with folks who find themselves in a tough position as a consequence of this.”

The shifting narrative started as Obama worked to sell the entire health care overhaul to a skeptical nation and Congress. To win support from those who already had insurance, he made the promise that no one who liked their plan would lose it. The key was that millions of plans would be “grandfathered” in the new law, thus protected from any new requirements.

Yet as insurance companies started notifying hundreds of thousands this fall that their current policies were being canceled in preparation for new ones, it became clear that many were not guaranteed to keep their plans.

The White House and Congress have focused on cancelations of plans in the individual market, where people buy their own policies.

Obama insisted anew Thursday that the problem is limited to people who buy their own insurance. “We’re talking about 5 percent of the population who are in what’s called the individual market. They’re out there buying health insurance on their own,” he told NBC.

But a closer examination finds that the number of people who have plans changing, or have already changed, could be between 34 million to 52 million. That’s because many employer-provided insurance plans also could change, not just individually purchased insurance plans

Administration officials decline to say how many employer-sponsored plans could change. But those numbers could be between 23 million to 41 million, based on a McClatchy analysis of estimates offered by the Department of Health and Human Services in June 2010.

Obama aides did acknowledge around the time the law was enacted in 2010 that some people could lose their coverage if their plans changed after the law was passed. Those people would in turn receive what the administration described as superior coverage. But in the years since the law’s passage, HHS officials have downplayed that consequence of the hard-fought law.

“If health plans significantly raise co-payments or deductibles or significantly reduce (them) . . . they’ll lose their grandfather status and their customers will get the same full set of consumer protections as new plans,” Health and Human Services Secretary Kathleen Sebelius said at a June 15, 2010, news conference.

Many changes in the old insurance plans could trigger the loss of the protected status. Regulations issued by HHS state that the grandfathered status would be lost if the policies eliminate coverage for a particular condition, reduce the annual dollar limit on benefits, increase co-payments by as little as $5 or 15 percent, or increase out-of-pocket maximums by more than 15 percent or premiums by more than 5 percent.

Later in June 2010, Sebelius’ department published estimates in the Federal Register that 39 percent to 69 percent of employers’ fully insured plans would relinquish the coverage they had prior to the March 2010 passage of the ACA and thus would have to cancel or change policies.

About 60 million people are covered in fully insured plans, which make up about 40 percent of employer-provided health plans. Fully insured plans are usually offered by large employers. These plans have the insurance company rather than the employer assume the financial risk of annual health care expenses exceeding expectations. The rest of employers self-insure.

To escape having to provide the new law’s minimum required benefits, plans would have to largely maintain the co-pays, premiums and out-of-pocket limits that existed prior to March 2010.

Already this year, only 36 percent of employer plans were pre-2010 plans, compared with 56 percent in 2011, according to the Kaiser Family Foundation, a leading health care research organization. That means that millions of people’s plans already had changed or were canceled in the three and a half years since the law was enacted in March 2010.

That doesn’t automatically mean the plans were changed or canceled because of the new law.

“I think there needs to be great emphasis that plans are not being canceled because of ACA requirements,” said Jon Gabel, a senior fellow at the University of Chicago’s Health Care Research Department. “They’re being canceled because insurers do not want to ‘grandfather’ some plans.”

This week, after millions of Americans mostly in the market for individually purchased plans began receiving cancellation notices or price hikes from their insurance companies, Obama added the caveat that people could lose their plans if insurance companies changed the plans.

“Now, if you have or had one of these plans before the Affordable Care Act came into law and you really like that plan, what we said was you could keep it if it hasn’t changed since the law was passed,” he said, adding the qualifier Monday during a Washington event with supporters.

Tuesday, November 5, 2013

2 Million Frauds and Climbing... Thank's Barrack!

from the Weekly Standard
In a continuing crackdown on the federal government's Lifeline program, sometimes known as "Obama phones," the Federal Communications Commission (FCC) has revealed that fraud and abuse in the program exceeded two million subscribers. New rules were established after it became clear that subscribers and providers were taking advantage of the system:
The FCC’s Enforcement Bureau has worked aggressively to enforce these new rules since their adoption, taking actions worth over $15 million, in addition to today’s $32.6 million in proposed forfeitures. Numerous additional investigations are ongoing. Moreover, over 2 million duplicate subscriptions have been eliminated, and the FCC’s reforms are on track to save the Fund more $2 billion over three years.
The two million is up from a figure of 1.1 million in an FCC press release just a month ago.

The Lifeline program was started in 1985 to allow low income household to have basic and emergency phone service, but has grown dramatically since its inception. The Wall Street Journal reported in February that payments ballooned from $819 million in 2008 to more than $2.2 billion in 2012. The Journal investigation also found that the kind of fraud uncovered by the FCC in its current action was rampant:
A review of five top recipients of Lifeline support conducted by the FCC for the Journal showed that 41% [almost 2.5 million] of their more than six million subscribers either couldn't demonstrate their eligibility or didn't respond to requests for certification.
The purpose of the November 1 press release was to announce that the FCC has proposed fines of $32.6 million against

three providers for rules violations. The FCC is accusing Conexions Wireless, i-wireless, and True Wireless of knowingly allowing multiple Lifeline subscriptions from the same household when the limit is one per household. Service providers may request reimbursement from the government under the program on the condition that they have verified eligibility of their subscribers under Lifeline rules. One of the companies, Conexions Wireless, also faces a $300,000 fine for "apparent willful and repeated failure to provide timely and complete responses to the FCC’s requests for information."

The total proposed forfeitures against providers to date amount to a relatively small $47.6 million versus the apparent billions in fraud. An email to the FCC requesting clarification regarding further actions possibly pending against providers has not yet been returned.

Growing Health Care Fraud - 357,000 Illinois Medicaid Benificieries Not Eligible?

Of the 712,000 Illinois Medicaid recipients audited so far, 357,000 have been found ineligible, and only 176,000 removed from the Medicaid rolls... Now would somebody PLEASE sign them ALL up for Obamacare subsidies?

Saturday, November 2, 2013

Got Employer Provided Health Insurance? Just Wait Until Next Year...

from the AP
MIAMI (AP) -- Dean Griffin liked the health insurance he purchased for himself and his wife three years ago and thought he'd be able to keep the plan even after the federal Affordable Care Act took effect.

But the 64-year-old recently received a letter notifying him the plan was being canceled because it didn't cover certain benefits required under the law.

The Griffins, who live near Philadelphia, pay $770 monthly for their soon-to-be-terminated health care plan with a $2,500 deductible. The cheapest plan they found on their state insurance exchange was a so-called bronze plan charging a $1,275 monthly premium with deductibles totaling $12,700. It covers only providers in Pennsylvania, so the couple, who live near Delaware, won't be able to see doctors they've used for more than a decade.

"We're buying insurance that we will never use and can't possibly ever benefit from. We're basically passing on a benefit to other people who are not otherwise able to buy basic insurance," said Griffin, who is retired from running an information technology company.

The Griffins are among millions of people nationwide who buy individual insurance policies and are receiving notices that those policies are being discontinued because they don't meet the higher benefit requirements of the new law.

They can buy different policies directly from insurers for 2014 or sign up for plans on state insurance exchanges. While lower-income people could see lower costs because of government subsidies, many in the middle class may get rude awakenings when they access the websites and realize they'll have to pay significantly more.

Those not eligible for subsidies generally receive more comprehensive coverage than they had under their soon-to-be-canceled policies, but they'll have to pay a lot more.

Because of the higher cost, the Griffins are considering paying the federal penalty - about $100 or 1 percent of income next year - rather than buying health insurance. They say they are healthy and don't typically run up large health care costs. Dean Griffin said that will be cheaper because it's unlikely they will get past the nearly $13,000 deductible for the coverage to kick in.

Individual health insurance policies are being canceled because the Affordable Care Act requires plans to cover certain benefits, such as maternity care, hospital visits and mental illness. The law also caps annual out-of-pocket costs consumers will pay each year.

In the past, consumers could get relatively inexpensive, bare-bones coverage, but those plans will no longer be available. Many consumers are frustrated by what they call forced upgrades as they're pushed into plans with coverage options they don't necessarily want.

Ken Davis, who manages a fast food restaurant in Austin, Texas, is recovering from sticker shock after the small-business policy offered by his employer was canceled for the same reasons individual policies are being discontinued.

His company pays about $100 monthly for his basic health plan. He said he'll now have to pay $600 monthly for a mid-tier silver plan on the state exchange. The family policy also covers his 8-year-old son. Even though the federal government is contributing a $500 subsidy, he said the $600 he's left to pay is too high. He's considering the penalty.

"I feel like they're forcing me to do something that I don't want to do or need to do," Davis, 40, said.

Owners of canceled policies have a few options. They can stay in the same plan for the same price for one more year if they have one of the few plans that were grandfathered in. They can buy a similar plan with upgraded benefits that meets the new standards - likely at a significant cost increase. Or, if they make less than $45,960 for a single adult or $94,200 for a family of four, they may qualify for subsidies.

Just because a policy doesn't comply with the law doesn't mean consumers will get cancellation letters. They may get notices saying existing policies are being amended with new benefits and will come with higher premiums. Some states, including Virginia and Kentucky, required insurers to cancel old policies and start from scratch instead of beefing up existing ones.

It's unclear how many individual plans are being canceled - no one agency keeps track. But it's likely in the millions. Insurance industry experts estimate that about 14 million people, or 5 percent of the total market for health care coverage, buy individual policies. Most people get coverage through jobs and aren't affected.

Many states require insurers to give consumers 90 days' notice before canceling plans. That means another round of cancellation letters will go out in March and again in May.

Experts haven't been able to predict how many will pay more or less under the new, upgraded plans. An older policyholder with a pre-existing condition may find that premiums go down, and some will qualify for subsidies.

In California, about 900,000 people are expected to lose existing plans, but about a third will be eligible for subsidies through the state exchange, said Anne Gonzalez, a spokeswoman for the exchange, called Covered California. Most canceled plans provided bare-bones coverage, she said.

"They basically had plans that had gaping holes in the coverage. They would be surprised when they get to the emergency room or the doctor's office, some of them didn't have drug coverage or preventive care," Gonzalez said.

About 330,000 Floridians received cancellation notices from the state's largest insurer, Florida Blue. About 30,000 have plans that were grandfathered in. Florida insurance officials said they're not tracking the number of canceled policies related to the new law.

National numbers are similar: 130,000 cancellations in Kentucky, 140,000 in Minnesota and as many as 400,000 in Georgia, according to officials in those states.

Cigna has sent thousands of cancellation letters to U.S. policyholders but stressed that 99 percent have the option of renewing their 2013 policy for one more year, company spokesman Joe Mondy said.

Cancellation letters are being sent only to individuals and families who purchase their own insurance. However, most policyholders in the individual market will receive some notice that their coverage will change, said Dan Mendelson, president of the market analysis firm Avalere Health.

The cancellations run counter to one of President Barack Obama's promises about his health care overhaul: "If you like your health care plan, you'll be able to keep your health care plan."

Philip Johnson, 47, of Boise, Idaho, was shocked when his cancellation notice arrived last month. The gift-shop owner said he'd spent years arranging doctors covered by his insurer for him, his wife and their two college-age students.

After browsing the state exchange, he said he thinks he'll end up paying lower premiums but higher deductibles. He said the website didn't answer many of his questions, such as which doctors take which plans.

"I was furious because I spent a lot of time and picked a plan that all my doctors accepted," Johnson said. "Now I don't know what doctors are going to take what. No one mentioned that for the last three years when they talked about how this was going to work."

Wednesday, October 23, 2013

How Dangerous is YOUR Neighborhood?

96% of Maryland's 1651 SWAT Team Deployments were in Response to Criminal Activities, 66% of Which Required the SWAT Teams to Employ Forcible Entry

Tuesday, October 22, 2013

I Know, No One is Interested...

Prepare Yourselves for the Great Deflation?

from CNBC
Marc Faber, publisher of The Gloom, Boom & Doom Report, told CNBC on Monday that investors are asking the wrong question about when the Federal Reserve will taper its massive bond-buying program. They should be asking when the central bank will be increasing it, he argued.

"The question is not tapering. The question is at what point will they increase the asset purchases to say $150 [billion] , $200 [billion], a trillion dollars a month," Faber said in a " Squawk Box " interview.

The Fed-which is currently buying $85 billion worth of bonds every month-will hold its October meeting next week to deliberate the future of its asset purchases known as quantitative easing .


Faber has been predicting so-called "QE infinity" because "every government program that is introduced under urgency and as a temporary measure is always permanent." He also said, "The Fed has boxed itself into a position where there is no exit strategy."

The continuation of Fed bond-buying has helped support stocks, and the Dow Jones Industrial Average (Dow Jones Global Indexes: .DJI) and S&P 500 Index (^GSPC) are coming off two straight weeks of gains, highlighted by record highs for the S&P.

While there may be little inflation in the U.S., Faber said there's been incredible asset inflation. "We are the bubble. We have a colossal asset bubble in the world [and] a leverage or a debt bubble."

Back in April 2012, Faber said the world will face "massive wealth destruction" in which "well to-do people will lose up to 50 percent of their total wealth."

In Monday's "Squawk" appearance, he said that could still happen but possibly from higher levels because of the "asset bubble" caused by the Fed.

"One day this asset inflation will lead to a deflationary collapse one way or the other. We don't know yet what will cause it," he said.

Thursday, October 17, 2013

RINO's to Ted Cruz...(response)

Participating Backstabbers

Alabama RINO: Bachus

Alaska RINOs: Young, and in the Senate Murkowski (R-AK)

Arizona RINOs: In the Senate Flake (R-AZ), McCain (R-AZ)

Arkansas RINOs: Cotton, Crawford, Griffin, Womack, and in the Senate Boozman (R-AR)

California RINOs: Calvert, Cook, Issa, McCarthy, McKeon, Miller Gary, Nunes, Valadao

Colorado RINOs: Coffman, Gardner, Tipton

Florida RINOs: Bilirakis, Buchanan, Crenshaw, Diaz-Balart, Ros-Lehtinen, Webster, Young, ?

Georgia RINOs: In the Senate Chambliss (R-GA), Isakson (R-GA)

Idaho RINO: Simpson

Illinois RINOs: Davis Rodney, Kinzinger, Roskam, Schock, Shimkus, and in the Senate Kirk (R-IL)

Indiana RINOs: Brooks, Young, and in the Senate Coats (R-IN)

Iowa RINO: Latham

Kansas RINOs: Jenkins, and in the Senate Moran (R-KS)

Kentucky
RINOs: Guthrie, Rogers, Whitfield, and in the Senate McConnell (R-KY)

Louisiana
RINO: Boustany

Maine
RINO: In the Senate Collins (R-ME)

Michigan RINOs: Benishek, Camp, Rogers, Upton

Minnesota
RINOs: Kline, Paulsen

Mississippi RINOs: Harper, and in the Senate Cochran (R-MS), Wicker (R-MS)

Missouri
RINO: In the Senate Blunt (R-MO)

Montana RINO: Daines

Nebraska
RINOs: Fortenberry, Smith, Terry, and in the Senate Fischer (R-NE), Johanns (R-NE)

Nevada RINO: Heck

New Hampshire RINO: In the Senate Ayotte (R-NH)

New Jersey RINOs: Frelinghuysen, Lance, LoBiondo, Runyan, Smith, and in the Senate Chiesa (R-NJ)

New York RINOs: Gibson, Grimm, Hanna, King

North Carolina RINOs: Coble, McHenry, Pittenger, and in the Senate Burr (R-NC)

North Dakota RINOs: Cramer, and in the Senate Hoeven (R-ND)

Ohio
RINOs: Boehner, Joyce, Stivers, Tiberi, and in the Senate Portman (R-OH)

Oklahoma RINOs: Cole, and in the Senate Coburn (R-OK)

Pennsylvania RINOs: Barletta, Dent, Fitzpatrick, Gerlach, Kelly, Meehan, Murphy, Shuster, Thompson

South Carolina RINOs: In the Senate Graham (R-SC), Scott (R-SC)

South Dakota RINO: In the Senate Thune (R-SD)

Tennessee RINOs: In the Senate: Alexander (R-TN), Corker (R-TN)

Utah RINO: In the Senate Hatch (R-UT)

Virginia
RINOs: Cantor, Rigell, Wittman, Wolf

Washington RINOs: Hastings, Herrera Beutler, McMorris Rodgers, Reichert,

West Virginia RINOs: Capito, McKinley

Wisconsin RINO: Ribble

Tuesday, October 15, 2013

Turning the Tide, Redux

from Realclearpolitics:
"History does not repeat itself, but it does rhyme."

Mark Twain's insight comes to mind as one observes the panic of Beltway Republicans over the latest polls in the battle of Obamacare.

According to Gallup, approval of the Republican Party has sunk 10 points in two weeks to 28 percent, an all-time low. In the Wall Street Journal/NBC poll, approval of the GOP has fallen to 24 percent.

In the campaign to persuade America of their Big Lie -- that the House Republicans shut down the government -- the White House and its media chorus appear to have won this round.

Yet, the truth is the Republicans House has voted three times to keep open and to fund every agency, department and program of the U.S. government, except for Obamacare.

And they voted to kill that monstrosity but once.

Republicans should refuse to raise the white flag and insist on an honorable avenue of retreat.

And if Harry Reid's Senate demands the GOP end the sequester on federal spending, or be blamed for a debt default, the party should, Samson-like, bring down the roof of the temple on everybody's head.

This is an honorable battle lost, not a war.

Why, after all, did Republicans stand up? Because they believe Obamacare is an abomination, a new entitlement program this nation, lurching toward bankruptcy, cannot afford.

It is imposing increases in health care premiums on millions of Americans, disrupting doctor-patient relationships and forcing businesses to cut workers back to 29 hours a week. Even Democratic Sen. Max Baucus has predicted a coming "train wreck."

Now if the Republican Party believes this, what choice did the House have except to fight to defund or postpone it, against all odds, and tune out the whining of the "We-can't-win!" Republican establishment?

And if Republicans are paralyzed by polls produced by this three-week skirmish, they should reread the history of the party and the movement to which they profess to belong.

In the early 1960s, when the postwar right rose to challenge JFK with Mr. Conservative, events and actions conspired to put Barry Goldwater in the worst hole of a Republican nominee in history.

Kennedy was murdered in Dallas one year before the election. Goldwater had glibly hinted he would privatize Social Security, sell the Tennessee Valley Authority and "lob one into the men's room at the Kremlin."

After his defeat of Nelson Rockefeller in the California primary assured his nomination, Goldwater was 59 points behind LBJ -- 77-18.

The Republican liberals -- Govs. Rockefeller, George Romney and William Scranton -- to the cheers of the Washington press, began to attack Goldwater for "extremism" and failing to vote for the Civil Rights Act of 1964.

At the Cow Palace convention, liberals demanded Goldwater rewrite the platform to equate The John Birch Society with the Communist Party USA and the Ku Klux Klan, which had murdered four black girls at a Birmingham church in 1963 and three civil rights workers in Neshoba County, Miss., that same summer.

Goldwater rejected this stinking outrage, declaring, "Extremism in the defense of liberty is no vice." And, so, the liberals all abandoned him.

One man stood by Goldwater. The two-time loser Richard Nixon, who had not won a race in his own right since 1950, campaigned for Goldwater and the party longer and harder than Barry himself.

And what became of them all?

Bill Scranton packed it in 1966. George Romney was trounced in 1968 by Nixon, with Goldwater's legions at his side, in New Hampshire, and quit the race two weeks before the returns came in.

Rockefeller, who had spent a career calling Nixon a "loser," lacked what it took to challenge Nixon in any of the contested primaries.

And, lest we forget, one other national Republican spoke up for Goldwater and conservatism in that 1964 humiliation, the retired Hollywood actor and impresario of GE Theater: Ronald Reagan.

Nixon and Reagan would go on to win four of the next five GOP nominations and presidential elections. In the one convention Reagan lost, 1976, the right, as the price of its support of Gerald R. Ford, demanded that Nelson Rockefeller be dumped as vice president.

Done. Rocky was last seen flipping a middle finger to the delegates happily marking "paid" on his account.

Prediction: The people who fought the battle of Obamacare will be proven right to have fought it, and America will come to see this.

And the people who said, "We can't win!" will never win.

America is at a turning point.

If she does not stop squandering hundreds of billions on liberal agenda items like Obamacare and if she do not end these trade deficits sucking the jobs, factories and investment capital out of our country, we will find ourselves beside Greece, Spain, Illinois and Detroit.

Even if America disagrees, as in 1964 when it embraced LBJ's Great Society plunge to social and economic disaster, Republicans need to stand up -- current polls and corporate Republicans be damned.

If the right is right, time will prove it, as it did long ago.

Monday, October 14, 2013

Democrats Admit: Obamacare Launch Has Failed in Maryland

from the Huffington Post
As the nation prepared for the launch of federal health reforms, Maryland was lauded as a leader in adopting the president's signature program. Obama used a community college in Maryland as a backdrop to promote his plan -- and to praise Maryland as a model.

But nearly two weeks after Maryland's online marketplace opened to the uninsured, the state program remains plagued by technical problems, and officials say it could be six weeks before the system is running smoothly. The Maryland Health Connection enrolled just more than 1,120 people in the first 10 days
-- compared with more than 9,000 in Kentucky, which has fewer uninsured, and tens of thousands in California and New York.

Other states have had similar problems, and the federal site, which serves 36 states, has been bogged down. But Maryland is now being targeted for criticism by conservatives on Capitol Hill and publications such as the Weekly Standard, which highlighted the fact that consumers could not search Maryland Health Connection to see if their doctors participate in the program.

Some Obamacare supporters are also expressing frustration about the balky website.

"Once you get beyond the slick-looking front page, it looks like something a college kid may have put together in an afternoon. It's rife with weird programming, verification errors and dead ends," said Jim Fortney of Silver Spring, who has built some small websites himself and says he supports the health care program. He has been trying to enroll himself and his 12-year-old son on the Maryland site.

Maryland officials have downplayed the troubles related to the Maryland Health Connection's online portal. They say initial problems -- some created by high demand -- are fixed and others, such as slow movement between pages on the site, are being addressed.

Still, Gov. Martin O'Malley said some problems are likely to continue in Maryland, which has about 800,000 uninsured residents. "My sense of it is, probably for the next month or so, month and a half, we will be working out glitches in the portal," he told reporters Friday.

Joshua Sharfstein, secretary of the state Department of Health and Mental Hygiene, said a planned upgrade is in the works and noted that the pace of enrollment in the health exchange is picking up. In the first six days, the state signed up 326 people; four days later there were 1,121.

Still, computer experts are trying to figure out why some state exchanges worked and others -- like Maryland's -- lagged as a key element of the Affordable Care Act took effect.

Sharfstein wasn't specific about the problems that Maryland has encountered, and Noridian Healthcare Solutions LLC, the company contracted to build the software, said it could not comment.

When Obama spoke before a crowd of nearly 2,000 students at Prince George's Community College on Sept. 26, he predicted that signing up for health insurance would be as easy as shopping for "a TV on Amazon."

He acknowledged that some computer problems could emerge around the nation, but praised Maryland's efforts.

"Like any law, like any big product launch, there are going to be some glitches as this thing unfolds," the president said. "Folks in different parts of the country will have different experiences. It's going to be smoother in places like Maryland where governors are working to implement it rather than fight it."

Many states reported they had trouble initially because there was far more interest than expected and servers were overwhelmed. Experts said the sites that worked smoothly -- once computer capacity was increased -- were those that allowed consumers to shop without creating an account. Maryland and the federal site both require registration to see the details of insurance plans, and bottlenecks developed as information was relayed among computers for user verification.

Kentucky officials say the simplicity of their system and strong oversight brought success. They used few graphics and limited text on the website so it wouldn't get bogged down and consumers wouldn't be overwhelmed, said Gwenda Bond, a spokeswoman for Kentucky's Cabinet for Health and Family Services, where the exchange is housed. They thought anonymous browsing would be popular, and as it turns out, that approach avoided the bottleneck plaguing other states.

Most importantly, Bond said, the state used its own technical people, who also oversee Medicaid and other social service systems, to create the overriding architecture of their exchange. They also "stayed in the room" with contractors -- some of the same ones who are running the troubled federal site -- to keep close tabs on the operation.

"We had some glitches," Bond said. "But we were able to correct them quickly."

New York and California also are enrolling thousands of residents. Peter Lee, executive director of Covered California, said enrollment was "going strong," with 16,311 applications completed to cover 28,699 people as of Oct. 5.

The website for the New York State Department of Health experienced some slowness upon opening, with 2 million hits in an hour on its first day, but officials added servers in the following days to handle the load and said they haven't experienced any interruption in service. As of Friday, nearly 80,000 residents had enrolled.

But problems with the federal exchange's website means consumers face delays in obtaining coverage in 36 states, including Delaware, Pennsylvania and Virginia. Delaware officials don't expect to have any estimate of enrollment until mid-November, said Jill Fredel, spokeswoman for that state's health department.

Other state-run exchanges have faced serious problems. In Oregon, for example, technical difficulties have prevented residents from completing enrollment, though about 4,000 people have filled out initial paperwork either online or in print.

"We're working through the problems," Cover Oregon spokeswoman Ariane Holm said. Officials hope to open the enrollment website to the public by the end of the month. "We want to make sure we get it right, not just get it out there."

Software experts question the approach that the federal government and some states took in creating the online marketplace.

Alexander Howard, a fellow at Harvard University's Ash Center for Democratic Governance and Innovation and Columbia University's Tow Center for Digital Journalism, said the federal government has a procurement problem, and some states may have fallen into the same trap. Governments often contract out large, complex systems to companies that may not be innovative and nimble enough to envision them, write code, communicate and anticipate user needs, he said.

"Maybe [the companies are] not the best at building systems, they're the best at getting government contracts," he said. "There is a thicket of rules and regulations that governs how government can buy and maintain technology."

Paul Smith, chief technology officer at Public Good Software, agreed. He headed software engineering efforts for Obama's 2012 re-election campaign while at the Democratic National Committee, and embraced cutting-edge technology more common to a Silicon Valley start-up to effectively raise donations and organize. He said rigid procurement rules limit such innovation among federal agencies.

Another issue is that the federal website and Maryland's are hitting bottlenecks because they depend on computer links to agencies, including the Social Security Administration and the Internal Revenue Service, to verify consumer information. The systems at such agencies weren't meant to handle high web-based traffic, the experts said.

The problems can be overcome with good computer code writers, enough servers, proper testing and lots of oversight, Smith and Howard said. But that takes time, and many health exchanges weren't ready by the Oct. 1 deadline for the start of enrollment.

Smith pointed out that the Medicare Part D prescription drug plan also had a rough roll out, though he suspects most people don't remember that because the program is hugely popular.

"I've been developing software for decades and it's buggy," he said. "The first time you always encounter challenges and everyone expects that with any product. ... Going forward I expect the sites to stabilize and be more responsive, and enrolling people in health care and the experience not to be a frustrating one."

If the kinks are not worked out soon, some say authorities may need to ease enrollment deadlines. The uninsured need to buy coverage by March. For coverage to begin in January, consumers must sign up by mid-December.

"There is still time," said Sabrina Corlette, a senior research fellow at Georgetown University's Center on Health Insurance Reforms. "Maryland had been seen as ahead of the pack. But now we're pointing to Kentucky as one of the only states moving smoothly. If this goes on another month, some policy decisions on open enrollment will need to be made."

Maryland officials said 1,121 people have enrolled for insurance through the state's health exchange. Here are samples from some other states:

Kentucky: 9,000-plus

New York: nearly 80,000

California: 28,000-plus

Oregon: zero

Federal system, serving 36 states including Delaware, Pennsylvania and Virginia: Statistics not available