The Obamacare fiasco is "going to get worse," opines Bob Woodward, because there are so many moving parts that remain out of joint. One of those pieces is the president's "keep your doctor" pledge, which many Americans will discover to be as inaccurate as "keep your plan" over the next year. Mainstream media sources and conservative analysts have warned of the impending problem of so-called "access shock," wherein consumers' choices on plans, doctors, and treatment facilities will be dramatically reduced in an effort to hold down costs. Expect to see more of these stories dripping into news coverage as the trend worsens:
dropped thousands of doctors from its networks in recent weeks, leaving many elderly patients unsure whether they need to switch plans to continue seeing their doctors, the Wall Street Journal reported on Friday.The insurer said in October that underfunding of Medicare Advantage plans for the elderly could not be fully offset by the company's other healthcare business. The company also reported spending more healthcare premiums on medical claims in the third quarter, due mainly to government cuts to payments for Medicare Advantage services. The Journal report said that doctors in at least 10 states were notified of being laid off the plans, some citing "significant changes and pressures in the healthcare environment." According to the notices, the terminations can be appealed within 30 days.
Meanwhile, the Obama administration is rewriting their metrics for Healthcare.gov. They've decided that if four out of five users are able to use the site properly, that outcome will constitute a "success." The Washington Post:
The goal for how many people should be able to make it through the insurance exchange is an internal target that administration officials have not made public. It acknowledges that as many as one in five Americans who try to use the Web site to buy insurance will be unable to do so. The measure is the first concrete performance standard in the 31/2 years since the government began to design the health exchange, and was defined by a group of federal officials and technical experts in late October. It is now guiding the work of hundreds of government employees and contractors racing to try to repair the balky Web site by the administration’s Nov. 30 deadline. Whether the government meets the benchmark — and whether the public regards it as adequate — will be a central factor in President Obama’s efforts to increase support for the controversial health-care law and lure customers to the federal insurance marketplace.
The process of "luring" customers into the federal exchanges isn't exactly cut-and-dried either. The law's viability rests on the correct mix of young and old, healthy and sick signing up. So far, among the tiny sliver of Americans who've managed to select a plan, early patterns are worrisome. The Wall Street Journal reported on the troubling demographics several weeks ago, and now the Associated Press confirms the trend:
Fears that insurance exchanges that are the linchpin of President Barack Obama's federal health care overhaul wouldn't attract the young, healthy people needed to make them financially viable are being heightened by the early results of signups in several states. If it becomes a trend, that could lead to increases in insurance premiums and deductibles next year. Along with the paltry enrollment numbers released this week, officials in a handful of states said those who had managed to sign up were generally older people with medical problems — those with the greatest incentives to get coverage...Insurers have warned that they need a wide range of people signing up for coverage because premiums paid by adults in the younger and healthier group, between 18 and 35, are needed to offset the cost of carrying older and sicker customers who typically generate far more in medical bills than they contribute in premiums.
Perhaps young people will rush to sign up at the very last minute. Or perhaps not. Weeks of horrible press over missed deadlines, broken websites, and data security breaches probably won't help lubricate the wooing process. And if the requisite blend doesn't materialize, insurers' losses will result in some combination of three effects: (1) Pulling out of the Obamacare exchange markets -- adding to the access shock problem -- (2) jacking up premiums substantially ahead of 2015 -- risking a death spiral affect -- or (3) counting on major federal bailouts, at great cost to current and future taxpayers. Sen. Marco Rubio's bill seeks to curtail expensive healthcare bailouts, as the administration moves to expand its authority to distribute such funds. This swirling uncertainty is disconcerting to the insurance industry and average consumers alike. Democrats continue to grapple with the political ramifications of this mess -- some venting exasperation at the White House's incompetence, with others shifting their attention to saving their own skins. Click through and read the quote about the political death spiral at which some vulnerable Democrats are staring, as the party faithful fret and commiserate. I'll leave you with Nancy Pelosi's painful Meet the Press appearance yesterday morning:
This law is affordable, she claims, in spite of the data-driven evidence on ">average premium increases and exorbitant deductible hikes. And the state exchanges are working great, she adds -- failing to mention Democrat-run jurisdictions such as Oregon, Vermont, Maryland and Hawaii. One of the examples she places in the "win" column is Covered California, which signed up approximately 35,000 residents in October. By comparison, more than one million Californians have lost their current coverage since the implementation process began. Success! Democratic officials who may be inclined to acknowledge any of these flaws -- or to question Obama's so-called "fix" -- might want to reconsider. Question The One, and you may find yourself out of a job.
Obamaland: Where Cowboys are Villains and Race-Baiters, Gay Radicals and Marxists are Heroes | Doug Giles