The deadline for selecting an Obamacare plan in order to be covered in the new year is five days away. Administration officials are bragging about how much better Healthcare.gov is today than it was on October 1, which is obviously true. It was unusable when they launched it -- and they knew it was unusable, yet launched it anyway. So "better than it was" is an extremely low bar to clear. Nevertheless, any number of nagging problems continue to bedevil consumers attempting to obtain health coverage through the Obamacare system. USA Today reports that some baffled and beleaguered customers have adopted a fingers-crossed mentality:
Some frustrated consumers are sending premium payments to insurers who have never heard of them. Others say they will pass up federal subsidies and pay full price through insurers, while still others have given up altogether on the promise of health insurance by Jan. 1. Consternation and confusion over applications sent through the federal HealthCare.gov website continue into the last seven days before the Dec. 23 enrollment deadline. Consumers with health issues are particularly nervous about the prospect of not having insurance at the start of the new year. Federal assurances last week about a "special enrollment period" for people whose applications have been hung up on the site are little comfort as neither insurers nor consumers have any idea how this will work and who will qualify...While HHS said the number of errors in information forms sent to insurers are now close to zero, insurers say they continue to find errors, especially duplicate enrollments and cancellations from the same consumer with the same time stamp.
Meanwhile, CNN reports that Obamacare shopping functions on private exchanges are still inoperative, "even though the government has said [these problems] should have been cleared up weeks ago." These ongoing issues explain why the Obama administration released their new "guidance" regulations last week, "suggesting" that insurers extend payment deadlines, voluntarily continue to pay for uncovered prescription medications, and treat out-of-network expenses as in-network -- all under the explicit threat of reprisals. A former government employee and current health insurance official explains the untenable and cynical nature of HHS' last-minute goalpost shifting:
It's still unclear how much cooperation HHS will get from insurers, who have been asked to extend payment deadlines into January, cover people's drugs and medical treatment if they are between plans and allow people to sign up later than Dec. 23 to get insurance Jan. 1. Health industry consultant Kip Piper said HHS doesn't have the authority to enforce what he calls these "political requests." But HHS said it will consider insurers' cooperation now when it decides which ones can participate on the insurance exchanges next year. "They are simultaneously asking insurers to assume the cost and risk of non-payment, taking public credit for it, and threatening insurers with loss of business if they don't comply," said Piper, a former government and insurance industry official.
Sure enough, some cornered insurers have agreed to extend the premium payment deadline to January 10. Just last Thursday, the administration announced that 365,000 Americans had selected plans through Obamacare's various exchanges in October and November. As we've explained, that number is the product of a ludicrously loose counting system, and only a fraction of those "enrolled" have actually gained coverage by paying their first month of premiums (again, hence those HHS "suggestions"). Experts are now discussing the very real possibility of Obamacare's foibles resulting in a net loss of insured people in January. Anecdotes and whispers are being buttressed by polling:
!!! RT @ByronYork: WaPo asks, Do you have some form of health insurance? Result 82%, down five points from time of Obamacare passage.— Brian Faughnan (@BrianFaughnan) December 17, 2013
Another piece to this intricate puzzle is the percentage of young and healthy people who comprise Obamacare's risk pool. If the pool continues to skew older and sicker, the resulting expenses could compel insurers to dramatically hike premiums next year, sending even more "young invincibles" scrambling for the exits. It's the death spiral. The Washington Post's liberal Wonk Blog, which just a few weeks ago was assuring its readers that the raw enrollment totals matter much less than the demographic breakdown of who's signing up, is now trying to explain that on second thought, that data point doesn't really matter either. It's enough to make a concerned fan of wonkery quite dizzy. But since the death spiral is now being dismissed as a myth, or whatever, what do those enrollment numbers look like thus far? Barack Obama is the Big Data president -- surely his team has access to these statistics, right? Of course they do, but they're obstinately refusing to reveal them.
I'll leave you with a new polling morsel from CBS News:
Skepticism about the health care law extends to both insured and uninsured Americans, according to a CBS News/New York Times poll. Both groups disapprove of the law overall, and while the uninsured are more positive about the law’s personal impact than those with insurance, more still think the law will hurt rather than help them...more Americans continue to disapprove (50 percent) than approve (39 percent) of the 2010 health care law. The intention of the Affordable Care Act may have been to help those without insurance obtain it, but Americans without health insurance (53 percent) are just as likely as those with insurance (51 percent) to disapprove of the law. Only 38 percent of uninsured Americans approve of Obamacare; 40 percent of those with insurance approve.
The survey also showed that nearly half of currently-insured Americans believe the law won't impact them at all. How many of those people will be unhappily caught up in next year's second wave of cancellations, and/or premium hikes?