ACA Federal Marketplace updates

[ERhoosier]

Getting 30,000,000 squeezed through that time portal is going to be more than just a little interesting!

The Feds stated goal is a more modest 6-7 million enrollees this 1st year.

Obamacare's key goal threatened by delayed Web marketplaces

FWIW- the early stats on enrollment may be inaccurate as there are credible reports of multiple enrollments per person. I would wait some time before making judgements.

Health Care Policy and Marketplace Review: How Many People Have Signed Up For Health Insurance on the Federal Health Insurance Exchanges?

 

[MRG]

The Feds stated goal is a more modest 6-7 million enrollees this 1st year.

Obamacare's key goal threatened by delayed Web marketplaces

FWIW- the early stats on enrollment may be inaccurate as there are credible reports of multiple enrollments per person. I would wait some time before making [/URL]

I've been forced to open my third account to work around 'glitches'. IMHO there's no idea about volumes.

The systems issues should have been resolved week 1. I've seen web applications deliver millions of transactions per hour, not sure what 'they'
think is high volume about this site.

MRG

 

[bUU]

The systems issues should have been resolved week 1.

Ask the stockholders how much they want to invest in the quality of their product.

 

[marko]

The systems issues should have been resolved week 1. I've seen web applications deliver millions of transactions per hour, not sure what 'they'
think is high volume about this site.

MRG

In the world I came from, (an actual business that had to make money) there were things called "product readiness reviews", stress testing, pre-testing, launch reviews, robust-ness reviews and so on.

Committees would play devils advocate, have their elderly relatives try to use the product, simulate glitches/problems and anticipate "what could go wrong", even 'try to break it' reviews. If you didn't have answers to 1000 questions, YOU DIDN'T GO TO MARKET!!

Catastrophic to miss your window, but even more catastrophic to launch a product that wasn't ready for the public.

Then again, we were using our own money.

Three years to prep for this? If these clowns didn't review these things, I'm worried...if they did, I'm even more worried!

 

[bUU]

In the world I came from, (an actual business that had to make money) there were things called "product readiness reviews", stress testing, pre-testing, launch reviews, robust-ness reviews and so on.

Yup me too. I assure you that such things are rapidly being set aside. It's becoming all about time to market, damn the consequences, now.

Then again, we were using our own money.

The people with the money don't deign to sit down and write software anymore. They can buy serfs in Indonesia to do that, now.

Three years to prep for this?

Don't forget that the customers were hemming and hawing about what the website should do as late as this past summer.

 

[pb4uski]

Thanks Rbmrtn, I did not know that...and I wish I didn't to be honest with you and that is just another kick in my groin. Why can't I have one of those, that is what I want. Oh wait, I know why because the government thinks I need prenatal care and drug rehab instead of a policy that suites my personal needs...

I'm wondering if I am better off buying a catastrophic plan AND paying the penalty (if that is possible). A bronze HDHI plan would cost us ~$675/month and a catastrophic plan would be ~$425/month so we would save ~$250/month with a catastrophic plan (for a couple, no kids). If we manage our income to ~$90k (the top of the 15% tax bracket) then the penalty would be $75/month in 2014 and gradually rise to $190/month.

So I come out ahead with the catastrophic plan by $175 a month in 2014 and ultimately $60/month and I'm protected from the financial consequences of a costly illness and have access to negotiated rates, which are the main reasons that I buy health insurance to begin with.

At first glance, it doesn't seem as if the coverage of the catastrophic plan is much different from the bronze level HDHI plan.

Thoughts?

 

[MichaelB]

I'm wondering if I am better off buying a catastrophic plan AND paying the penalty (if that is possible). A bronze HDHI plan would cost us ~$675/month and a catastrophic plan would be ~$425/month so we would save ~$250/month with a catastrophic plan (for a couple, no kids). If we manage our income to ~$90k (the top of the 15% tax bracket) then the penalty would be $75/month in 2014 and gradually rise to $190/month.

So I come out ahead with the catastrophic plan by $175 a month in 2014 and ultimately $60/month and I'm protected from the financial consequences of a costly illness and have access to negotiated rates, which are the main reasons that I buy health insurance to begin with.

At first glance, it doesn't seem as if the coverage of the catastrophic plan is much different from the bronze level HDHI plan.

Thoughts?

We're part of the retired geezer class, so we don't qualify by age (must be under 30). One can qualify by hardship by meeting any of these criteria https://www.healthcare.gov/exemptions/

1. You were homeless.
2. You were evicted in the past 6 months or were facing eviction or foreclosure.
3. You received a shut-off notice from a utility company.
4. You recently experienced domestic violence.
5. You recently experienced the death of a close family member.
6. You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property.
7. You filed for bankruptcy in the last 6 months.
8. You had medical expenses you couldn’t pay in the last 24 months.
9. You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member.
10. You expect to claim a child as a tax dependent who’s been denied coverage in Medicaid and CHIP, and another person is required by court order to give medical support to the child. In this case, you do not have the pay the penalty for the child.
11. As a result of an eligibility appeals decision, you’re eligible for enrollment in a qualified health plan (QHP) through the Marketplace, lower costs on your monthly premiums, or cost-sharing reductions for a time period when you weren’t enrolled in a QHP through the Marketplace.
12. You were determined ineligible for Medicaid because your state didn’t expand eligibility for Medicaid under the Affordable Care Act.

The actuarial value of a catastrophic plan is less than 60%, so there are coverage differences. If you meet the hardship criteria you should be able to get a subsidized policy.

 

[pb4uski]

I wouldn't meet any of the hardship criteria (and am thankful for that).

But could I chose to buy the catastrophic plan and pay the penalty?

We're both healthy, so I would be willing to take the risk of the coverage difference between a bronze HDHI plan and a catastrophic plan to save $175/month or $2,100/year.

I guess I could just stop paying my electric bill until I get a disconnection notice and then pay the bill (or ask DW to beat me up ).

 

[mpeirce]

I'm wondering if I am better off buying a catastrophic plan AND paying the penalty (if that is possible). A bronze HDHI plan would cost us ~$675/month and a catastrophic plan would be ~$425/month so we would save ~$250/month with a catastrophic plan (for a couple, no kids). If we manage our income to ~$90k (the top of the 15% tax bracket) then the penalty would be $75/month in 2014 and gradually rise to $190/month.

So I come out ahead with the catastrophic plan by $175 a month in 2014 and ultimately $60/month and I'm protected from the financial consequences of a costly illness and have access to negotiated rates, which are the main reasons that I buy health insurance to begin with.

At first glance, it doesn't seem as if the coverage of the catastrophic plan is much different from the bronze level HDHI plan.

Thoughts?

I've been thinking along these lines too, but I don't think there will be any insurance companies offering non-ACA compliant plans in the future. Does anyone know if this is even legal for them to do? I'd certainly be happy to purchase that and also pay the penalty to escape the new system.

Our rates appear to be tripling for our family

We're in Ohio, I'm 52, DW is 61, DS is 18. We used to pay $365/month ($4400/year) for our plan from Anthem. The cheapest plan I can see for next year is $1205/month ($14,500/year). It has a slightly lower deductible ($10,000 rather then our current $11,500). My wife is kinda of freaking out over the extra $10,000 we'll need to pay next year.

The info above is from ehealthinsurance.com which took all of 15 minutes to deal with. Healthcare.gov on the other hand has been a huge sink of my time over the last
week. Other's have detailed the purgatory that site is, so I won't pile on, but heads should be rolling over at HSS.

When (if!) Healthcare.gov finally decides it's OK to actually offer me some plans, I doubt that it will tell me anything more than ehealthinsurance.com does, but I'm really hoping that maybe there is another provider listed that's missing from ehealthinsurance.com that might offer a slightly better rate for us.

 

[Mulligan]

I wouldn't meet any of the hardship criteria (and am thankful for that).

But could I chose to buy the catastrophic plan and pay the penalty?

We're both healthy, so I would be willing to take the risk of the coverage difference between a bronze HDHI plan and a catastrophic plan to save $175/month or $2,100/year.

I guess I could just stop paying my electric bill until I get a disconnection notice and then pay the bill (or ask DW to beat me up ).

I love the criteria needed to buy catastrophic...it makes such perfect sense to me, why didn't I think of that....let's see, I can't afford to pay for my electric bill, but I have enough cash to buy an insurance policy. Most people I know would quit paying their insurance policy before going without electricity.. Being single with income over 75k, I don't think I can make the math work for me like it would for you, otherwise I would try that option also. Concerning income, I guess other people besides posters on forum are figuring it out. A letter to editor just today in my paper wrote how Obamacare was changing their individual premium from $7900 a year with 3k deductible, to $13,700 with $6,000 deductible. The early retiree who wrote the letter said they will now be forced to move a few assets around and then will get it all for free (she was implying they were fine financially). How can the nation afford this was her final comment.

 

[pb4uski]

I love the criteria needed to buy catastrophic...it makes such perfect sense to me, why didn't I think of that....let's see, I can't afford to pay for my electric bill, but I have enough cash to buy an insurance policy. Most people I know would quit paying their insurance policy before going without electricity.. Being single with income over 75k, I don't think I can make the math work for me like it would for you, otherwise I would try that option also. Concerning income, I guess other people besides posters on forum are figuring it out. A letter to editor just today in my paper wrote how Obamacare was changing their individual premium from $7900 a year with 3k deductible, to $13,700 with $6,000 deductible. The early retiree who wrote the letter said they will now be forced to move a few assets around and then will get it all for free (she was implying they were fine financially). How can the nation afford this was her final comment.

She needs to be careful what she wishes for. If I was looking for free or close to free, I would have my income just barely enough to not qualify for Medicaid but sufficient to maximize the subsidy. I would NOT want to be on Medicaid whereas from the medical vendor perspective a person with a private policy getting the maximum subsidy is the same as a person with the same private policy with no subsidy.

 

[mpeirce]

Just as I open my big mouth here, the solution to my $10,000 "Affordable" Care Act cost increase arrives in the mail.

We received a letter from Anthem in today's mail offering us the option of renewing our existing insurance for a year with an effective date of Dec 1, 2013.

This doesn't solve the long term issue of how much more expensive ACA compliant health insurance is for us, but it does buy us a one year reprieve.

 

[samclem]

This doesn't solve the long term issue of how much more expensive ACA compliant health insurance is for us, but it does buy us a one year reprieve.

Great news. Be sure, before you leap, that you won't need a sex change operation or other essential coverage that ACA insurance would have provided.

 

[GLM]

Good for you mpeirce! I must admit I am a bit jealous.

Hoping Golden Rule (AKA United Healthcare ) would send us a letter like yours . As it is our policy is up Feb 1 2014 . About a month ago they sent us a "good news "you can keep your coverage with us next year - for a price yet to be determined. So I am doubtful I will be hearing from them with an offer like yours . We might go for underwriting and switching before the end of the year if we have to . Just don't want to !

 

[sheehs1]

Just as I open my big mouth here, the solution to my $10,000 "Affordable" Care Act cost increase arrives in the mail.

We received a letter from Anthem in today's mail offering us the option of renewing our existing insurance for a year with an effective date of Dec 1, 2013.

This doesn't solve the long term issue of how much more expensive ACA compliant health insurance is for us, but it does buy us a one year reprieve.

I received this letter for my September1, 2013 to September1, 2014 policy from Anthem BC/BS back in July/August or so. I was good to go until next September 1, 2014.. Then I started thinking that I should see if I can get it to be a Dec 1 to Dec 1 policy renewal. Lo and behold, I received a letter last week offering me just that for an extra $20/mth charge. Only a 16% increase from prior year (totaling both renewal offers). It's a "little" reprieve I'm grateful to have too mpierce. My husband however, received a 100% increase with his (different state right across the line in Va. into N.C.- he works in N.C.).

Since we are 58 , do not have access to employer sponsored plans and do not qualify for a subsidy, our premium costs will exceed the $10,000 mark this year because of my husbands' increases, even with what Anthem did for my policy. But otherwise, it would have exceeded the $15,000 mark.

 

[sheehs1]

In the world I came from, (an actual business that had to make money) there were things called "product readiness reviews", stress testing, pre-testing, launch reviews, robust-ness reviews and so on.

Committees would play devils advocate, have their elderly relatives try to use the product, simulate glitches/problems and anticipate "what could go wrong", even 'try to break it' reviews. If you didn't have answers to 1000 questions, YOU DIDN'T GO TO MARKET!!

Catastrophic to miss your window, but even more catastrophic to launch a product that wasn't ready for the public.

Then again, we were using our own money.

Three years to prep for this? If these clowns didn't review these things, I'm worried...if they did, I'm even more worried!

+1

 

[harley]

In the world I came from, (an actual business that had to make money) there were things called "product readiness reviews", stress testing, pre-testing, launch reviews, robust-ness reviews and so on.

Committees would play devils advocate, have their elderly relatives try to use the product, simulate glitches/problems and anticipate "what could go wrong", even 'try to break it' reviews. If you didn't have answers to 1000 questions, YOU DIDN'T GO TO MARKET!!

Catastrophic to miss your window, but even more catastrophic to launch a product that wasn't ready for the public.

Then again, we were using our own money.

Three years to prep for this? If these clowns didn't review these things, I'm worried...if they did, I'm even more worried!

From some of what I've read, there wasn't a single complete run through of the user experience before it went live. Gov't can get away with a lot that private industry would be bankrupted by.

Obamacare Crashes Months in Coming Not Easily Repaired - Businessweek

HHS was making changes to the exchanges hours before they were scheduled to go live, Sanjay Singh, chief executive officer at software contractor hCentive Inc., said in a Sept. 30 phone interview.
Singh, whose company did exchange work for an insurer working with the federal site, said at the time that his employees were rushing to accommodate “a late-night patch” that the department had just added.
“There was not enough time to do end-to-end testing,” he said. “The system keeps changing, so how do you run the tests?”
Singh nonetheless said on Sept. 30 that he thought the exchanges were ready to open, with basic functions available. Insurers and government were counting on low volume initially to give them more time to complete development, he said.

I wonder how that's working out for them?

 

[killingme]

The government wants us to trust them with administering our health care when they can't even put up a web site after three years and hundreds of millions of dollars.

Worse still is this bit of news Thousands Of Consumers Get Insurance Cancellation Notices Due To Health Law Changes - Kaiser Health News

Also anyone see Sibelius interview with Sanjay Gupta:

"I think that we talked about having testing going forward, and if we had an ideal situation and could have built a product in, you know, a five-year period of time, we probably would have taken five years."

As an ex IT programmer/manager that had me scratching my head...there are milestones which have to be met not kind of sort of but go no go dates.

This though was my favorite exchange :

SEBELIUS: We've asked all of our contractors to look at the their teams on the ground and bring in their absolute A team, and I'm confident that that is happening every day.

GUPTA: The contractor didn't do such a great job so far.

SEBELIUS: Well, I ..

GUPTA: And why didn't they bring their A team in in the first place?

SEBELIUS: I can't tell you why they..

GUPTA: Why are we saying in three weeks now, bring your A team into this whole equation?

SEBELIUS: We have -- hope that they had their A team on the table, but I -- I am talking to CEOs and urging them to make sure that we have the talent that they have available.

Really sad from every angle.

 

[NW-Bound]

From some of what I've read, there wasn't a single complete run through of the user experience before it went live. Gov't can get away with a lot that private industry would be bankrupted by...

Testing? Well, there was testing according to a Washington Post article.

Days before the launch of President Obama’s online health *insurance marketplace, government officials and contractors tested a key part of the Web site to see whether it could handle tens of thousands of consumers at the same time. It crashed after a simulation in which just a few hundred people tried to log on simultaneously.

Despite the failed test, federal health officials plowed ahead.​

See: Health insurance exchange launched despite signs of serious problems - The Washington Post

 

[samclem]

I wonder how that's working out for them?

Apparently it is working just fine so far. No individual consequences for anyone yet. Maybe some uncomfortable interviews, but that just provides a platform to tell everyone just how hard all this is. My bosses were always full of sympathetic words when I did that.

 

[M Paquette]

The government wants us to trust them with administering our health care when they can't even put up a web site after three years and hundreds of millions of dollars.
...
GUPTA: Why are we saying in three weeks now, bring your A team into this whole equation? SEBELIUS: We have -- hope that they had their A team on the table, but I -- I am talking to CEOs and urging them to make sure that we have the talent that they have available. Really sad from every angle.

Good thing it will actually be medical organizations reimbursed by private insurers administering our health care, then, isn't it? The government is organizing (for varying values of 'organize') one purchasing mechanism for private medical insurance, and setting minimum performance requirements for compliant private medical insurance.

As far as the web site goes, I eagerly await the solution to a set of complex technical issues. I am quite certain that some combination of media newsreaders and bureaucrats who have their e-mail printed out so they can read will eventually be able to identify and specify corrective measures for design of the web servers, back-end database systems and authentication servers involved. I do suspect that they may need to bring Congress into the loop at some point, as I know of no better authority on database throughput optimization than certain select Congressmen. When TPS is on the line, they are your go-to people.

 

[MRG]

...............................................

As far as the web site goes, I eagerly await the solution to a set of complex technical issues. I am quite certain that some combination of media newsreaders and bureaucrats who have their e-mail printed out so they can read will eventually be able to identify and specify corrective measures for design of the web servers, back-end database systems and authentication servers involved. I do suspect that they may need to bring Congress into the loop at some point, as I know of no better authority on database throughput optimization than certain select Congressmen. When TPS is on the line, they are your go-to people.

I would agree 100%. Every time Megacorp had serious IT performance issues, Congress was the absolute authority. Who better to understand queueing!

MRG

 

[NW-Bound]

Congress [-]may[/-] does not know much about Web software, but it is good at calling the culprits up to congressional hearings.

In the past, when I was bored, I would watch a few of these sessions on C-SPAN, and though some of these congressmen look like goons (from both parties, I should add), the thought that they would make some of the responsible officials squirm in their seat might prevent others from causing similar future debacles.

Or am I too optimistic?

 

[meierlde]

Here is an interesting link to an article that says most large software projects fail:
Healthcare.gov website 'didn't have a chance in hell' - Computerworld
" A majority of large IT projects fail to meet deadlines, are over budget and don't make their users happy. Such is the case with Healthcare.gov."
There have been many books detailing these issues with big projects in the past. The article points out that big rollouts nearly always fail as well. The folks developing the site never took the message of the mythical man month to heart. (Published in 1975). Among its lessons is that adding more bodies to a project just delays it. We have not yet learned how to develop large software projects in general either in government or industry.
Issues range from how to verify identity, perhaps they should have required id scans from day 1, for example, not go the questions route.

 

[NoMoreJob]

Here is an interesting link to an article that says most large software projects fail:
Healthcare.gov website 'didn't have a chance in hell' - Computerworld
" A majority of large IT projects fail to meet deadlines, are over budget and don't make their users happy. Such is the case with Healthcare.gov."
There have been many books detailing these issues with big projects in the past. The article points out that big rollouts nearly always fail as well. The folks developing the site never took the message of the mythical man month to heart. (Published in 1975). Among its lessons is that adding more bodies to a project just delays it. We have not yet learned how to develop large software projects in general either in government or industry.
Issues range from how to verify identity, perhaps they should have required id scans from day 1, for example, not go the questions route.

How true! The company I retired from as since spent well over $100 million on a custom ERP system (with a preeminent software vendor) and it has failed. They recently cancelled the roll out and will be going back to industry specific software vendors. What a shame.