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ACA Federal Marketplace updates
Old 06-18-2013, 08:30 AM   #1
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ACA Federal Marketplace updates

For those of us living in states who are defaulting to federally-run HI exchanges ("Marketplace"), the 'official' HHS website offers little detail & is significantly outdated (as of today- last update was Mar 1st!). Link here

Marketplace is supposed to be functioning (accepting applications) in just over 3mo (Oct 1st). Anyone seen further info on progress of the HHS-run state Marketplace(s)?
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Old 06-18-2013, 11:11 AM   #2
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Not much, but there is an article that summarizes Blue Cross/Blue Shield offerings for the Georgia marketplace that will be run by the Feds.

The insurance exchange | www.ajc.com
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Old 06-18-2013, 11:59 AM   #3
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There are a couple of things on the CMS site. Healthcare.gov is supposed be overhauled, relaunched this month. This is supposed to be where you go to complete the enrollment online.

http://www.cms.gov/CCIIO/Resources/F...e-timeline.pdf

http://www.cms.gov/CCIIO/Resources/F...-narrative.pdf
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Old 06-18-2013, 01:08 PM   #4
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I've relayed this a few times in other threads: My wife works on a health exchange project (though she's actually leaving that project in a couple of weeks) and what she's heard is that some of the health exchange projects have been so badly underfunded by Congress (and I'm sure the sequester didn't help) that everything is going to run behind schedule and there's going to be a lot less customer service than there would have been had funding been adequate.

Penny-wise, pound-foolish!
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Old 06-18-2013, 01:48 PM   #5
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Thanks for the additional links. It was my understanding that healthcare.gov was scheduled to be updated by June 1st. Several other links (inc some CMS) still take you to the 'old' site.

It appears that next month is the deadline (loose term these days I know) for approval of QHP's for Marketplace (Fed Exchange), yet I still cannot find which companies (if any??)actually submitted plans for approval in various states (inc mine). From the CMS timeline, those plans were to have been submitted for consideration in April.
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Old 06-18-2013, 02:28 PM   #6
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Originally Posted by ERhoosier View Post
For those of us living in states who are defaulting to federally-run HI exchanges ("Marketplace"), the 'official' HHS website offers little detail & is significantly outdated (as of today- last update was Mar 1st!). Link here

Marketplace is supposed to be functioning (accepting applications) in just over 3mo (Oct 1st). Anyone seen further info on progress of the HHS-run state Marketplace(s)?
Actually, there is still a lot of activity and fresh announcements daily, most of which are interesting us but do not affect us. The thing we are all waiting for, plans, prices and network for our regiojs, probably won't hit the airwaves until September. Between now and then much will be written and lots of hair will catch fire on TV, but little substance, if any.
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Old 06-18-2013, 06:55 PM   #7
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Agree there's lots from the various pundits & talking heads.
Guess I don't consider that useful "info", just chatter
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Old 06-19-2013, 07:20 AM   #8
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Here's an example of the " activity and fresh announcements" I was referring to

Quote:
The government’s decision to mandate a menu of payment options including cashier’s checks, money orders and re-loadable pre-paid debit cards comes amid increasing pressure from consumer advocates and business groups that are concerned low-income working families would be required to purchase health coverage under the Affordable Care Act but would have no way to pay their monthly bill.
Feds Pitch Broad Payment Options For Obamacare Customers – Capsules - The KHN Blog
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Old 06-19-2013, 08:41 AM   #9
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In a report to be released today, the GAO describes the progress of local and state officials in setting up the exchanges. From the WSJ:

Quote:
Government officials have missed several deadlines in setting up new health-insurance exchanges for small businesses and consumers—a key part of the federal health overhaul—and there is a risk they won't be ready to open on time in October, Congress's watchdog arm said.
For enrollments to start in October, the info should have been in the hands of consumers already. This ain't like choosing a toaster oven.
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Old 06-19-2013, 08:57 AM   #10
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I cannot get into details, but let me just say that recent info I have overheard gives me further reason to believe the watchdog's report.

I am beginning to think we're going to see what will become the next "textbook case" of the damaging impact of under-funding.
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Old 06-19-2013, 08:58 AM   #11
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Originally Posted by samclem View Post
In a report to be released today, the GAO describes the progress of local and state officials in setting up the exchanges. From the WSJ:

For enrollments to start in October, the info should have been in the hands of consumers already. This ain't like choosing a toaster oven.
It pains me to say this Sam, but I think as a whole you give the masses too much credit... Almost half of Americans still don't even know the Act exists as law.
Three quarters of the other half probably won't understand what they signed up for until after they need the benefits, anyways.
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Old 06-19-2013, 09:57 AM   #12
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It pains me to say this Sam, but I think as a whole you give the masses too much credit... Almost half of Americans still don't even know the Act exists as law.
Three quarters of the other half probably won't understand what they signed up for until after they need the benefits, anyways.
And I'm willing to wager that half believe it will all be free. "...what do you mean, I have to PAY for this?!"
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Old 06-19-2013, 10:12 AM   #13
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I've relayed this a few times in other threads: My wife works on a health exchange project (though she's actually leaving that project in a couple of weeks) and what she's heard is that some of the health exchange projects have been so badly underfunded by Congress (and I'm sure the sequester didn't help) that everything is going to run behind schedule and there's going to be a lot less customer service than there would have been had funding been adequate.

Penny-wise, pound-foolish!
So, you're saying that this program hasn't even been launched and there's not enough money to run it properly? That can't be good.
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Old 06-19-2013, 10:22 AM   #14
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Many of various programs were never properly funded.
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Old 06-19-2013, 11:29 AM   #15
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Many of various programs were never properly funded.
Maybe the writers of the law assumed that the various insurers would be competing for customers and would be active in setting up the exchanges? And educating(selling) to the masses?
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Old 06-19-2013, 11:41 AM   #16
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Rather, I think that they weren't planning on states dragging their feet dragging their feet dragging their feet so badly, mostly for partisan posturing, thereby forcing the exchanges to be developed in unnecessarily short time-frames, concentrating costs within a much shorter window, and introducing all manner of inefficiencies in that wouldn't have been there if the development projects were undertaken from the earliest point in time they could have been.

Imagine a team of eight people doing something over four months that was supposed to have been done by two people spread over a year. Back when I was in software quality management, Frederick Brooks wrote excellent essays outlining the myth that throwing more people at a project could get it done just as efficiently in less time. The reality is that there is overhead associated with managing large groups of people that make large groups far less efficient, and therefore costly. I can also attest to the fact that it incurs more churn in the resources for the project, introducing even more inefficiency.
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Old 06-19-2013, 12:02 PM   #17
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Rather, I think that they weren't planning on states dragging their feet dragging their feet dragging their feet so badly, mostly for partisan posturing, thereby forcing the exchanges to be developed in unnecessarily short time-frames, concentrating costs within a much shorter window, and introducing all manner of inefficiencies in that wouldn't have been there if the development projects were undertaken from the earliest point in time they could have been.
The law is what it is. The provision for Federal exchanges in lieu of those run by the states was explicitly built into the law.
There is one part of the whole process that seems well ahead schedule: assigning blame for failure to get things done. Please, let's just see how well the executive branch does its job (executing the legislation written and passed by Congress) before we jump to any conclusions. Maybe everything will go great. Yes, we know that the competitive private insurance offerings won't happen as promised (one year delay) and that the whole CLASS ACT LTC insurance plan that was part of the legislation has now been abandoned (in accordance with provisions in the legislation itself: HHS found it couldn't be made to work). It's been a long and tortured road, a lot is riding on this, and those who favored this solution now have a chance to show us their vision. With all this pre-planning, deliberation, and the best minds in the federal government at work, we owe them our patience. They surely know that excuses, finger-pointing, and whining will not win any converts--they (and all of us) need this to be successful. It's the opportunity of a lifetime, according to many people.
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Old 06-19-2013, 12:21 PM   #18
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The law is what it is.
However politics is still politics regardless of that.

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The provision for Federal exchanges in lieu of those run by the states was explicitly built into the law.
And many states waited and waited and waited to decide, and some even switched their answer yet-even-later. Again: politics is politics. Many states were hanging their hats on the SCOTUS overturning ACA, and therefore they refused to incur costs that they felt that SCOTUS would eventually relieve them of having to incur. They took a gamble and their citizens lost.
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Old 06-19-2013, 12:35 PM   #19
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Lets try to keep some perspective. The GAO report has no new news for us, we have been discussing these issues for months. It is a progress or readiness report on all 51 exchanges, not just the FFE's, and also covers SHOPs, even though a key component of their rollout has been delayed to 2015.

The GAO report can be found here U.S. GAO - Patient Protection and Affordable Care Act: Status of Federal and State Efforts to Establish Health Insurance Exchanges for Small Businesses
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Old 06-19-2013, 12:42 PM   #20
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Originally Posted by samclem
The law is what it is. The provision for Federal exchanges in lieu of those run by the states was explicitly built into the law.
There is one part of the whole process that seems well ahead schedule: assigning blame for failure to get things done. Please, let's just see how well the executive branch does its job (executing the legislation written and passed by Congress) before we jump to any conclusions. Maybe everything will go great. Yes, we know that the competitive private insurance offerings won't happen as promised (one year delay) and that the whole CLASS ACT LTC insurance plan that was part of the legislation has now been abandoned (in accordance with provisions in the legislation itself: HHS found it couldn't be made to work). It's been a long and tortured road, a lot is riding on this, and those who favored this solution now have a chance to show us their vision. With all this pre-planning, deliberation, and the best minds in the federal government at work, we owe them our patience. They surely know that excuses, finger-pointing, and whining will not win any converts--they (and all of us) need this to be successful. It's the opportunity of a lifetime, according to many people.
Yes, patience. It's highly unlikely that our healthcare system will look anything like what was planned in the law 20 years from now. I see costs being more concentrated with improved efficiency. Many docs are closing up shop to join hospitals so they are saving facility expense, impact fees, property taxes, employee expenses, supplies, etc.
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