Good Bye Sebelius, Don't Let The Door Hit You In The Butt. You Won't Be Missed!

HHS Secretary Sebelius resigning on heels of ObamaCare rollout

Published April 10, 2014

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Health and Human Services Secretary Kathleen Sebelius, who was the face of the president's health care law, is resigning from the Obama administration -- a decision that closes one of the rockiest tenures in Obama's Cabinet. 

Sebelius leaves the administration after the tumultuous launch of the Affordable Care Act exchanges last fall. Despite calls for her ouster from Republicans at the time, she stayed on until the enrollment period ended at the end of March. 

A White House official said President Obama will formally make the announcement on Friday, and nominate White House budget office director Sylvia Matthews Burwell to replace the outgoing secretary. The Senate would have to confirm Burwell to the position. 

The administration has since touted the surge in enrollment in the last few weeks, with Sebelius saying Thursday that 7.5 million American have now signed up for coverage under the law. 

But the technical difficulties surrounding the launch, as well as ongoing concerns about the implementation of the law, hung over her. She leaves just one week after the enrollment period ended, and as a tough midterm election cycle expected to focus heavily on ObamaCare begins. 

Republicans quickly made clear that Sebelius' departure will not temper their criticisms of ObamaCare. 

"Secretary Sebelius oversaw a disastrous rollout of ObamaCare, but anyone can see that there are more problems on the way," Republican National Committee Chairman Reince Priebus said. "The next HHS Secretary will inherit a mess -- Americans facing rising costs, families losing their doctors, and an economy weighed down by intrusive regulations. No matter who is in charge of HHS, ObamaCare will continue to be a disaster and will continue to hurt hardworking Americans." 

Senate Finance Committee Ranking Member Orrin Hatch said Sebelius "had one of the toughest jobs in Washington" because she had to implement the law, which he said is "flawed" and continues to fall short. 

"While we haven’t always agreed, Secretary Sebelius did the best she could during the tumultuous and volatile rollout of the law," Hatch, R-Utah, said in a statement. 

House Minority Leader Nancy Pelosi praised Sebelius' leadership during the rollout, saying she had "been forceful, effective, and essential."

"Her legacy will be found in the 7.5 million Americans signed up on the marketplaces so far, the 3.1 million people covered on their parents' plans, and the millions more gaining coverage through the expansion of Medicaid," Pelosi, D-Calif., said. 

The White House official said Sebelius notified Obama of her decision to leave in early March. 

"At that time, Secretary Sebelius told the president that she felt confident in the trajectory for enrollment and implementation of the Affordable Care Act, and that she believed that once open enrollment ended it would be the right time to transition the department to new leadership," the official said, adding the president "is deeply grateful for her service." 

West Virginia Democratic Sen. Joe Manchin praised the nomination of Burwell, a fellow West Virginia native, in a statement Thursday.

"I am confident that her leadership will ensure that we enact commonsense fixes to the Affordable Care Act to help improve the lives of millions of Americans," Manchin said. 

Sebelius, having served five years with the president, was among the longest-serving Cabinet secretaries in the administration. 

But Sebelius' relationship with the White House frayed during last fall's rollout of the insurance exchanges that are at the center of the sweeping overhaul. The president and his top advisers said they were frustrated by what they considered to be a lack of information from HHS over the extent of the website troubles. 

The White House sent management expert Jeffrey Zients to oversee a rescue operation that turned things around by the end of November. 

The Associated Press contributed to this report. 

ObamaCrapCare Site May Cause Younger Americans To Avoid It And Pay Fines. If So, Pricing Structure In Future Years Will Be Driven Higher. So Much For Lower Premiums For Health Insurance As Were Promised By ObamaLiar!

Overhaul website problems may trigger price hikes

Thursday, December 19th 2013, 9:48 am

by tom murphy ap business writer

Problems with the government's main health care overhaul website carry a bigger risk than frequent crashes: Higher prices could follow for many Americans if technical troubles scare off young people.

The government has touted recent improvements to HeathCare.gov, which millions of Americans are expected to use to sign up for coverage. But enrollment still lags far behind projections, and that has triggered worries that legions of potential customers in their 20s and 30s might not sign up. If that happens — and older, sicker people continue to register in larger numbers — insurers might have to raise future prices to address the imbalance.

Although the chance of an age imbalance has loomed since the health care overhaul became law in 2009, it has become more worrisome since the website made its glitch-plagued debut in October.

Aetna Chairman and CEO Mark Bertolini said then that it was "incredibly important" to get the site running properly because "younger, healthier people aren't going to give them more than one shot."

Americans have until Monday to sign up for coverage that starts Jan. 1, and many are expected to wait until the last minute. They have until March 31 to find coverage and avoid a penalty for being uninsured next year.

Insurers need younger, healthier people to essentially subsidize the coverage they give older customers due to limits placed on the insurers by the overhaul. Americans in their 60s generally use about $5 in health care for every $1 used by those in their 20s, but the law limits insurers to collecting $3 in premiums from that 60-year-old for every $1 they collect from a 20-something.

On average, that means an older customer's premiums won't fully cover their medical expenses, while the opposite happens for younger customers.

Insurers factored that in when they began planning for the overhaul. They set rates based in part on the number of customers they expected to enroll who were above and below age 45. Even a small shift in the balance between those two groups can hurt an insurer if it comes after the company has set prices.

For every 10 percent decline in the younger population, an insurer's cost for care could rise by 1 percent, said Dave Axene, a fellow of the Society of Actuaries who helped insurers set prices for the overhaul's insurance exchanges in several states. If the older population also winds up bigger than expected, then costs could rise even more, depending on how other variables play out.

"Just a little shift in this ... all of a sudden you're caught with a serious problem," Axene said, noting the hikes will eat away at profitability, and many insurers were only expecting profit margins of 2 to 4 percent from business they get on the exchanges.

Insurers who wind up with a smaller profit or older-than-expected population in 2014 may be compelled to raise rates when they set prices for 2015. "These companies are not participating in these markets out of benevolence," said Jennifer Lynch, an analyst who follows health insurers for BMO Capital Markets.

Whether premiums change due to an age imbalance remains to be seen, in part because people are still signing up for coverage.

Insurers and the state-based insurance exchanges that are central to covering uninsured people under the law have stepped up their marketing to young adults as enrollment deadlines draw near. California's state exchange, for instance, is encouraging people to pledge to help get a young adult covered.

Young, healthy customers have some strong incentives to enroll, starting with tax penalties for those who remain uninsured. They also could qualify for income-based tax credits or subsidies that help them pay for coverage. "The health care law is making health insurance more affordable for young adults," said Joanne Peters, a spokeswoman for the U.S. Department of Health and Human Services.

If younger adults stay away and enrollment remains biased toward the older adults, insures may only hike future premiums by a couple percentage points, said Gary Claxton, a vice president with the Kaiser Family Foundation, a nonprofit that studies health care issues. He noted that companies can still vary their prices based on age, just not as much as they used to.

But insurers note that such an increase would be added to other cost hikes due to things like the rising cost of care.

The hit an insurer takes and the impact on future prices also may depend on how it approached the exchanges. Companies that saw them as a "land grab" for new customers and entered with low prices to attract as many people as possible may suffer a bigger blow than those that acted more conservatively, Lynch said.

The overhaul builds in safeguards to protect insurers during their first few years on the exchanges, when the new system is taking shape. A reinsurance fund will help insurers pay high claims, and another provision will help make up some of the difference in markets where an insurer's expenses exceed the premiums it collects.

Still, Axene and others say these programs will ease but not erase the impact of an insured population that skews older than an insurer expected.

"Those are important programs," said Robert Zirkelbach, a spokesman for the industry trade group America's Health Insurance Plans. "But that doesn't change the fact that if the young, healthy people chose not to participate, there still will be an impact on premiums."

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Troubles For Agents Trying To Help Clients, Cannot Due To Website Problems

Insurance agents feeling left out of "Obamacare"

 

By KELLI KENNEDY4 hours ago

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MIAMI (AP) — When insurance agent Kelly Fristoe recently spent 30 minutes helping a client pick a mid-level health plan and the federal marketplace website froze, he called the government's hotline and tried to finish the application. But the operator refused to credit Fristoe as an agent on the application, meaning he wouldn't get the commission or be listed as the follow-up contact if his client needed help again later.

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The Wichita Falls, Texas, insurance agent is one of many brokers around the country finding frustration as they try to help customers navigate the Affordable Care Act's marketplaces while earning the commissions they've long built their businesses around. Some insurers and insurance agents are calling on President Barack Obama's administration to allow them to bypass healthcare.gov and enroll consumers directly amid growing complaints about problems with enrollment information generated from the website.

The so-called 'back-end' problems could mean that consumers who think they've successfully signed up for a health plan, may find themselves unable to access their coverage come January. The problems include enrollment information that's rendered practically useless by errors, duplication or garbles. Efforts to fix the issues are underway.

Nearly 70,000 agents and brokers have been certified nationwide to sell health insurance on the federal exchange. Many say they could be the troubled health law's best ambassadors with the potential to boost lackluster enrollment figures — only about 27,000 had enrolled via the federal website nationwide in the first month. But instead, many agents said they're continually met by obstacles.

"You look at this dismal number they have of how many people have enrolled on healthcare.gov," said Fristoe. "If they would just relax and loosen up, because me and all of my associates across this nation want to help these consumers get enrolled into the market."

Federal health officials announced on Nov. 22 that they'd fixed some portions of the website to allow more insurers and insurance agents to enroll consumers directly. The feds are asking roughly 16 insurers, agents and brokers in Florida, Texas and Ohio to test it out and give detailed feedback about the fixes, hoping to expand it to other states in the coming weeks. Health officials have been vague about the scope of the botched applications insurers are receiving and what steps they're taking to fix the problems. One bug related to Social Security numbers, which federal health officials said accounted for more than 80 percent of insurers' problems, was fixed last weekend.

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Ken Statz, a health insurance broker, and president of Statz and Associates General Agency, is shown …

But the problems have persisted, prompting the head of the National Association of Health Underwriters to write the president Tuesday, urging him to make additional fixes a priority, saying agents have a significant backlog of clients with incomplete applications.

"We want to make it clear that a number of back-end technical obstacles still exist for health insurance agents and brokers trying to actively support the federal marketplace," said CEO Janet Trautwein.

Insurance industry executives also met with Obama last month and encouraged him to let them take a more active role in enrolling consumers in the 36 states relying on the federal website. Brokers' frustrations with the website are amplified by the pressure they face to add customers to offset reductions in their commissions under the law.

Among the complaints, agents say the website isn't always crediting brokers when they help enroll consumers — meaning they're losing out on commissions. Once an application is started, consumers can't go back in and add a broker's name if they help midway through the process. Federal health officials said there are 975,000 customers who have started an application but not selected a plan.

Agents say they're also still waiting on the federal government to add a promised feature on the website that would easily connect consumers with local insurance brokers.

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Ken Statz, a health insurance broker, and president of Statz and Associates General Agency, is shown …

Insurers and insurance agents are allowed to sign consumers up for health plans through a "direct enrollment" process. Even though the process may start on the insurer's website, at some point it's redirected to the technology-plagued healthcare.gov website to determine if customers are eligible for subsidies, and then ideally transferred back to the insurer's site. But various points in the process have been mired in glitches. Federal health officials said they've fixed some of the problems, but skeptics fear the improvements still won't allow for a smooth shopping experience and are pushing for a way to bypass the website.

Brokers face similar problems in some of the states that are running their own exchanges, such as Oregon. It's easy for insurers to enroll customers who want a health plan and don't qualify for a subsidy. The trouble comes when insurers and agents need to sync to federal data hubs to verify income, citizenship and other personal information. Democratic Florida state Rep. Richard Stark, who is also an insurance agent, said many of his clients have received inaccurate subsidy estimates from the federal government for clients. For example, a client with twin children was told one is eligible for a subsidy, but not the other.

Like others stymied by website malfunctions, Ken Statz and other agents at his firm in Brecksville, Ohio, filled out paper applications and mailed them, but it was taking time to hear back from the federal government about whether clients are eligible for a subsidy. Then they tried to get creative, planning to fill out the applications with clients during the day and hire someone to input the information into healthcare.gov during off-hours after 11 p.m. But that didn't work either because the site asks personal identification questions that only the user would know.

"We don't have a clear pathway to get them enrolled into the plan. (The federal government) hasn't given us the ability to do that. They're kind of missing the mark on this. They need to realize that we are the best pathway," he said.

Democratic U.S. Sen. Jeanne Shaheen of New Hampshire, recently sent a letter to federal health officials urging them to fix the barriers hampering brokers and possibly create a way to bypass the healthcare.gov site. She suggested a dedicated call-center line or mailing locations for paper applications.

Stark has noticed a chilly reception toward his industry when he's attended local outreach organizations on the health overhaul.

"They basically didn't want to work with insurance agents because they felt agents were going to steer a customer toward (a plan) where they think they will make the most money," said Stark. "If I steer someone incorrectly to a plan that doesn't meet their needs, there's a lot of hell to pay as an agent."

Navigators will likely be gone when enrollment ends in March. That's why Statz said it's important for federal health officials to empower agents to "help people now, but help them make decisions on their accounts moving forward."

Will ObamaCrapCare Work Right Next Week Or Will It Be Another Failure? We Are Predicting The Latter

Obamacare Woes Continue as Weekend Deadline Looms

Friday, 29 Nov 2013 08:12 AM

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President Barack Obama's healthcare law is facing its biggest test this weekend since its disastrous October 1 launch, as Americans find out whether the administration has met a self-imposed deadline to fix its insurance shopping website.

Another major outage of glitch-ridden HealthCare.gov could spell more political trouble for the president, who was forced to apologize for the botched rollout and admit burdening Democratic Party allies in their bids for re-election to Congress in 2014.
 

If the website does not work on Saturday's deadline, that could turn off millions of uninsured Americans, especially young and healthy consumers whose participation in the new insurance exchanges are critical for keeping costs in check.
 

Democratic leaders in Congress might also find it necessary to extend open enrollment beyond the March 31 deadline and delay fines mandated by the law for people who do not have insurance by that date - a prospect that insurers warn would destabilize the market.
 

Obama officials are confident that this second coming of HealthCare.gov will be much improved from the October 1 debut. Millions of people looked into the website in its first month, but only about 27,000 cleared the gauntlet of technical obstacles to sign up for insurance.
 

The portal is the gateway for health insurance plans in 36 states under the Patient Protection and Affordable Care Act, commonly called Obamacare, which was passed in 2010. It is intended to move the United States closer to universal care by subsidizing insurance sold by the private sector for less affluent families.
 

Officials have said that by Saturday the website will be able to load quickly and work accurately for at least 80 percent of users. They have said it will be able to handle 50,000 simultaneous visitors, for a daily total of about 800,000, twice the capacity seen even on Wednesday before a final flurry of hardware and software fixes over the Thanksgiving holiday.
 

And officials have warned that the website will still suffer some delays and outages in the weeks to come. To help consumers left hanging when traffic exceeds capacity, they have created a new "queuing system" to tell consumers when to come back.
 

Short of a major outage, it may be difficult to immediately measure the administration's success because officials only release enrollment figures once a month. That will make anecdotes from consumers and enrollment groups all the more important.
 

"Even if it's working well, people will encounter problems," said Mark Hall, a Wake Forest University professor of law and public health. "You hope there's more good stories than bad stories."

 

The abysmal launch of Obamacare has hurt the president and congressional Democrats, with Obama's approval ratings dipping to the lowest point of his presidency. A Reuters/Ipsos poll this week showed 56 percent of Americans disapprove of how Obama is doing his job, while 38 percent approve.
 

If the situation worsens, Democrats could risk losing control of the Senate in 2014, when 20 Democratic senators face reelection, and many are in tight races. Republicans have called for the law to be scrapped because they consider it an unwarranted expansion of the federal government and believe it will push up insurance costs.
 

Obama's chief of staff Denis McDonough now meets every other week with Democratic senators running in 2014 to reassure them Obamacare is on the mend, a White House official said.
 

The administration has prioritized fixes that consumers see, leaving other parts of the system for a later date. On Wednesday, officials said they would delay online enrollment for small businesses for a year.
 

Obama issued a rare apology earlier this month for mishaps with the rollout.

But as November 30 has drawn closer, Obama has become more assertive. "The website is continually working better, so check it out," Obama said in a speech on Tuesday.
 

Kathleen Sebelius, secretary of Health and Human Services, told a group of state and local officials on a call this week that "we are definitely on track to have a significantly different user experience by the end of this month."
 

Insurance companies have also noticed the difference.
 

"I don't expect this to be an overnight change because it appears they have been making improvements as they go," said J. Mario Molina, chief executive of Molina Healthcare Inc, a company offering plans in nine states, including California.
 

"It is easier to navigate. It's working better. It's faster," Molina said.

Even if the website does stand up to increased traffic, there are issues on the system's "back end" that need to be addressed.
 

As much as 30 to 40 percent of the site still needs to be built to handle payments and federal subsidies, a federal official told lawmakers earlier this month.
 

And the administration is planning a "soft launch" with small volumes for long-delayed Spanish language enrollment tools for more than 10 million uninsured Latino Americans.
 

Once the website is fixed, the White House also faces the challenge of raising awareness about the law. More than 35 percent of people without insurance say they have heard nothing about the new marketplace, according to polling by the Kaiser Family Foundation.

© 2013 Thomson/Reuters. All rights reserved.

New Washington Game: The Lie Of The Day. Now We Find Out That Liar In Chief Obama Was Briefed On Website Problems. Are You As Sick Of This Man As We Are?

Obama Was Briefed Last Spring on Obamacare Problems

Wednesday, 20 Nov 2013 05:58 AM

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President Barack Obama, who has portrayed himself as surprised by technical problems with the government's new healthcare website, was briefed earlier this year on a consultant's report that warned of possible widespread site failures, the White House said on Tuesday.There have been weeks of questions about whether Obama understood the depth of the site's problems and let it open anyway, or simply "did not have enough awareness" of them, as the president stated at a Nov. 14 news conference.
While the government says it is improving the portal's performance every day, security experts told a Republican sponsored congressional hearing Tuesday that in their opinions, it is still not sufficiently secure to be used confidently by consumers.

Even as the administration fended off criticism of the so-called "front end" of the system, officials revealed Tuesday that they had not completed development of the "back end," the financial management component needed to finalize federal subsidies for consumers who buy health plans.
A spokeswoman for the Centers for Medicare and Medicaid Services, the lead agency for the website, said it would not be completed until mid-January, weeks after the first enrollees are scheduled to begin receiving benefits under the Affordable Care Act, passed in 2010 as Obama's signature domestic policy.
The law, commonly called Obamacare, mandated that Americans have health insurance and created new online marketplaces to buy and sell policies.
Meanwhile, Obama's approval rating dipped to a low of 37 percent in a Reuters/Ipsos poll.
Bits and pieces have leaked out over the past few weeks about flaws in the site's development process. Monday night, however, Republican lawmakers who oppose Obamacare released a report and recommendations prepared by McKinsey & Co. at the government's request in March 2013.
It cited, among other things, a rushed process that left insufficient time for testing and a focus by officials on getting people enrolled versus making the system work right.
The consequence, it said, could be system failures that could make enrollment slow or at times impossible for consumers, which is exactly what happened.
Questioned about the McKinsey study, White House spokesman Jay Carney said the president had been briefed on it in the spring.
But he said the president's familiarity with the report and recommendations did not contradict previous statements from the White House that described Obama as surprised by the scope of flaws in HealthCare.gov.
Obama was told that the problems identified by McKinsey were being addressed, Carney said. And Obama had never claimed to be unaware of "red flags" about the site, only of their seriousness.
But since the disastrous rollout of Obamacare, the question has persisted whether the president has been "less than competent or less than candid," said John Pitney, professor of politics at Claremont McKenna College in Claremont, Calif. "This tips the scales in favor of less than candid."
Release of the report by the Republican chairman of the House Energy and Commerce Committee was part of a broad effort by Republicans to discredit the healthcare program and to portray the administration as incompetent in implementing the healthcare law.
DEMOCRATS JOINING CRITICISM
Democrats are increasingly joining the chorus of criticism. Rep. Elijah Cummings of Maryland, a senior Democrat and ally of Obama, called Tuesday for a White House shakeup over the handling of the rollout.

The botched rollout has hurt the popularity of the initiative, but the decline has been fairly modest, a Reuters/Ipsos poll showed on Monday.
Forty-one percent of Americans expressed support for Obamacare in a survey conducted from Thursday to Monday. That was down 3 percentage points from a Reuters/Ipsos poll taken from Sept. 27 to Oct. 1.
Opposition to the healthcare law stood at 59 percent in the latest poll, versus 56 percent in the earlier survey.
© 2013 Thomson/Reuters. All rights reserved.