Obamacare Schadenfreude on the Run

Another nice day here. I don't know what we did to deserve it, but we'll take it.

From the Department of "If It Works, Don't Fix It" Healthcare.gov is working so good it needs another redesign:

When the Affordable Care Act passed in March 2010, HHS had three and a half years and $400 million to produce a web portal for individual-market consumers that would … pretty much do what the existing portal did for the Medicare Advantage program that ObamaCare raided to pay for its own operation. HHS rolled it out on time last October, whereupon it crashed repeatedly and had to be overhauled. A few months later, the Obama administration bragged about the system when it hit eight million signups, even though the back end couldn’t actually determine how many actually paid for their insurance.

Last week, we found out that the part of the system that actually manages the government-run coverage may have screwed up two million or more of those signups.
The next open enrollment date is in mid-November, so now HHS will overhaul Healthcare.gov again with five months to get it functioning properly. What could go wrong? Er …

The Obama administration is revamping HealthCare.gov and scrapping significant parts of the federal health-insurance marketplace in an effort to avoid the problems that plagued the site’s launch last fall, according to presentations to health insurers and interviews with government officials and contractors.
But the makeover—and the tight timeline to accomplish it—are raising concerns that consumers could face another rocky rollout this fall when they return to the site to choose health plans. Some key back-end functions, including a system to automate payments to insurers, are running behind schedule, according to a presentation federal officials made to health insurers.
Adding to the pressure, HealthCare.gov is still in the midst of transitioning to new government contractors to manage basic functions.
Among the changes in the new version of HealthCare.gov: a revamp of the site’s consumer-facing portion including the application for coverage most people will use, as well as the comparison tool that lets them shop for plans, according to slides from a May 20 meeting for insurers held by the Centers for Medicare and Medicaid Services, which oversees HealthCare.gov.

Of course, HHS has a new boss in Sylvia Burwell, who sailed to confirmation this week on a 78-17 Senate vote. The former OMB official has no particular expertise in web-portal project management, but then again, neither did her predecessor … and look how well that went.

After all, it's only money. And speaking of money: In a Single Year, Basic Hospital Prices Soar and Experts Aren't Sure Why

Over the course of a single year, hospitals charged noticeably more for a range of standard procedures, the New York Times finds. Medicare data show that for 91 of 98 common ailments, hospitals' 2012 prices increased more than the rate of inflation from a year earlier: Chest pain charges jumped 10%, while digestive procedures jumped 8.5%. At the same time, Medicare boosted payment rates by 1%, and inflation was 2%, theTimes reports. Meanwhile, amid a push for hospitals to focus on cheaper outpatient care, the number of Medicare patients hospitalized for these 98 ailments fell from 7.5 million to 7.2 million.

Charges for the procedures swung widely from hospital to hospital, and the rise in price at some hospitals was particularly notable: one Florida facility, for instance, more than doubled its price for irregular heartbeat treatment, to a cost of almost $54,000. Why the price hikes? One explanation is hospital mergers following ObamaCare; another cost driver is the expense of shifting to electronic medical records. Still, more broadly, "it just isn’t clear what has gone into the increase in hospital charges for the past decade," says an expert. Click for the entire piece.

Hint to "experts". When suppliers of a good or service expect their costs to rise, or the business to get more difficult due to onerous regulations, they tend to raise prices to compensate. For example:

CareFirst seeks price hikes for individual health plans

Maryland’s dominant insurance company, CareFirst, is proposing hefty premium increases of 23 to 30 percent for consumers buying individual plans next year under the federal health-care law, according to filings released Friday.

The rate proposals by CareFirst and several other carriers were posted on the Web site of the Maryland Insurance Administration and paint a mixed picture. Two other insurers, Kaiser Foundation Health Plan and Evergreen Health Cooperative, are proposing to lower rates for next year, by 12 percent and about 10­­ percent, respectively. And two new carriers — Cigna and United Healthcare — are offering plans for the first time in the state’s individual market, which serves about 200,000 of Maryland’s nearly 6 million residents.

The proposals do not affect health insurance plans that provide coverage for most Marylanders, such as those offered by large employers or employers who self-insure. Nor do they apply to “grandfathered” plans that were bought before March 2010 or federal plans such as Medicare, Tricare and federal employee plans.

The Maryland Insurance Administration will review the plans and can ask insurers to lower them before approving final rates. Last year, CareFirst proposed a 25 percent rate increase but regulators cut the final rates by 10 percent. Maryland’s rates in 2014 were among the lowest in the country, analysts have said.

Can't have that. All pigs must be equal. Except the boss pigs, of course. It's almost enough to drive people out of the system.

Opponents of health-care law turn to faith-based nonprofits to cover medical expenses

“When all this came up with the ACA, I just realized I don’t want to be a part of any of this,” said Tucker, who views the Affordable Care Act as the government meddling in her personal health care. The Christian Healthcare program is not as comprehensive as insurance — she has to pay for her preventive care, for example — but the monthly payment of $150 can’t be beat, she said.

Tucker is part of a small but growing group of Americans whose opposition to the Affordable Care Act is spurring them to seek out alternatives, choosing once-fringe methods to pay for their medical care in an effort to skirt the many requirements the law imposes on the private health insurance market.

The result is a burgeoning business among brokers, clinics and insurers that are advertising themselves as a way to avoid the sweeping federal program. The options range from Christian co-ops such as Tucker’s to membership-based primary-care clinics to insurance policies that cover specific diseases, such as cancer.

In some cases, such as Tucker’s, the options are permitted by the health law; the people who sign up don’t have to pay the penalty for not carrying adequate coverage. In other cases, the options are not sanctioned by the law, leaving people on the hook to pay the fine. But some critics of the law say that even with the penalty, the alternatives are worth it.

Those damned fundies must be brought to heel.