Sunday, October 13, 2013

The Beginning or The End to the Affordable Care Act

 

By now perhaps 20 million or more Americans have tried to log into the National Health Benefit Exchange, or one of the State-run portals.

There is probably no way to tell exactly since the analytics are not working for the site. However Google could probably tell us. (Maybe HHS should have contracted with  them.

These are not glitches,” said an insurance executive who has participated in many conference calls on the federal exchange. Like many people interviewed for this article, the executive spoke on the condition of anonymity, saying he did not wish to alienate the federal officials with whom he works. “The extent of the problems is pretty enormous. At the end of our calls, people say, ‘It’s awful, just awful.' ”

The reluctance for many states to join the national HBX effort is outlined by the following.

Interviews with two dozen contractors, current and former government officials, insurance executives and consumer advocates, as well as an examination of confidential administration documents, point to a series of missteps — financial, technical and managerial — that led to the troubles.

Politics made things worse. To avoid giving ammunition to Republicans opposed to the project, the administration put off issuing several major rules until after last November’s elections. The Republican-controlled House blocked funds. More than 30 states refused to set up their own exchanges, requiring the federal government to vastly expand its project in unexpected ways.

Deadline after deadline was missed. The biggest contractor, CGI Federal, was awarded its $94 million contract in December 2011. But the government was so slow in issuing specifications that the firm did not start writing software code until this spring, according to people familiar with the process. As late as the last week of September, officials were still changing features of the Web site, HealthCare.gov, and debating whether consumers should be required to register and create password-protected accounts before they could shop for health plans.

 

From the Start, Signs of Trouble at Health Portal

Dr. Donald M. Berwick, the administrator of the federal Centers for Medicare and Medicaid Services in 2010 and 2011, said the time and budgetary pressures were a constant worry. “The staff was heroic and dedicated, but we did not have enough money, and we all knew that,” he said in an interview on Friday.

There are opposing opinions as to how long it will require to unravel another Gordion knot.  Some say weeks and others say several months.

How much will it cost? Like every government project it will most likely come in over budget, which can also be said about the entire Affordable Care Act.

And while I compare apples to oranges, at  $150 million USD a pop for a state of the art F35 stealth fighter, that will sound like a Walmart special, as compared to Obamacare.  

And like Health Benefit Exchanges, there is a web site dedicated to the F35 Raptor .

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