Obamacare rollout status report: central place for updates

[woolfe9998]

From what I have read no proof is required.


http://www.forbes.com/sites/theapot...or-system-without-verifying-your-eligibility/

"The government is going with what Kliff and Somashekhar call “the honor system.” “We have concluded that the…proposed rule is not feasible for implementation for the first year of operations,” say the Centers for Medicare and Medicaid Services. “The exchange may accept the applicant’s attestation regarding enrollment in an eligible employer-sponsored plan…without further verification, instead of following the procedure in §155.320(d)(3)(iii).”"


I wonder if this will work for taxes too, just say your employer covers you so you don't have to pay the fine (even if you aren't covered)?

This was accurate as of several months ago. However, IIRC this was the one concession the GOP got to end the shutdown, a verification procedure for the subsidies. Not sure about the details.

 

[EagleKeeper]

This jogged something in my memory. I seem to remember that one proposal for ending the shutdown was that there be proof of need for subsidies and that was rejected.

Is proof required and how does that work?

One is asked to estimate 2014 income.
How can proof be required of future income? - that would have to come from a politician.
For past income it might make sense; still for many in this economy, income can fluctuate year to year.

 

[hans030390]

It is truly disgusting that after the 3 year time frame and $90M budget (which ballooned to $360M) that was given to develop and test this system, the resulting product was such a piece of shit.

First, I want everyone to understand that what I'm about to say does NOT indicate my thoughts on the ACA one way or the other. I am speaking about this strictly from the perspective of problematic IT project launches as a person that as of recently works in a data center and has recently studied these problems in project management and IT strategy courses during my college career (which I recognize is not always as valuable as real-world experience, but I do have at least a base understanding of the topic).

The sad fact is that this (over-budget, over-schedule, and under-delivered projects) is a common problem with any large IT project in any type of organization or industry. And it's amazing how much knowledge there is on how to prevent these types of problems (can't recall the number of case studies I've done...also PMBOK), yet the problem persists regularly. Given how common the problem is, I'm not sure I would call it "disgusting." While it certainly isn't good, if anything, these issues would best be described as "expected." And, yes, it's sad when such affairs are simply expected. But, on the other hand, given the commonality of this problem across any group, it's hard to point fingers at the government without pointing fingers at every other organization and industry for even allow these practices to continue as regularly as they do.

I find it very frustrating that both Democrats and Republicans are crying out against these problems as though they were entirely unexpected and act as an indicator for the ACA's supposed impeding failure. Yes, it's not good, and, yes, it should be fixed as soon as possible (though there is a good bit of time still before it actually hits the panic stage). Yes, it would have been better to roll out without issues in the first place.

Though, realistically, rolling out services like this on such a large scale RARELY goes off without a hitch. Anyone on these forums should be aware of this fact. I know these aren't perfect comparisons, but there are enough parallels and similarities and the comparison holds merit. Think of most MMO launches, the GTA Online launch, etc. (There are too many similar, problematic IT-service-based launches for me to know that could go on the list as well, many that aren't related to gaming. Can you think of some?) These had months and years of development time put into them and millions of dollars as well. What happened at the launch? Glitches, slowdowns, disconnects, being unable to connect at all, outages, data loss, and following patches/fixes. You'd also read reports of "greater interest than expected." I'd like for services to roll out trouble free as much as the next guy, but what in the hell was anyone expecting with the ACA? You can't foresee every launch issue, and I guarantee you many would not have been comfortable buying more hardware than what would be the bare minimum to meet the estimated level of interest. So, you can't argue from the perspective of, "Buy more to be safer, because more interest than expected seems like it should be expected if this is such a common issue," because that's just potentially throwing away money. It might also make more sense to buy for average expected interest/demand vs. the higher-than-average surge of interest at launch (basically a problem that will smooth itself out over time) from a monetary perspective. It seems like people tend to forget about launch issues after time anyway (the country has the collective memory of a goldfish).

These issues are not issues that can be fixed quickly, especially with a system of this size and complexity. When you consider the amount of time required to identify the root cause(s) of the issue, troubleshoot it, find solutions, test solutions, and implement solutions (which often does not go off without problems), it starts to become clear. Then when you factor in the need to purchase, build, test, and install new hardware in combination with what I just mentioned, it should be painfully obvious to anyone that has worked on that side of IT that this should not be expected to be fixed immediately.

Too many people in the country talking about an issue when they don't even know what's inside their computer box thing. I find that horribly frustrating. Anyway, rant over.

 

[EagleKeeper]

The major complaint I have on such is that the basic uneerlying fundementals of the system design are not very complicated.
They have determined the data that is required for a person to enroll and/or browse.

They have a database of parameters that need to be used to query the database for proper results.

The insurance companies are provided to provide the data in a format that can be imported into the database for searching.

the Feds are providing the subsidy info based on some formula.

So other than pretty pages; the basic steps to collect user data; prepare into the prop query and go get the results from the database; everything else is formatting/display of the dynamic pages.

 

[Doppel]

You want to manually check 10s if not 100s of millions of applications? What was the system for then, just the world's most expensive word processor and dead tree form completion engine?

Like, 7 applications got through. I could probably personally screen all the successful submissions in my free time.

 

[spacejamz]

First, I want everyone to understand that what I'm about to say does NOT indicate my thoughts on the ACA one way or the other. I am speaking about this strictly from the perspective of problematic IT project launches as a person that as of recently works in a data center and has recently studied these problems in project management and IT strategy courses during my college career (which I recognize is not always as valuable as real-world experience, but I do have at least a base understanding of the topic).

The sad fact is that this (over-budget, over-schedule, and under-delivered projects) is a common problem with any large IT project in any type of organization or industry. And it's amazing how much knowledge there is on how to prevent these types of problems (can't recall the number of case studies I've done...also PMBOK), yet the problem persists regularly. Given how common the problem is, I'm not sure I would call it "disgusting." While it certainly isn't good, if anything, these issues would best be described as "expected." And, yes, it's sad when such affairs are simply expected. But, on the other hand, given the commonality of this problem across any group, it's hard to point fingers at the government without pointing fingers at every other organization and industry for even allow these practices to continue as regularly as they do.

I find it very frustrating that both Democrats and Republicans are crying out against these problems as though they were entirely unexpected and act as an indicator for the ACA's supposed impeding failure. Yes, it's not good, and, yes, it should be fixed as soon as possible (though there is a good bit of time still before it actually hits the panic stage). Yes, it would have been better to roll out without issues in the first place.

Though, realistically, rolling out services like this on such a large scale RARELY goes off without a hitch. Anyone on these forums should be aware of this fact. I know these aren't perfect comparisons, but there are enough parallels and similarities and the comparison holds merit. Think of most MMO launches, the GTA Online launch, etc. (There are too many similar, problematic IT-service-based launches for me to know that could go on the list as well, many that aren't related to gaming. Can you think of some?) These had months and years of development time put into them and millions of dollars as well. What happened at the launch? Glitches, slowdowns, disconnects, being unable to connect at all, outages, data loss, and following patches/fixes. You'd also read reports of "greater interest than expected." I'd like for services to roll out trouble free as much as the next guy, but what in the hell was anyone expecting with the ACA? You can't foresee every launch issue, and I guarantee you many would not have been comfortable buying more hardware than what would be the bare minimum to meet the estimated level of interest. So, you can't argue from the perspective of, "Buy more to be safer, because more interest than expected seems like it should be expected if this is such a common issue," because that's just potentially throwing away money. It might also make more sense to buy for average expected interest/demand vs. the higher-than-average surge of interest at launch (basically a problem that will smooth itself out over time) from a monetary perspective. It seems like people tend to forget about launch issues after time anyway (the country has the collective memory of a goldfish).

These issues are not issues that can be fixed quickly, especially with a system of this size and complexity. When you consider the amount of time required to identify the root cause(s) of the issue, troubleshoot it, find solutions, test solutions, and implement solutions (which often does not go off without problems), it starts to become clear. Then when you factor in the need to purchase, build, test, and install new hardware in combination with what I just mentioned, it should be painfully obvious to anyone that has worked on that side of IT that this should not be expected to be fixed immediately.

Too many people in the country talking about an issue when they don't even know what's inside their computer box thing. I find that horribly frustrating. Anyway, rant over.

In response to your post, which I can completely relate to, the HHS had 3 years and spent $300M to get where they are at today...Of course there will be glitches when the system rolls out, but to the degree that was experienced since Oct 1 is inexcusable. It would be interesting to see exactly what was 'tested' before the go-live date.

I have been a business systems analyst for over 15 years and have been involved with many multi-year million dollar projects, some of which have had inept project management, uncooperative stakeholders and numerous other reasons that cause projects to fail. I do understand that business owners/users think every requirement is a top priority needed in Phase I which needs to be delivered yesterday.

However, the HHS had 3 years and an ungodly budget to accomplish their goal. The White House should have been provided with a project plan that detailed when certain phases of the project should be completed by (some dates that should have been identified are when the requirements should have been finalized, when coding should be complete, when testing should start/end, etc). When these dates weren't being met, flags should have been raised and heads should have been rolling.

If the project management team was reporting these delays back to the White House, then the Obama and company are at fault for not taking the proper action to bring the project back on schedule.

If the project management team wasn't reporting these delays to the White House, the White House is still at fault for not ensuring the project was kept on track...

Either way, when someone spends $300M dollars on a project, they are responsible for ensuring the project is on track and that they get what they paid for. That obviously did not happen in this case.

 

[irishScott]

http://arstechnica.com/information-...aunches-tech-surge-to-improve-healthcare-gov/

While public reports from HHS's chief information officer had shown the program to be on schedule, the department caused major delays early in the project by holding up the specifications for the site. And those specifications kept changing throughout the development project. According to the New York Times, changes were being made to the site's required features by HHS officials as recently as September.

/facepalm

I wonder if these constant updates had anything to do with the fact that no one understands the law. But clearly it's a massive improvement!

 

[Uhtrinity]

http://arstechnica.com/information-...aunches-tech-surge-to-improve-healthcare-gov/



/facepalm

I wonder if these constant updates had anything to do with the fact that no one understands the law. But clearly it's a massive improvement!

Part of it could have been the massive number of states that didn't set up their exchanges hoping that ACA would be overturned.

 

[Bowfinger]

Repost, or at least there is already a thread dedicated specifically to the issues with the ACA implementation.


Threads have been now merged

EK
Admin

 

[sactoking]

This jogged something in my memory. I seem to remember that one proposal for ending the shutdown was that there be proof of need for subsidies and that was rejected.

Is proof required and how does that work?

This item is a bit out of context. When you input your information into the website to calculate the tax credit you have to input your expected income for 2014. The website then pings the federal data hub to verify the information you input. One of the pieces is to corroborate your projected 2014 income to actual 2012 income. If there is a variance of +/- 10% then you have to substantiate the variance (loss of employment, promotion, etc.). IF the Treasury component of the data hub can find no prior income history and there is no other way to verify, THEN the person's attestation will serve as proof of income.

So yes, there is no "proof" of income required, but that's only if there actually exists no true proof of income.

(Plus it's worth noting that understating income would lead to having to repay the tax credit. While the penalty can't be enforced by law, unlawful claiming of a tax credit can, so you could be subject to civil and/or criminal penalties for failure to repay.)

 

[glenn1]

http://www.washingtonpost.com/natio...1a35ce-39b4-11e3-a94f-b58017bfee6c_story.html

HealthCare.gov’s glitches prompt Obama to call in more computer experts

The Obama administration said Sunday that it has enlisted additional computer experts from across the government and from private companies to help rewrite computer code and make other improvements to the online health insurance marketplace, which has been plagued by technical defects that have stymied many consumers since it opened nearly three weeks ago.

This expanded team has come up with new ways of monitoring which parts of the federal Web site, HealthCare.gov, are having problems and has been taking the site offline for rigorous overnight tests, according to a Department of Health and Human Services spokesman.

“Unfortunately, the experience on HealthCare.gov has been frustrating for many Americans,” HHS officials said in a blog post Sunday afternoon, acknowledging what has been obvious to millions of insurance seekers who live in the three dozen states relying on the federal exchange. For the first time, the administration appealed to people to report their interactions, good or bad, with the exchange, a core element of the 2010 health-care law.

President Obama is expected to address the site’s technical problems — “troubles that he and his team find unacceptable” — at a White House event Monday to highlight the law, according to an administration official who spoke on the condition of anonymity because the event has not yet taken place.

“I think that there’s no one more frustrated than the president at the difficulty in the Web site,” Treasury Secretary Jack Lew said Sunday on NBC’s “Meet the Press.”

The remarks Sunday, and Obama’s expected comments Monday, represent a slight strategic shift for an administration that has repeatedly refused to say publicly exactly what is wrong with the site or what is being done to fix it. The new tack offers a bit more information while allowing officials to strike a sympathetic tone toward consumers exasperated by their experiences.

<snip>

 

[irishScott]

Part of it could have been the massive number of states that didn't set up their exchanges hoping that ACA would be overturned.

Which is obviously why the states that did set up their exchanges are also having issues...

But yeah, I'll admit that there's no way to prove Republicans aren't responsible for Obamacare's failings.

 

[EagleKeeper]

Will the gov penalize the company that put together the flawed site.
Who is covering the cost of the revamp.
What gov people are going to be held responsible or will those people now ensure a proper implementation

 

[spacejamz]

Will the gov penalize the company that put together the flawed site.
Who is covering the cost of the revamp.
What gov people are going to be held responsible or will those people now ensure a proper implementation

Nah, don't need to do any of that....just fire up the treasury's printer and spit out some new bills...problem solved...

 

[spacejamz]

Part of it could have been the massive number of states that didn't set up their exchanges hoping that ACA would be overturned.

Heaven forbid the HHS would have 'contingency' plans when this started rolling out 3 years ago...you know, when you think of the plausible scenarios that might need to be dealt with? Or maybe they really thought everyone loved the ACA so this possibility was not not even on their radar...LOL

 

[Genx87]

A glimpse into the project management capability of the US govt. This kind of crap goes on through out the govt. How does a fighter program end up years delayed and costing billionsover budget? This just happens to be a program the public interfaces with and not some military or non-public interfacing project.

Im sure someday this will be fixed. But it will cost far more than promised and still be a craptacular experience.

 

[Uhtrinity]

Heaven forbid the HHS would have 'contingency' plans when this started rolling out 3 years ago...you know, when you think of the plausible scenarios that might need to be dealt with? Or maybe they really thought everyone loved the ACA so this possibility was not not even on their radar...LOL

Just pointing out that states ho humming for the last three years may have contributed to constantly changing specifications for the national site. If a state doesn't get its exchanges together I see that drastically increasing the load of what the fed has to accomplish. My state (Idaho) is one of those who decided to redirect to the national site until next year.

edit: Btw, there are quite a few succesful state exchanges:
http://www.forbes.com/sites/rickung...cesses-and-why-they-dont-want-you-to-know-it/

Fyi, I am bypassing the fed site for now and working directly with my sons insurance company. It doesn't help that I only have 2 choices atm vs 3 or 4 5 years ago. I get my own insurance through my employer, so there is nothing to change there.

 

[spacejamz]

http://firstread.nbcnews.com/_news/...ffordable-care-act-is-not-just-a-website?lite

According to the NBC News.com headline, "No is madder than Obama [about the website glitches]"

Wonder why he wasn't mad last year or the year before when the $90M budget ballooned to $300M or when they had not even started coding yet??

 

[Genx87]

http://firstread.nbcnews.com/_news/...ffordable-care-act-is-not-just-a-website?lite

According to the NBC News.com headline, "No is madder than Obama [about the website glitches]"

Wonder why he wasn't mad last year or the year before when the $90M budget ballooned to $300M or when they had not even started coding yet??

Too busy spying on Americans or bombing them and others in the ME and trying to get involved in Syria while pushing to disarm people are home to care.

 

[shady28]

Next big problem unfolding :

"Under Obamacare, consumers are eligible to benefit from two different streams of subsidies.
...
...“premium tax credits”...“cost-sharing subsidies,”
...
At least half a dozen states have already said publicly that their systems are coming up with the wrong calculations.
...
Under current law, those who get more money than they were eligible for will see the excess payments clawed back on their subsequent years’ tax return."



http://www.forbes.com/sites/scottgo...ill-owe-much-more-money-than-were-being-told/

 

[EagleKeeper]

http://firstread.nbcnews.com/_news/...ffordable-care-act-is-not-just-a-website?lite

According to the NBC News.com headline, "No is madder than Obama [about the website glitches]"

Wonder why he wasn't mad last year or the year before when the $90M budget ballooned to $300M or when they had not even started coding yet??

Chump change with respect to the overall budget.

Reported that they needed 200M more in order to make things be more efficient and support the states

 

[glenn1]

Next big problem unfolding :

"Under Obamacare, consumers are eligible to benefit from two different streams of subsidies.
...
...“premium tax credits”...“cost-sharing subsidies,”
...
At least half a dozen states have already said publicly that their systems are coming up with the wrong calculations.
...
Under current law, those who get more money than they were eligible for will see the excess payments clawed back on their subsequent years’ tax return."



http://www.forbes.com/sites/scottgo...ill-owe-much-more-money-than-were-being-told/

That doesn't sound like it would go over well, but it sounds like a state income tax issue rather than federal? Not that it would probably matter that much to someone who got the tax bill, but still....

 

[shady28]

That doesn't sound like it would go over well, but it sounds like a state income tax issue rather than federal? Not that it would probably matter that much to someone who got the tax bill, but still....

There's some indication that they may make the insurance companies eat the shortfall, referred to in the article.

That though falls into the problem I outlined where insurance companies who participate extensively in the exchanges may go under, or withdraw after 2014 if they survive.

The insurance companies participating have 3 MAJOR problems right now.

1 - Too few enrollees, and of the wrong demographic
2 - The data they are getting from the exchange is wrong, requiring them to go get the data manually, increasing their costs
3 - Since the exchange set the wrong subsidized numbers, they may be on the hook for the difference

I think #3, if it occurs, will result in a bunch of major lawsuits. The Gov't cant really absolve itself of responsibility for providing incorrect information.

#1 kills them for obvious reasons - they're insuring un-insurables without an offset.
#2 kills them because they have to refund anything over 20% admin cost
#3 kills them because, frankly, they don't get paid

So this goes back to the big 3 insurers not participating in very many exchanges - Aetna, Cigna, and UnitedHealthCare.

They knew what they were doing.

 

[sactoking]

That doesn't sound like it would go over well, but it sounds like a state income tax issue rather than federal? Not that it would probably matter that much to someone who got the tax bill, but still....

It's most definitely a federal tax issue; the tax credits are federal tax credits.

Interesting point: If you understate your income and get too large of a tax credit you have to pay (a portion) of the excess credit back. If you understate your income and qualify for a cost-sharing reduction (typically a reduced deductible) you don't have to pay anything back and there is no penalty (that I'm aware of).

 

[shady28]

Released by The Heritage Foundation :

Looks like only 4 states have decreases - NJ, NY, DE, and RI.

Virginia is getting raped.