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U.S. Secretary of Health and Human Services Kathleen Sebelius testifies before a House Energy and Commerce Committee hearing on the failures of the Affordable Care Act enrollment website on Capitol Hill in Washington, October 30, 2013.    REUTERS/Jason Re
Now that is running smoothly, priority number one for Health and Human Services has to be fixing this:
Tens of thousands of people who discovered that made mistakes as they were signing up for a health plan are confronting a new roadblock: The government cannot yet fix the errors.

Roughly 22,000 Americans have filed appeals with the government to try to get mistakes corrected, according to internal government data obtained by The Washington Post. They contend that the computer system for the new federal online marketplace charged them too much for health insurance, steered them into the wrong insurance program or denied them coverage entirely.

For now, the appeals are sitting, untouched, inside a government computer. And an unknown number of consumers who are trying to get help through less formal means—by calling the health-care marketplace directly—are told that’s computer system is not yet allowing federal workers to go into enrollment records and change them, according to individuals inside and outside the government who are familiar with the situation.

Right now, there's not even an ETA for when the appeals system will be working. The only option people have in the meantime is to start all over again and create new accounts. That doesn't work for people like Addie Wilson, who is featured in this story. She qualifies for a subsidy, but the broken site didn't give her one. She had to have insurance this month because she had to have gallbladder surgery, so she bought a plan. Going through the whole process again and getting a different plan will not allow her to get the refund she's due for having to pay her full premiums.

It's not just the appeals process that's messed up, either. In some states, children are being left out of coverage when they qualify for Medicaid, but the rest of the family doesn't. Parents can't enroll children who are eligible for Medicaid in private plans, and there's a big backlog from the federal government in informing the states of children who should be on Medicaid. Which means these children are in insurance-less limbo right now. Additionally, there are "loopers," people that the federal site said would be eligible for Medicaid, but who the states have determined aren't eligible. So they've looped back into the federal system, where they can't purchase private insurance because it still has them identified as eligible for Medicaid.

These aren't the horror stories that Republicans are going to push into the news because, face it, most of them involve people eligible for Medicaid and Republicans couldn't care less about those people. But they're the stories that should be lighting a fire under the butts of everyone at HHS, and a few in the White House, too.

Originally posted to Joan McCarter on Mon Feb 03, 2014 at 08:35 AM PST.

Also republished by Daily Kos.

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Comment Preferences

  •  Tip Jar (28+ / 0-)

    "The NSA’s capability at any time could be turned around on the American people, and no American would have any privacy left, such is the capability to monitor everything. [...] There would be no place to hide."--Frank Church

    by Joan McCarter on Mon Feb 03, 2014 at 08:35:30 AM PST

  •  I wonder how well the Software Developers were (3+ / 0-)
    Recommended by:
    Roadbed Guy, LOrion, NoFortunateSon

    vetted. If there is data in a database that cannot be examined or changed by at least a Super-User, this means every word has to be spelled correctly and anything entered is there to stay.
    When I say vetted, I mean politically vetted. It appears there was some form of sabotage or little Easter eggs placed in the original software.
    If one person dies because they could not get the medical help or prescription help they signed up for, there go the Mid-Terms.

    "If you tell the truth, you won't have to remember anything", Mark Twain

    by Cruzankenny on Mon Feb 03, 2014 at 09:13:25 AM PST

    •  You ask: (0+ / 0-)
      I wonder how well the Software Developers were vetted
      Well, rumor has it that they hired a bunch of hosers from the great white north to do the job.

      Methinks that is all you need to know.

      •  There are some very good developers in Canada (1+ / 0-)
        Recommended by:

        with expertise in health care programming.

        Of course, they're working on Canadian health care issues.

        LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

        by dinotrac on Mon Feb 03, 2014 at 09:43:14 AM PST

        [ Parent ]

        •  You're clearly just catching up. (1+ / 0-)
          Recommended by:

          The contractor they hired had a sketchy record - their background was widely reported in the Fall.

          Part of the problem falls upon the procurement team and the Federal government's procurement system as a whole - although it would not be right to throw all of the blame towards that entity.

          •  In the US Territories there was no medicaid (2+ / 0-)
            Recommended by:
            inclusiveheart, tofumagoo

            expansion and we have no "State Exchange". We may have as many as 3 Health Insurance Providers; who do not offer individual policies. I guess the good thing is we won't have to pay a fine if we don't have an insurance policy.
            So I guess you might say it's clear I'm just catching up or you could say I'll never catch up.

            "If you tell the truth, you won't have to remember anything", Mark Twain

            by Cruzankenny on Mon Feb 03, 2014 at 10:33:31 AM PST

            [ Parent ]

            •  Ditto for Texas. (0+ / 0-)

              LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

              by dinotrac on Mon Feb 03, 2014 at 10:37:20 AM PST

              [ Parent ]

            •  Twas referring to the question of the (1+ / 0-)
              Recommended by:

              contractor, but interesting to hear (but sadly not surprising) that the USVI and other territories would be left out of the "universal" reform.  It happens to DC more often than people know, too - although not in this case.

              Shaking head.

              •  We have enjoyed some of the benefits like (0+ / 0-)

                the pre-existing condition clause and keeping your children on until they're 26 helps if they're going to the mainland for college.
                I believe if we focus on something as radical as not being penalized for pre-existing conditions, we can see something good happening until they get this set up.
                We have to remember 1/2 the States are not participating fully and the Republicans continued to challenge small parts of the Act which, if successful, would have meant rewriting whole sections of code.
                The large insurance companies have been against this from the beginning and I'm sure they are doing their best to find loopholes.
                Then you're dealing with Medicaid, which has seen their workload become exponentially greater and they have no vested interest in making this smooth, so even if your website says you qualify for Medicaid assistance, it still has to be certified by them. Their job has been to disqualify as many people as possible for years.
                What a recipe for disaster, considering every Federal Employee already has the best insurance policy in the country and half could give a rats ass whether we have a policy or not.

                "If you tell the truth, you won't have to remember anything", Mark Twain

                by Cruzankenny on Mon Feb 03, 2014 at 11:22:20 AM PST

                [ Parent ]

          •  I know that...just couldn't help a little snark. (1+ / 0-)
            Recommended by:

            LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

            by dinotrac on Mon Feb 03, 2014 at 10:37:00 AM PST

            [ Parent ]

    •  YES Get new TECH Savvy surgeon general... (3+ / 0-)
      Recommended by:
      lgmcp, Involuntary Exile, tofumagoo

      Here is PBO’s nominee…a real surgeon and really tech savvy!POLITICO:  Spotlight on Vivek Murthy, TechSavvy Surgeon, as surgeon general nominee

      President Barack Obama’s selection of a 36-year-old founder of an Obamacare advocacy group to serve as the nation’s top doctor has brought accusations that he’s too young and too political to be surgeon general.
      Vivek Murthy, a Boston physician, software entrepreneur and political ally of the president, will face a Senate confirmation hearing on Tuesday.

      If confirmed, Murthy would be one of the youngest surgeons general in history. And he’s expected to be a much more vocal national presence than recent physicians who have held the post. His immediate predecessor, Regina Benjamin, had a low political profile.

      Proud to be part of the 21st Century Democratic Majority Party of the 3M's.. Multiracial,Multigender and MiddleClass

      by LOrion on Mon Feb 03, 2014 at 09:46:40 AM PST

      [ Parent ]

    •  chances are pretty good (4+ / 0-)

      that it has nothing to do with software developers, and everything to do with lack of user interface and mandated security measures. My bet is that the devs were told to drop everything to scale up the data ingestion side of things and one of the casualties was the UI for fixing problems and modifying existing records... this would leave fixing issues in the realm of DBAs, not agents - and there are probably only a few DBAs with that sort of access, nowhere near enough to fix 22000 broken applications in their copious spare time.

      Water which is too pure has no fish -- Ts'ai Ken T'an

      by mik on Mon Feb 03, 2014 at 10:00:05 AM PST

      [ Parent ]

  •  My sister is in this group (9+ / 0-)

    She can't sign herself up on the exchange because she already has a profile made. But the profile was made on Day 1 and is broken and literally dozens of hours of phone calls nobody can fix it. She went to the website on Day 1 trying get covered on Jan 1, she and her newborn still no coverage.

    I'm a huge Obamacare supporter, but it's been really, really hard watching her go through this. Website glitch is one thing but WHY can't govt employees be empowered to override her "denied" flag in the system by phone or even require an in-person visit but something? Her file is in deadlock right now, and her family is hurting.

    The purpose of writing is to inflate weak ideas, obscure poor reasoning, and inhibit clarity. --Calvin & Hobbes

    by reid fan on Mon Feb 03, 2014 at 09:27:45 AM PST

    •  I cannot speak to the Fed. employee problem... (4+ / 0-)

      but if the problem is with her profile being broken there is a work around.

      Accounts created in October and early Nov are usually too messed up and probably will never be fixed.  I was one of those stuck in the glitch loop too.

      Creating a new account (profile) from scratch using a new email address did the trick for me.  Also, when going through the application process, do NOT enter SS numbers or any of the fields marked as optional until the very end.  

      Disconnecting the original corrupted profile/application by not using unique identifiers (email addy & SS #) seems to be the best way of breaking free of the earlier glitches.

      Also, if ID verification is required, as of the last time I checked, it's better to mail that in (address will be supplied at completion of the application) via USPS as the uploading function was not working well.

      I've managed to help several people over at the FB page get through the application process with these tips.  Hope it helps!

      •  I've been wondering how hard it is to fake it out (1+ / 0-)
        Recommended by:

        with missing/different/still-legal data in order to be allowed to start over.  

        Thanks for answering that question.  I don't know anyone affected personally, but when I read comments such as the above I always wonder.  

        "The extinction of the human race will come from its inability to EMOTIONALLY comprehend the exponential function." -- Edward Teller

        by lgmcp on Mon Feb 03, 2014 at 10:03:50 AM PST

        [ Parent ]

        •  Since the major fixes were put in place around... (1+ / 0-)
          Recommended by:

          Thanksgiving it's been very easy to get around corrupted profiles/applications by starting fresh.  

          I called the 800# and some of the reps will recommend it some won't.

          Most of the people I helped had either a corrupted profile/application OR were having problems with ID verification.  

          Two weeks ago I finally proceeded all the way through the process with a clean profile of my own and it was fast and operated smoothly.  I think for most people using new accounts most of the problems/glitches have been fixed.  :-)

      •  So here we have Americans having to fake out..... (2+ / 0-)
        Recommended by:
        maryabein, AlexDrew

        .......a website to get health coverage? And we are supposed to spread the word?

        If you hate government, don't run for office in that government.

        by Bensdad on Mon Feb 03, 2014 at 10:44:35 AM PST

        [ Parent ]

    •  and what is the point of all thise employees (0+ / 0-)

      just to sooth us?

      fact does not require fiction for balance (proudly a DFH)

      by mollyd on Mon Feb 03, 2014 at 09:51:31 AM PST

      [ Parent ]

  •  Honestly, the lack of humans involved (5+ / 0-)
    Recommended by:
    LOrion, dinotrac, Terre, mollyd, Bensdad

    in this Health & Human Services project is appalling to me.

    Far too much faith was put into computer automation in this initiative.  Really, anyone with half a brain would have predicted that especially at the roll out having actual people be an integral part of the adoption process would be critical.

    •  Where is data bob ?…. (0+ / 0-)

      What does he say?

      Proud to be part of the 21st Century Democratic Majority Party of the 3M's.. Multiracial,Multigender and MiddleClass

      by LOrion on Mon Feb 03, 2014 at 09:43:22 AM PST

      [ Parent ]

    •  It is infuriating to go through -- and people (3+ / 0-)
      Recommended by:
      mollyd, Bensdad, schnecke21

      act as if being unable to insure your child is just -- well, gee, too bad.

      LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

      by dinotrac on Mon Feb 03, 2014 at 09:43:52 AM PST

      [ Parent ]

      •  Are they callous? (1+ / 0-)
        Recommended by:

        I don't know that that is what I think is at the root of these problems.

        I think that they were unprepared; lacked redundant systems (like people); and were operating under the misguided theory that computers can universally replace people.

        The fact that this roll out was only planned to be ongoing for a few months on a brand new website that was to deal with thousands of different kinds of plans and millions and millions of people with millions of different stories - and it was all NEW to EVERYONE - is your first clue that there were major failings in the planning.

        I don't think that means that people didn't care.  I think that means that people were pretty stupid.

        I won't even go into the fact that the majority of the people that I know who would qualify for Medicaid; or simply are in that group of uninsured working three jobs don't even have computers to use to access the site.

  •  agreed, this should have been (1+ / 0-)
    Recommended by:

    fixed already,  the computer says no is not much of an excuse.  "I'm sorry Dave, I can't  do that." works in the movies not real life. People's health and well being are at stake.

    On the other hand, we may be talking a failure rate of something like 1% which for a new and massive undertaking, still really isn't that bad except that it will be blown out of proportion by the right wing noise machine.

    •  It's pretty bad for something that has such an (2+ / 0-)
      Recommended by:
      inclusiveheart, schnecke21


      The real problem is that nobody made appropriate plans for problems with the system and how to make sure people could get the coverage they need.  A rigid system that doesn't allow for edits --- especially when the consequences can be significant -- is a bad system.

      LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

      by dinotrac on Mon Feb 03, 2014 at 09:45:23 AM PST

      [ Parent ]

      •  It is shocking that when the problems (0+ / 0-)

        started to emerge in October, there was no parallel initiative created to assist people with fixing the problems.

        Doesn't that shock anyone else?  The problems with that website burned the shit out of the Administration and the overall image of the ACA.  If I had been in the White House, I would have directed HHS to create a system to address the problems and to enlist an army of people to help people work through solutions to their problems.  That should have been a no brainer and an immediate reaction on the part of the Administration.

        •  there would have been (0+ / 0-)

          a lag before the second group of problems became as obvious, ie, people couldn't get on,  but many hadn't paid premiums or been through the state systems or health insurance compnay systems yet, so if you have one problem in October, the other problem isn't obvious until late November,  not an excuse not to address it immediately,  Sebelius seems to have a problem getting out in front of problems.  No excuse not to have it fixed by the end of December.

          •  Well, here's the thing, it was clear that (0+ / 0-)

            people were having problems navigating the website from the first week.  Regardless of whether or not creating a workforce of people who could help to assist with problems made sense at the time for specific reasons, it was clear (at least to me) that a parallel paper-based, human driven system would probably be smart to set up at least for the short term to get through the time when fixes needed to be made to the website.  And going back to the thousands of different plans and who knows how many unique potential outcomes, it would be surprising if there was not a need for assistance and adjustments.  Not to have anticipated that need is just totally shocking to me.

            The article says that there are 22,000 appeals right now.  But how do those people know that they are entitled to an appeal?  How many people don't know that they are entitled to an appeal or adjustment?  If nothing else getting right to the task of analyzing what went wrong in these cases would be top priority to me - what if those 22,000 are representative of many others who just aren't aware of an error?  What in the experience flow chart is not set up properly that would yield these results?  Isn't that at its core the root of "fixing" the website?

  •  Agreed with the fire under the butts (2+ / 0-)
    Recommended by:
    DRo, mollyd

    There should be more of an urgency at the White House to get this solved, enough of the excuses, get'r done.

  •  Maybe they can get the NSA to help out with (2+ / 0-)
    Recommended by:
    dinotrac, inclusiveheart


    For now, the appeals are sitting, untouched, inside a government computer.
    just saying, if everything I've been reading about the NSA, they should be able to retrieve this information from inside their computer, where (if the POTUS's claims are to be believed) it is also sitting untouched.
    •  Appeals sitting untouched? ARRRRRGHH! (4+ / 0-)
      Recommended by:
      Roadbed Guy, mollyd, VClib, schnecke21

      I believe it, though.  We called and somebody "expedited" our appeal, which meant only that somebody called us back to tell us they couldn't do anything yet and that our appeal hadn't yet "hit the system".

      LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

      by dinotrac on Mon Feb 03, 2014 at 09:46:39 AM PST

      [ Parent ]

      •  The "sitting untouched" is probably hyperbole (1+ / 0-)
        Recommended by:

        on some level - as a group, they probably are being processed, but at an unseemly slow rate (so, at any given time, most of them are for all intents and purposes "untouched").

        In retrospect (or even in advance if you asked me) why didn't they roll this out in a couple of states 2 or 3 years ago (maybe small computer literate ones like Massachusetts and Utah) on a trial basis just to get a sense of what would or could go wrong and learn from that?

  •  This is pretty basic stuff (3+ / 0-)
    Recommended by:
    Terre, dinotrac, mchristi314

    It is not the overarching scandal that Republican opponents of ACA are trying to make it into.

    But it is pretty pitiful. This is basic stuff that should have been planned for, incorporated and tested.

    Il est dangereux d’avoir raison dans des choses où des hommes accrédités ont tort. - Voltaire
    Don't trust anyone over 84414 - BentLiberal

    by BentLiberal on Mon Feb 03, 2014 at 09:38:32 AM PST

    •  I'm not sure how bad incompetence has to be (4+ / 0-)
      Recommended by:
      BentLiberal, hmi, schnecke21, mchristi314

      to rise to the level of scandal, but, given the stakes and the impact on those (like my family) who are affected, this has got to be getting closer and closer.

      LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

      by dinotrac on Mon Feb 03, 2014 at 09:47:39 AM PST

      [ Parent ]

      •  It' s simply very poor governing (4+ / 0-)
        Recommended by:
        dinotrac, Bensdad, maryabein, mchristi314

        The administration should rightfully be ashamed at this failure to serve people adequately.

        And on the political front, it's disastrously stupid.

        Il est dangereux d’avoir raison dans des choses où des hommes accrédités ont tort. - Voltaire
        Don't trust anyone over 84414 - BentLiberal

        by BentLiberal on Mon Feb 03, 2014 at 09:50:30 AM PST

        [ Parent ]

        •  "Disastrously stupid" is a good phrase. (1+ / 0-)
          Recommended by:

          Considering that the act really needs some work and, as a country, we need to start taking a poke beyond the insurance and getting to the health care itself, the last thing we need is something that says we can't trust the government to do it right.

          LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

          by dinotrac on Mon Feb 03, 2014 at 09:52:39 AM PST

          [ Parent ]

  •  Thanks: Waiting since 10/14, need advice... (1+ / 0-)
    Recommended by:

    We think our four kids qualify for CHIP, which is administered through Medicaid (?) at the County level(?), working from State guidance(?) in North Carolina. said we'd be hearing from the state directly after I submitted our app successfully on 10/14. Nothing yet.

    Meanwhile the kids are on my wife's plan at her job and I got signed up with an HSA compatible plan through Coventry directly, rather than through the exchange, just under the wire before Christmas.

    I called right after the New Year, and was told they were making an (appeal, escalation or something?). No answer so far.

    Does this have something to do with NC being a Republican ruled state that officially hates "Obamacare", and refused the Medicaid Expansion?

      Should I give up on and apply for CHIP directly through our county'sSocial Services office?

    Does anyone see anything else I might be missing?

    •  Sympathies. We have the opposite problem. (1+ / 0-)
      Recommended by:
      Snow Camp

      The system thinks our daughter might qualify for Medicaid and (we found out yesterday) that it won't let us put her on our plan (even without a subsidy) until she gets rejected by Medicaid, and ---

      We don't need to do anything because that's already being handled, though...who knows?

      LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

      by dinotrac on Mon Feb 03, 2014 at 09:49:21 AM PST

      [ Parent ]

      •  Can your daughter be covered through a work plan? (1+ / 0-)
        Recommended by:

        Since our kids were already on my wife's plan, we avoided the trap that you're in.

        Or, try calling one of your state's carriers directly.

        •  We're self-employed, which is why we need to (1+ / 0-)
          Recommended by:
          Snow Camp

          buy coverage.  We have applied for coverage for her that is not incredibly expensive, but we should be able to put her on our plan and save a few bucks.

          LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

          by dinotrac on Mon Feb 03, 2014 at 10:06:40 AM PST

          [ Parent ]

          •  OK... some thoughts... may or may not apply (0+ / 0-)

            I'm self-employed as well, and it would have cost a fortune to go my wife's plan.

            Have you looked into an HSA plan? Health Savings Accounts are tax favored, and work like an IRA. You need a high deductible plan, but since most of the silver and bronze plans have high deductibles anyway, this may not be a deal breaker. HSA plans are not the "use it or lose it"  Flexible Spending Arrangements that people have at work, that start over every year. You can pre-tax your HSA contributions and they stay in your account until spent (tax free if spent on appropriate medical and related expenses).

            Depending on how your business is structured, another thing to look into is an HRA or Health Reimbursement Arrangement.

            In your present situation, it might be worth a phone call to a different carrier from the one you signed with. You can bypass (and its SNAFU's) and maybe start over with an actual person on the phone who will be wanting to make a sale, and is thus personally motivated to try to help you. It was amazing how easy it was to get enrolled in my case, two months after my Exchange application got hung up in the Medicaid mess.

            I'm speculating here, but it's still open enrollment, so you might be able to switch, just as you could cancel your plan if you got coverage theough a job, or went on Medicare.

            Good luck

    •  Apply for CHIP directly... (0+ / 0-)

      You need to do that anyway. The federal site can only tell you that you need to do it. They can't enroll you. I did this right away in Tennessee when I found out I couldn't enroll my daughter through the exchange. Now she has great healthcare through the state with no premiums!

      Never interrupt your enemy when he is making a mistake.

      by Libertina on Mon Feb 03, 2014 at 01:51:39 PM PST

      [ Parent ]

  •  I am "conditionally" eligible (1+ / 0-)
    Recommended by:

    and they wanted me to send additional documentation, including birth certificates or passports and copies of Social Security cards (which we didn't have) for all family members. So I obtained all that and send it but so far no response.

    I've voted and paid taxes for almost 40 years now, and last year I took out a sizable mortgage, which required filling out a lot of paperwork, but nobody asked me for what the government is asking me for to get insurance.

    Hopefully somebody someday will look at this and declare I'm eligible.

    •  Keep bugging them. (1+ / 0-)
      Recommended by:

      Call the 800# and check on status. In cases where it's the ID verification that's what you must do.  

      Hang in there, people have been posting over at the FB they have been getting their ID verified!

  •  These problems will eventually be fixed (3+ / 0-)
    Recommended by:
    Terre, dinotrac, mollyd

    and they don't mean that the ACA is itself bad, but Jesus Tap-Dancing Christ on a Cracker, the boneheads who built the site could not have fucked it up more thoroughly.

    Obama needs to get on the goddamned phone to HHS and order the appropriate HUMANS to fix this problem NOW. If you have to set up a separate office with real people writing down information on scraps of paper with fucking pencils, fine.

    •  It goes beyond the technicians -- (4+ / 0-)
      Recommended by:
      hmi, Bensdad, mollyd, schnecke21

      Who in the Hell failed to ask the question, "What do we do when the system screws up" and -- "Gee, don't you think it's bad to tell people they'll have to go without health insurance for three months or more"?

      LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

      by dinotrac on Mon Feb 03, 2014 at 09:50:44 AM PST

      [ Parent ]

    •  but fixing retroactively is difficult (1+ / 0-)
      Recommended by:

      and in the meantime people are either dealing with collection agencies for bills they thought would be covered -- or, even worse, are putting off needed medical care because they don't have insurance coverage.

      I agree that this needs humans, NOW.

  •  Well, there's your "insecure website" Issa. (2+ / 0-)
    Recommended by:
    Terre, DRo

    Not even the gubmint can get into it.

    Fox News: Redistribution Of Ignorance.

    by here4tehbeer on Mon Feb 03, 2014 at 09:40:22 AM PST

  •  We are among the parents who couldn't get (1+ / 0-)
    Recommended by:

    a child on our plan.  We were told that we would have to appeal and that it's a 90 day process -- all while our daughter goes uninsured.

    Absolutely infuriating -- and nobody is able to fix it.

    In the meantime, we have found her some other insurance, but we have to take the law's promise that we could insure our daughter on our plan as a lie right now.

    LG: You know what? You got spunk. MR: Well, Yes... LG: I hate spunk!

    by dinotrac on Mon Feb 03, 2014 at 09:42:16 AM PST

  •  This debacle over the whole handling of this (3+ / 0-)
    Recommended by:
    Terre, DRo, Bensdad

    setup by the Obama admin. has been my biggest disappointment so far. I would have thought that for someone who championed his entire first 4 years on this health care bill, the i's would have been dotted, and the tees crossed. Would coulda shoulda. My next hope is that President Obama says NO to Keystone, if he does not, then that will be my second biggest disappointment of his term.

  •  Regarding the 'loopers' (0+ / 0-)

    I think it's important to clarify that adults who would have qualified for Medicaid but live in states that did not expand it aren't going to be eligible for subsidies through the ACA Insurance exchanges, until their states expand Medicaid.

    That's not a problem with the website, that's a problem with the SCOTUS decision that took the proverbial 'State Medicaid Ban Hammer' out of the legislation.  

    My understanding is the way the ACA was budgeted (to be budget neutral) to pay for, basically, 100% of the premiums for the Medicaid gap folks at the last minute, would bust the ACA budget.  Putting them on Medicaid was (according to my research) much more cost effective.  

    For all practical purpose people who live in states that did not expand Medicaid, but should have qualified are stuck between a rock and a hard place but that's on the states they live in, not the website.  

  •  But the websites working...move on already. (1+ / 0-)
    Recommended by:

    They could be screening at least a couple hundred appeals a week by hand if they thought it was important. They don't.

    This administration is into happy talk and looking forward, not looking back.

  •  all of these same problems and more in Maryland (0+ / 0-)

    and yes there are superusers, but its the just of those answering phones to not allow you access to them
    it appears that the nice young folks hired to "navigate" are instructed to navigate you away from anyone with any power...

    I did get one phone call from someone higher up
    and that was to get me to withdraw my appeal

    fact does not require fiction for balance (proudly a DFH)

    by mollyd on Mon Feb 03, 2014 at 09:55:54 AM PST

  •  I just don't get it (2+ / 0-)
    Recommended by:
    mollyd, mchristi314

    How could you fail to design and resource an appeals process and/or an error correction process?

    Just how drastically under-resourced WAS this project?

    Seems like they put off even thinking about it until they were sure John Roberts was gonna let it live.  

    "The extinction of the human race will come from its inability to EMOTIONALLY comprehend the exponential function." -- Edward Teller

    by lgmcp on Mon Feb 03, 2014 at 10:00:59 AM PST

    •  Precisely. There seems to have been a massive... (1+ / 0-)
      Recommended by:

      rush to get this done, starting after the Roberts ruling and the Romney loss. As if the President didn't really believe he'd done it until Roberts and Romney got out of the way.

      All of which means they could've rolled the whole thing out back in 2012, since the interim 4 years was apparently never going to be properly utilized.

      "The Democratic Party is not our friend: it is the only party we can negotiate with."

      by 2020adam on Mon Feb 03, 2014 at 10:46:39 AM PST

      [ Parent ]

  •  about time for this diary (4+ / 0-)
    Recommended by:
    hmi, Bensdad, maryabein, schnecke21

    have been thinking of diary my similar experiences with the Maryland ACA

    to point out it starts with computer gliches but that doesn't explain all the rest

    hiring a legion of people and poorly training them and giving them no power to do anything

    not giving access to anyone except level one eployees

    not fixing existing problems

    not giving last names of anyone working o no tracking or accountability can be done

    those in charge should be ashamed

    fact does not require fiction for balance (proudly a DFH)

    by mollyd on Mon Feb 03, 2014 at 10:03:45 AM PST

  •  COVERED CALIF IS A MESS... (3+ / 0-)
    Recommended by:
    hmi, Bensdad, schnecke21

    I confirmed with Covered CA back in Dec that my Silver Plan (with no Gov Subsidy) would take my Doctors in network (Dr's that I have had for 15 years) and allow me to use my local hospital. So I signed up, paid, received my card in the mail and found out last week that the Plan does NOT allow me to use my Primary Dr or any of my other Dr's and does not cover my local Hospital either. (the one I was born in)

    Since I found all this info out last week, I have tried calling Covered Calif for hours ever day with no one answering. Just a recorded voice saying "We are busy and cannot take your call, Goodbye". The website is a mess and no help either. I called Anthem BC and they confirmed this info and offered no help, none of their Individual plans include any of my needs. ALSO, one of my Dr's offices I called went so far to tell me that they will never take anyone that has a policy with Covered Calif. Another one told me that my Sliver EPO plan is no better than an HMO and is like Medicaid, both of which they do NOT take. It is becoming harder and harder for me to fight for this new ACA law. Their websites are of no help and are a mess too. So I am now paying $506 for a plan that none of my providers and Dr's accept. Rock meet Hard place. What a fucking Joke. Now what do I do?


    by Chamonix on Mon Feb 03, 2014 at 10:04:23 AM PST

    •  Chamonix - that is just awful (1+ / 0-)
      Recommended by:

      If this wasn't the government it would be a candidate for a class action lawsuit. How could your receive so much misinformation without some entity being held responsible, returning your premiums, and helping you find a policy that fits your needs?

      Experiences like yours could make the ACA an anvil for the Dems in 2014, as they face an uphill battle in the midterms. I fear the employer mandate will be even worse, just in time for the election.

      "let's talk about that"

      by VClib on Mon Feb 03, 2014 at 11:38:40 AM PST

      [ Parent ]

      •  thanks, just off phone with CoCalif (1+ / 0-)
        Recommended by:

        Totally useless. They are, of course, blaming the Doctors and Hospital for bowing out of plan, after they originally had a deal with them? What total BS. ANY PROFESSIONAL COMPANY would have at least had their shit together and guaranteed their Customers 1 year of service with the plan they signed  up with. Now they are telling me that if I switch to Blue Shield PPO that my Dr is covered but NOT my Local Hospital. WTF? This is NOT going away. The doctors and Hospitals are running away screaming from any plans that have been linked and approved to the new health care law. Make my words, they are dumping anyone who will have high quality plans and are paying hardly anything for them thru ACA. It has become a total Class thing and will take years for the best doctors and med centers to welcome new people (Individuals) under the new health care law.  IN the meantime I am totally screwed as they are offering no new Individual plans that cover both my Dr and my Hospital. So I'm paying over $500 for a plan that neither covers my doctors or local hospital. UGhhhhhh


        by Chamonix on Mon Feb 03, 2014 at 01:03:15 PM PST

        [ Parent ]

        •  Networks (0+ / 0-)

          The next phase of health care reform must do away with the in-network/out-of-network distinction, require all health care providers to except any and all insurance without balance billing, and allow all customers to choose any properly credentialed doctor or hospital they choose. To go along with this, the rates of reimbursement need to be set by state, regional, or federal panels or agencies.

  •  Compare and contrast these SNAFUs with (4+ / 0-)
    Recommended by:
    2020adam, atana, didaskalos, mollyd

    single payer:

    "Oh, you are alive and human?  Please take a seat, you'll see the doctor shortly and we'll bill the government."

  •  it almost seems like (1+ / 0-)
    Recommended by:

    these glitches were done on purpose unless you think this govt is completely incompetent which i don't.

    •  Not on purpose, but (1+ / 0-)
      Recommended by:

      I think those at the top of the agencies responsible for implementing the web sites at the federal and state levels had no real appreciation for how complex the task was and placed too much confidence in the vendors hired to create the sites.  While I don't expect the executives in charge of these agencies to be familiar with software development or what constitutes a good test plan, I would expect them to at least have people on staff who do know those things. I don't think government is generally incompetent, but I think in the case of the exchange web sites we're seeing a failure of leadership at high levels.

      •  sounds about right (0+ / 0-)

        but that tells me the admin didn't do its do diligence in making sure the aca was implemented properly by knowledgeable people, that alone leads to the conclusion that it was on purpose because like you i don't believe the govt is incompetent just duplicitous.

        save america defeat all republicans and conservatives

  •  Thank you thank you thank you..... (4+ / 0-)
    Recommended by:
    mollyd, VClib, Nannyberry, schnecke21

    ...for this diary and for acknowledging an ugly truth: It is nearly impossible to sign up for ACA through Federal and State websites.

    As I've mentioned elsewhere, I live in a very blue state: Hawaii. I am retired but not yet of Medicare age. My COBRA coverage ran out and I needed health insurance. On the first possible day, October 1st, I tried to sign up through Hawaii's "Health Connector". It was not operational.

    On January 14th, 2014, I finally gave up on signing up through the health connector and signed up directly through one of the two insurers.

    The Hawaii Health Connector is still not functioning correctly and is making hundreds if not thousands of people prove that they are not incarcerated (a known glitch).

    All of this in a state so blue that the blue extends farther than the eye can see. Cobalt blue.

    Anybody ---such as I--  who has worked with government IT contractors would have known that this was the weakest link. This was all forseeable. And having umpteenn different websites was also a form of folly -- you simply increase the potential for something to go wrong.

    Something HAS gone wrong. If a retired life-long Democrat in a blue state can't sign up through the exchange despite his best efforts, then what about the busy soccer Mom or the single dad or the busy young couple?

    We do ourselves NO favors when we ignore the catastrophe that is the exchanges.  I am not entitled to a subsidy but if I were, I would be very upset about this.

    There is no quick fix --and perhaps no fix at all-- because of the multiplicity of websites, different contractors and different (proprietary probably) codes. Whoever thought up this part of the law was ill informed. AND IT IS THE SINGLE MOST IMPORTANT PART OF THE LAW because it is the public face of the law.

    If you hate government, don't run for office in that government.

    by Bensdad on Mon Feb 03, 2014 at 10:42:35 AM PST

  •  Establishing an appeals process would've... (2+ / 0-)
    Recommended by:
    mollyd, maryabein

    required a project manager or general contractor with the experience to notice such gaps in the broader system.

    The President seems to have thought that inspiring rhetoric obviated the need for management. Despite having chosen the most complex, management-heavy design for his insurance reform.

    "The Democratic Party is not our friend: it is the only party we can negotiate with."

    by 2020adam on Mon Feb 03, 2014 at 10:56:06 AM PST

  •  You have to create a new account (0+ / 0-)

    In my experience with it's best to reapply and create a new account with a new new email address. My first attempts at using the site in early October and in November gave ridiculous results  that I was not able to change ($800 month after credits and split my family into 2 different plans). Third time the charm in January and I now have affordable plans to choose from that include the whole family.

  •  The computer is only a tool. Empower people (3+ / 0-)
    Recommended by:
    mollyd, maryabein, VClib

    to get their nose out of the computer and manually deal with these issues.

    These are not computer issues. These are customer service issues. They need customer service people to resolve them, not computer techies.

    It's not that difficult. Example: One year I got a penalty notice from the IRS for allegedly not paying my balance due. But I had the cancelled check image. So I called the number on the notice -- and unlike the people caught in purgatory, got someone on the phone who could help. He went into the computer record, saw the payment, and saw that it had been miscoded as something else. I asked if they needed a copy of the check (clearly labelled "balance due, 19__" in the memo field). He said no, did whatever he needed to do to correct the coding, and that's the last I ever heard about it.

    Worst case -- if the computer did not exist -- I would have photocopied the cancelled check and mailed it back to them, and a customer service person would have been able to match that against the penalty notice and straightened it out.


  •  I am one of the 22,000... (0+ / 0-)

    who filed an appeal. Thanks for reminding me to get my paperwork in to close it!

    The short version: The web site determined that my husband and I qualified for subsidized coverage but that our daughter qualified for "medicaid" in Tennessee. What she really qualified for was CHIP coverage (here called CoverKids). However, prior to January 1, to qualify for CoverKids, a child had to "go bare" (have no insurance) for three months or longer before they could be insured. After January 1, you must have a letter from your last insurance company called a Certificate of Creditable Coverage saying that the insurance was cancelled by the company. Fortunately, we were on short-term insurance that ended Dec 31, so we sent the letter in. She actually ended up going bare for January, but now she has better coverage than we do through CoverKids, at no cost to us.

    We hated having her go bare, but our only other option was to buy individual insurance for her off the exchange and not qualify for others at all. Since she was eligible for CHIP we took the chance. So, some bugs still need to be worked out, but I just mailed a letter which will drop the number of problem cases down to 21,999.

    To those still waiting, you can still get short-term coverage for emergencies but not pre-existing conditions. Make sure you're not messing up your eligibility for other programs though.

    Never interrupt your enemy when he is making a mistake.

    by Libertina on Mon Feb 03, 2014 at 01:46:18 PM PST

  •  The biggest mistake (0+ / 0-)

    The biggest mistake was to put eligibility requirements on being able to purchase insurance through the exchange. Some of the people caught in loops wouldn't be if buying insurance on the exchange was open to anyone and everyone, regardless of other insurance options they had, income, Medicaid eligibility, etc.

  •  This is a big database (0+ / 0-)

    Of course records can be accessed or changed. It doesn't take much to change a database entry. The problem is that they haven't built a specific and pretty interface. Train a group of people to use rather low level database tools to make the necessary changes in the necessary tables directly, and the problems can get solved rather than simply sit there and wait for lack of a nice user interface.

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