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- 11/14/13--10:37: _Sorry, You Still Ma...
- 11/14/13--10:44: _Here's The Letter D...
- 11/14/13--12:30: _Insurance Commissio...
- 11/15/13--02:16: _The New York Post's...
- 11/15/13--03:21: _A U.S. Official Fea...
- 11/15/13--05:45: _JON STEWART TO OBAM...
- 11/15/13--06:32: _Obama's Bet On Heal...
- 11/15/13--07:40: _Actually, Nothing H...
- 11/15/13--09:51: _Why 'If You Like Yo...
- 11/15/13--10:36: _Nearly 40 Democrats...
- 11/15/13--14:08: _Here Are The 39 Dem...
- 11/15/13--19:27: _Report: UnitedHealt...
- 11/17/13--07:57: _Watch Nancy Pelosi ...
- 11/18/13--09:12: _OOPS! Donnie Wahlbe...
- 11/19/13--04:33: _Obama's Poll Number...
- 11/19/13--07:00: _Jon Stewart Destroy...
- 11/19/13--09:36: _Security Expert: He...
- 11/19/13--10:06: _Republicans Suddenl...
- 11/19/13--15:24: _Here Are Three Thin...
- 11/20/13--02:41: _Cyber Experts To Co...
- 11/14/13--10:37: Sorry, You Still May Not Be Able To Keep Your Plan
- 11/15/13--02:16: The New York Post's Obamacare Cover Says It All
- 11/15/13--05:45: JON STEWART TO OBAMA: At Least You're Not Rob Ford!
- 11/15/13--06:32: Obama's Bet On Healthcare.gov Has Gone Bust
- 11/15/13--07:40: Actually, Nothing Has Changed In The Obamacare Fight
- 11/15/13--09:51: Why 'If You Like Your Plan' Can't Be Fixed
- Plans are getting more expensive because they close coverage gaps: This is the "junk insurance" issue liberals like to talk about. Old plans may have had annual benefit limits, or excluded key items like prescription drugs or maternity coverage.
- Plans are getting more expensive because they have lower patient responsibility: Old plans may not have covered 100% of the cost of preventive care and may have had higher deductibles and out-of-pocket maximums than are allowed under the ACA.
- Plans are getting more expensive because they are community rated: Old plans had "experience rating": People who were young and healthy and male and otherwise expected to consume little health care paid low premiums; people who were sick and expensive to cover paid high premiums. Now, "community rating" means everyone will pay the same price, except that a limited degree of age-based variation will be allowed.
- Eight of nine Democrats who hail from districts won by Mitt Romney in the 2012 presidential election voted for the bill.
- Only two Democrats who come from districts in which Obama won less than 53% of the vote last year voted "no" on the bill.
- 28 of 36 Democrats who come from districts in which Obama won less than 55% of the vote voted in favor of the bill.
- Rep. Ron Barber (D-Ariz.)
- Rep. John Barrow (D-Ga.)
- Rep. Ami Bera (D-Calif.)
- Rep. Tim Bishop (D-N.Y.)
- Rep. Bruce Braley (D-Iowa)
- Rep. Julia Brownley (D-Calif.)
- Rep. Cheri Bustos (D-Ill.)
- Rep. Jim Costa (D-Calif.)
- Rep. Peter DeFazio (D-Ore.)
- Rep. Suzan DelBene (D-Wash.)
- Rep. Tammy Duckworth (D-Ill.)
- Rep. Bill Enyart (D-Ill.)
- Rep. Elizabeth Esty (D-Conn.)
- Rep. Bill Foster (D-Ill.)
- Rep. Pete Gallego (D-Texas)
- Rep. John Garamendi (D-Calif.)
- Rep. Joe Garcia (D-Fla.)
- Rep. Ron Kind (D-Wis.)
- Rep. Ann McLane Kuster (D-N.H.)
- Rep. Dave Loebsack (D-Iowa)
- Rep. Dan Maffei (D-N.Y.)
- Rep. Sean Maloney (D-N.Y.)
- Rep. Jim Matheson (D-Utah)
- Rep. Mike McIntyre (D-N.C.)
- Rep. Jerry McNerney (D-Calif.)
- Rep. Patrick Murphy (D-Fla.)
- Rep. Rick Nolan (D-Minn.)
- Rep. Bill Owens (D-N.Y.)
- Rep. Scott Peters (D-Calif.)
- Rep. Gary Peters (D-Mich.)
- Rep. Collin Peterson (D-Minn.)
- Rep. Nick Rahall (D-W.Va.)
- Rep. Raul Ruiz (D-Calif.)
- Rep. Brad Schneider (D-Ill.)
- Rep. Kurt Schrader (D-Ore.)
- Rep. Carol Shea-Porter (D-N.H.)
- Rep. Kyrsten Sinema (D-Ariz.)
- Rep. Filemon Vela (D-Texas)
- Rep. Tim Walz (D-Minn.)
- 11/15/13--19:27: Report: UnitedHealth Drops Thousands Of Doctors From Insurance Plans
- 11/19/13--04:33: Obama's Poll Numbers Continue To Crash
- 11/19/13--09:36: Security Expert: Healthcare.gov Data Is At 'Critical Risk'
- 11/19/13--15:24: Here Are Three Things We Can Do About Obamacare Rate Shock
- Instead of letting healthy people buy insurance cheaply and locking many sick people out of the market, we set common premium rules for everyone, even though that means healthy people will pay more.
- We don't let insurers sell policies with provisions like annual benefit limits that can leave their buyers destitute.
Rep. Fred Upton (R-Mich.) has proposed a bill that to fix Obama's "if you like your plan, you can keep it" lie. It won't work and a Fox News segment last night shows it.
Upton's bill would "grandfather" in all plans that existed as of Jan. 1st, 2013 and allow insurers to continue selling them outside of the exchange.
President Obama announced a similar approach this afternoon which faces similar issues.
Neither Upton's bill nor Obama's executive action would require insurers to bring back canceled plans and they often won't want to do so. Many insurers canceled plans because they were full of high-cost beneficiaries. In some circumstances, like with United Healthcare in California, they have exited the states' individual health insurance markets entirely. Even if Upton's bill became law, many insurers would choose not to bring back canceled plans.
In addition, plan restorations may be technically infeasible. Insurers have already sent out cancellation notices and configured their computers for the new plans. They are ready for Obamacare. To sell their old plans, insurers would have to receive permission from state insurance regulators. Industry sources told Politico yesterday that "it’s likely too late to undo the cancellation notices that already have gone out."
On Fox News last night, Greta Van Susteren pressed Rep. Adam Kinzinger (R-IL) on how the Upton bill would actually help people whose plans have been cancelled.
Van Susteren played out the scenario of what would happen if the legislation became law:
How in the world do you expect it to even be operable because the insurance companies that have cancelled these policies, you can't make them all of a sudden un-cancel policies. Even to un-cancel the policies to get new policies, they have to go to their states to get the state's insurance commissioner to OK these policies. So how in the world can this possibly change things for the many Americans who are out there freaked tonight because they're sick or in the middle of some medical procedure or care? I don't get it.
Kinzinger immediately pivoted in his response without addressing anything Van Susteren said. "The issue frankly is the bigger issue of Obamacare in general," he said. "This thing is going to collapse and fail on its own."
She cut him off and pushed harder for an answer saying, "This is an urgent situation for some people."
And Kinzinger responded by attacking the enrollment numbers: "Exactly. Look right now the White House has not even released the demographics of the people who have signed up."
The reason that Kinzinger couldn't actually defend how the Upton bill would help people is because it doesn't work. It's a great soundbite and a good way to earn political points, but it isn't a solution to Obama's lie.
President Barack Obama on Thursday announced an administrative "fix" to the Affordable Care Act that will allow insurers to keep offering current plans for a year, even if they don't meet certain minimum requirements of the law.
The change is intended to reassure people who have been receiving cancellation notices, as it is aimed at allowing more people to keep their health plans.
The Obama administration laid out the fix in a guidance to state insurance commissioners on Thursday.
The letter, from the Centers for Medicare and Medicaid Services, specifies that insurance policies must have been in existence as of Oct. 1, 2013. It encourages state agencies "responsible for enforcing the specified market reforms" to take action to allow plans to continue into 2014.
Insurers have already expressed concern about how the "fix" will affect premiums. Karen Ignagni, president of America's Health Insurance Plans, released a statement warning that fewer young people and at-risk individuals could now opt not to purchase coverage in the exchanges, causing premiums to rise and offering consumers fewer choices.
"Though this transitional policy was not anticipated by health insurance issuers when setting rates for 2014, the risk corridor program should help ameliorate unanticipated changes in premium revenue," read the letter, which was signed by Gary Cohen, the director for the Center for Consumer Information and Insurance Oversight.
An organization of U.S. state insurance commissioners on Thursday expressed "concern" at President Barack Obama's administrative "fix" to the Affordable Care Act, which will allow insurers to keep offering current plans for a year even if they don't meet certain minimum requirements of the law.
Jim Donelon, president of the National Association of Insurance Commissioners, said in a statement that he's not sure how the proposed patch will practically be put into effect.
He also warned of disruption to the insurance market and a rise in premiums, concerns that were echoed by America's Health Insurance Plans, a lobbying group that represents the insurance industry.
Here's Donelon's statement, in part:
"We ... are concerned by the President’s announcement today that the federal government would use its 'enforcement discretion' to delay enforcement of the ACA’s market reforms in 2014 for plans that are currently in effect. This decision continues different rules for different policies and threatens to undermine the new market, and may lead to higher premiums and market disruptions in 2014 and beyond.
In addition, it is unclear how, as a practical matter, the changes proposed today by the President can be put into effect. In many states, cancellation notices have already gone out to policyholders and rates and plans have already been approved for 2014. Changing the rules through administrative action at this late date creates uncertainty and may not address the underlying issues. We look forward to learning more details of this policy change and about how the administration proposes that regulators and insurers make this work for all consumers."
His statement is especially significant, since a letter the Obama administration sent to state insurance commissioners makes it clear that the fix is reliant upon insurance commissioners taking action and implementing the changes.
Washington state insurance commissioner Mark Kreidler also released a statement saying that he does not believe Obama's proposal is a "good deal." He said that the state would "stay the course" with regards to implementation of Obamacare.
"In the interest of keeping the consumer protections we have enacted and ensuring that we keep health insurance costs down for all consumers, we are staying the course," Kreidler said. "We will not be allowing insurance companies to extend their policies. I believe this is in the best interest of the health insurance market in Washington."
WASHINGTON (Reuters) - Almost three months before the botched launch of HealthCare.gov, a U.S. health official expressed frustration with a main contractor working on the website, fearing quality assurance issues could "crash the plane at take-off," according to government documents obtained by Reuters.
The documents were released by Republican investigators with the House of Representatives Energy and Commerce Committee.
Republican lawmakers, who have consistently sought to undermine President Barack Obama's signature health system overhaul, are probing the law's disastrous rollout.
Two series of internal emails in July between officials at the Centers for Medicare and Medicaid Services (CMS), including HealthCare.gov project manager Henry Chao, describe struggles with contractors, staff shortages and software problems long before the federal healthcare website crashed on its October 1 launch and threw the rollout of Obamacare into political turmoil.
In a July 16 email sent ahead of a meeting with then-prime contractor CGI Federal, Chao describes the agency's low confidence level in the project work, from constant struggles with releases to changing delivery dates and poor quality assurance on software.
"I just need to feel more confident they are not going to crash the plane at take-off," Chao says in the email, which was among several documents the Republican investigators released.
In congressional testimony released October 23, CGI Federal blamed early website problems on another contractor's software and also said the federal government was ultimately responsible for the website's performance.
CMS released a statement that did not directly address Chao's email but described the challenging task of building HealthCare.gov. "This is a complex project with a short timeline," CMS said.
Chao, the deputy chief information officer at CMS, declined a request to speak directly with Reuters.
President Barack Obama and administration officials have come under fire for launching a malfunctioning website, but it's not clear if officials knew the extent of the site's problems or when they knew.
A day after writing the email about CGI, Chao assured a House Oversight and Government Reform subcommitteethat HealthCare.gov would be ready on time.
It is not known whether Chao learned new information to change his assessment in the intervening hours.
On July 20, he distributed a video link to the testimony via email and urged CMS staff to make good on the pledge to lawmakers.
"I wanted to share this with you so you can see and hear that both Marilyn and I under oath stated we are going to make October 1," Chao wrote.
"I would like you (to) put yourself in my shoes standing before Congress, which in essence is standing before the American public, and know that you speak the tongue of not necessarily just past truths but the truth that you will make happen."
But HealthCare.gov, the federal government's health insurance marketplace portal for millions of uninsured people in 36 states, crashed shortly after its launch and has been plagued by technical problems even since.
(Reporting by David Morgan; Editing by Karey Van Hall and Lisa Shumaker)
"The Daily Show" host Jon Stewart has one silver lining for President Barack Obama — at least he's not Toronto Mayor Rob Ford?
Stewart continued to bash the President for the rollout of his signature health care law on Thursday, taking aim at Obama's press conference in which he announced a change that would allow insurers to keep offering plans for a year even if they do not meet certain minimum standards of the Affordable Care Act.
Stewart mocked Obama for qualifying the fact that his administration had "fumbled" the law's rollout by acknowledging that he's "not a perfect man" or a "perfect president."
"That wasn't the slogan you campaigned on," Stewart said. "I think when you campaigned, you were all, 'Yes we can!' I don't remember the other slogan" of "Pobody's Nerfect."
And so it's come to this.
"Certainly, the rollout of the president's signature health care law has been rocky. But at least it's not Mayor-of-Toronto rocky," Stewart said.
Watch the clips below:
When President Obama repeatedly told Americans, "If you like your plan, you can keep it," he understood that it wasn't true. Health care reform is very disruptive. There simply was no way Obama could keep that promise.
But the president also knew that many Americans who discovered their policies were cancelled would find new ones that offered more comprehensive coverage for a lower price.
Their anger would melt away as soon as they saw their new options. Some Americans would have to pay more for worse coverage and they certainly would be angry, but that would only be a small subset of the individual health care market. It wouldn't be enough to seriously hurt him or Obamacare. That was the bet the president made.
The latest announcement reveals that it's quickly going bust.
The administrative fix the president unveiled allows insurers to continue offering health plans to current beneficiaries through 2014. Insurers are not required to do so and state insurance commissioners must still approve all the plans. It's unclear whether insurers have the technical ability to un-cancel plans and how many will actually take up the president's offer.
Whether or not this plan is technically feasible or insurers will actually un-cancel plans, Obama would never have had to make this fix if the website worked. There would still be millions of people with cancellation notices, but they would have had plenty of new choices to look through. The president admitted this last week in his apology.
"Keep in mind that most of the folks who are going to– who got these c– cancellation letters, they’ll be able to get better care at the same cost or cheaper in these new marketplaces," he said. "Because they’ll have more choice. They’ll have more competition. They’re part of a bigger pool. Insurance companies are going to be hungry for their business.So– the majority of folks will end up being better off, of course, because the website’s not working right. They don’t necessarily know it right [now]."
The president always planned to break his promise. He just didn't plan to do so with a systematically flawed website that won't work seven weeks after launch.
Years ago, Obama probably didn't think this was a risky bet. He had recently run the most high tech campaign ever. There was every reason to believe that his administration was eminently capable of setting up the federal exchange. In his announcement yesterday, Obama stated this clearly.
"I think it's fair to say that we have a pretty good track record of working with folks on technology and IT from our campaign, where, both in 2008 and 2012, we did a pretty darn good job on that." he said. "What is true is that, as I said before, our IT systems, how we purchase technology in the federal government is cumbersome, complicated and outdated."
Later he added: "When I do some Monday morning quarterbacking on myself one of the things that I do recognize is since I know that the federal government has not been good at this stuff in the past, two years ago as we were thinking about this, you know, we might have done more to make sure that we were breaking the mold on how we were going to be setting this up. But that doesn't help us now. We got to move forward."
The latest fix, which has left insurers furious and health policy wonks wondering how it will affect the law, was necessary, because Obama bet that the government was capable of setting up Healthcare.gov. If the administration eventually gets the site working, this will all be forgotten and the outcome of law will be determined on its merits. Right now though, that bet isn't looking very good.
Around 1 pm today, the House will vote on Rep. Fred Upton's "Keep Your Health Plan Act" which would grandfather in all plans up until January 1st, 2013 and allow insurers to continue selling those plans outside of the exchanges. The bill is certain to pass, but many pundits are watching carefully for the number of Democratic defections.
Obama's intent for the administrative "fix" that he announced yesterday was to reassure panicking congressional Democrats that he will not let Obama doom them in 2014. Many repeated his "if you like your plan, you can keep it" lie and now have to face their angry constituents. Obama tried to shoulder most of that blame and offer those Democrats a political scapegoat for their broken promise. This vote is indicative of how worried Democrats are about the law.
Ultimately though, Upton's bill doesn't matter. Neither does Sen. Mary Landrieu's or the House Democrat's. These pieces of legislation are very unlikely to pass. Kevin Drum explained this clearly:
This is just a quick note to anyone who's worried and/or hopeful that Congress will pass some kind of legislative fix for people whose health insurance has been canceled due to Obamacare. It won't happen. Republicans are interested only in Obamacare's failure and will refuse to support any Democratic bill that genuinely addresses the problem. Conversely, Democrats are interested only in improving Obamacare and relieving the political pressure they're feeling. They will refuse to support any Republican bill that contains an obvious poison pill. Unless I'm missing something, the intersection of these two positions is the null set. Thus, there is no bill that can pass Congress.
Even if something were to miraculously pass, Obama still can veto the legislation.
That means that Obamacare is here to stay. No matter how angry Republicans feel or scared Democrats get, Obama has full power over the law. He's in control.
This was a bad week for the president. He's lost the trust of congressional Democrats and was forced to announce a "fix" that infuriated both insurers and liberals alike. His approval rating is dropping and many Americans feel deceived. In the end though, nothing much has changed. The law's fate will be determined by the success or failure of Obamacare on its merits.
The first step, obviously, is to get the website working. Every day that passes without major improvements is another day closer to the law collapsing under the weight of an IT failure. Here, as well, the White House has control. Its on them to figure this thing out. If they don't, the law fails. That has always been the case from day 1. It's certainly more likely to happen now that we're seven weeks into the open enrollment period and most Americans still cannot use the site. But nothing that happened this week changes those underlying facts.
The next step is the substantive policy in the law. Assuming the administration eventually gets Healthcare.gov working, then the initial arguments over enrollment and rate shock return. Do enough young people sign up? Are people receiving better coverage? Etc. Obamacare was always going to be evaluated on those questions. Once again, nothing about that changed this week. Obama's "fix" is unlikely to seriously undermine the law, partially because insurers do not seem to be taking him up on his offer and partially because the policy implications of it are not as fatalistic as some have reported.
So even if dozens of House Democrats vote for the Upton bill today, ultimately that doesn't matter. What's truly important, as it has always been, is the substantive policy results of the law. Nothing about that has changed.
NYT columnist Ross Douthat says there's no good way to let people keep their health plans within the context of Obamacare (and he's right).
Instead, he suggests an approach the President might take to placate people who are losing lower-cost coverage that they liked:
Obamacare’s regulations could be rewritten to allow insurers to sell less comprehensive plans on the exchanges. This wouldn’t require doing away with every new regulation, or rolling back the pre-existing condition guarantee, which is what liberals argue the Upton bill currently being considered in the House would do. But it could involve heeding the recent hint from the University of Chicago’s Harold Pollack, a card-carrying Obamacare advocate, that perhaps in the wake of the last month’s developments the government should ”revisit just how minimal the most minimal insurance packages should be,” which in turn could open the door to allowing many more people to buy the kind of high-deductible catastrophic plans that the law currently allows insurers to only sell to twentysomethings.
I don't think this can work, either. Broadly, there are three reasons people who buy individual market insurance may be facing premium increases due to Obamacare. The Douthat/Pollack approaches don't go very far in addressing them:
Douthat's idea would address point (2) and Pollock's idea (which is different) would go to point (1), but point (3) is the big elephant in the room here that nobody can fix because it's a key policy aim of the ACA.
Douthat wants to allow everybody to buy the catastrophic plans that the ACA currently contemplates just for 21- to 30-year olds. For people over 30, the minimum plan you can buy from an ACA exchange and comply with the individual mandate is a "bronze plan," which is supposed to be designed with an actuarial value of 60%, meaning on average it will pay 60% of a participant's medical bills.
The ACA does not set a minimum actuarial value for catastrophic plans, but the formula the ACA uses for risk adjustments assumes it will be 57%. And this is the problem with Douthat's idea: a "bronze plan" is only very slightly more generous than a "catastrophic plan."That's because bronze plans are already high-deductible plans. Anthem Blue Cross offers a Bronze PPO in California with a deductible of $5,000 for a single adult. In New York, Aetna's Bronze EPO has a $3,000 deductible.
We should expect that catastrophic plans will be about 5% cheaper than bronze plans. Opening these plans up to the broader market would help a little with sticker shock, but not very much. The insurance consultancy Milliman warns that ACA rules "may make it hard to differentiate" between catastrophic and bronze plans, since the catastrophic plans and bronze plans must both limit out-of-pocket expenses to $6,350 for an individual subscriber.
Pollock's suggestion is to tweak the definition of "essential health benefits" under the Affordable Care Act. In other words, he'd hold down premiums by letting insurers exclude more items from coverage. But it's not clear what these exclusions could be, and Pollack doesn't make specific suggestions. The additions that add lots of cost (mental health coverage, prescription drugs, substance abuse treatment) tend to be pretty important components of health care.
We can tinker a little with the comprehensiveness of coverage, both in terms of what services of covered and what fraction of the bills the insurer will pay. But there is no "fix" to the fact that the ACA creates a shadow fiscal transfer by charging higher health insurance premiums to healthy people in order to subsidize coverage for the sick.
This was a key design feature of the law. It is not a bug. And it will lead to premium increases for a few million people. The president can say he's sorry all he wants, but rate shock is one of the key financing mechanisms for the ACA. Without coming up with a new way to finance the law, it can't be fixed.
The House of Representatives has passed a bill by Rep. Fred Upton (R-Mich.) that would allow insurers to keep offering health plans even if they do not meet certain minimum requirements of the Affordable Care Act.
All but four Republicans voted for the bill. And 39 Democrats broke ranks with the White House to vote for the bill, fearing a "no" vote could be politically damaging in the 2014 midterm election.
The final vote was 261-157. Here's the full roll-call vote on the bill.
The vote came a day after President Barack Obama announced his own tweak to his signature legislation.
The White House on Thursday night issued the strongest possible veto threat of the bill, saying in a statement of administration policy that Obama would veto the legislation if it reaches his desk. The White House said that the Upton bill rolls back "progress" of the law.
The House bill not only allows insurers to continue to offer the canceled plans, but it also permits them to sell them to new customers indefinitely. This is different from Obama's tweak, and Democrats say that the Upton bill is akin to "destroying" the Affordable Care Act.
In a rebuke to President Barack Obama and his threat of veto, 39 House Democrats earlier Friday voted for GOP-sponsored legislation that would allow insurers to keep offering health plans even if they do not meet certain minimum requirements of the Affordable Care Act.
It wasn't as many as Democratic aides had privately feared earlier this week, but the defections are a significant jump from a Democratic caucus that, for the most part, has stood unified on the 40-plus House GOP attempts to repeal or alter the law. Before Friday, the largest number of Democrats that had voted against the law was 35, on a July bill to delay Obamacare's employer mandate.
What do the 39 Democrats have in common? Most are in competitive districts in next year's midterm election, and all are being targeted by the campaign arm of Republicans for their support of Obamacare at a time when it is becoming less and less popular and its rollout has been a disaster.
"I will work with any member, Democrat or Republican, who is willing to work together to find common-sense solutions such as this to put the American people first," said Patrick Murphy (D-Fla.), a freshman Democrat who is a prime target for Republicans next year.
Murphy's praise of the law went directly against many other Democrats and the White House, who painted it as a step in Republican attempts to dismantle the law. It is understandable in light of the expected attacks against him — but it definitely does not mean that Republicans will stop targeting him.
The National Journal's Scott Bland has some good data profiling the Democrats who voted in favor of Rep. Fred Upton's (R-Mich.) bill on Friday:
Here's the full list of Democratic defectors:
(Reuters) - UnitedHealth Group <UNH.N> dropped thousands of doctors from its networks in recent weeks, leaving many elderly patients unsure whether they need to switch plans to continue seeing their doctors, the Wall Street Journal reported on Friday.
The insurer said in October that underfunding of Medicare Advantage plans for the elderly could not be fully offset by the company's other healthcare business. The company also reported spending more healthcare premiums on medical claims in the third quarter, due mainly to government cuts to payments for Medicare Advantage services.
The Journal report said that doctors in at least 10 states were notified of being laid off the plans, some citing "significant changes and pressures in the healthcare environment." According to the notices, the terminations can be appealed within 30 days.
Tyler Mason, a UnitedHealth spokesperson, was not immediately available for comment when reached by Reuters.
The insurer told the WSJ that its provider networks were always changing and that it expected its Medicare Advantage network to be 85 percent to 90 percent of its current size by the end of 2014.
UnitedHealth is participating in about a dozen new state insurance markets that launched on October 1 to offer subsidized health coverage under President Barack Obama's healthcare overhaul.
The insurer said previously it planned to withdraw from some markets in 2014 because of the government funding cuts.
Another top health insurer, Aetna Inc <AET.N>, also warned in October that it expected slowing growth in 2014 in its Medicare Advantage plans.
(Reporting by Zeba Siddiqui in Bangalore; Editing by Peter Cooney)
Minority Leader Nancy Pelosi (D-CA) joined David Gregory on Meet The Press this morning and attempted to justify President Obama's line that "if you like your plan, you can keep it." Despite the fact that millions of Americans are receiving cancellation notices, Pelosi has refused to admit that the president's promise has not come true.
"Are you accountable for saying something that turned out not to be correct," Gregory asked.
"It's not that it's not correct, it's that if you want to keep," Pelosi responded, " It's important that the insurance companies to say to people this is what your plan does. It doesn't prevent you from being discriminated against on the basis of pre-existing conditions. It doesn't prevent lifetime limits, annual limits"
Gregory continued to pressure her about the minimum standards that Obamacare requires.
"If you had your plan before the enactment of the law in 2010, there is nothing in the law says you have to [change it]," Pelosi answered.
This is the line that Obama used when Americans first received their cancellation notices, but has since given up on. The Affordable Care Act grandfathers in all insurance plans before the law passed in 2010, but insurers are only allowed to make minimum changes to those plans to keep that status. Otherwise, they are required to meet the consumer protection regulations in the law. Given the notable yearly change in insurance coverage, this effectively guaranteed that insurers would cancel millions of plans.
This past week Obama took executive action to extend that grandfather clause to plans offered this year so that insurers can continue to offer plans to current beneficiaries that do not meet those minimum requirements. Insurance regulators and insurers still have the choice to continue offering those plans and many Americans will still find themselves holding cancellation notices.
Here's Pelosi on Meet The Press:
"Blue Bloods" star Donnie Wahlberg may not want to quit his day job.
The former New Kid On The Block proposed a simple-sounding fix for HealthCare.gov — the troubled website for the Affordable Care Act — on Friday via Twitter and the Internet had a field day.
“Why dump 600,000,000 taxpayer dollars into healthcare website?” he posted to his over 514,000 followers. “Why not dump $2,000,000 in the pockets of 300,000,000 U.S. taxpayers instead?”
Wahlberg continued, “That is not a bash on our president. I respect and admire him. Just doing the math."
Great plan, Wahlberg! Except for the fact that 600,000,000 divided by 300,000,000 is two.
Realizing his mistake, Wahlberg apologized and laughed it off: "I know my math is f***ed. Ha Ha Ha! Thats why I stick to acting!” he said. “Thats only $2 a person. Enough for half an aspirin! Screw it. Forget what I said! Load up the website and healthcare for all!”
Wahlberg's tweets have since been deleted, but he did leave us with these:
People really need help and care and I don't feel good making light of it. Even in a self deprecating manner. I don't use twitter to bitch ❤— Donnie Wahlberg (@DonnieWahlberg) November 15, 2013
I will say this though... My math may be bad but it's better than most of our politicians!— Donnie Wahlberg (@DonnieWahlberg) November 15, 2013
President Obama's approval ratings drop to record lows in a new Washington Post/ABC News poll. Just 42% approve of him while a new high of 55% disapprove.
Faith in Obama's handling of different issues has fallen across the board, but has particularly plummeted in health care. Nearly two-thirds of Americans (63%) disapprove of how he has implemented the Affordable Care Act while only a third approve. This comes seven weeks after the catastrophic launch of Healthcare.gov and minimal improvement since then.
In the meantime, millions of Americans have received cancellation notices from their insurers and the president has found himself backtracking on his "if you like your plan, you can keep it" promise. Last week, he announced an administrative fix that gave insurers the option of continuing to offer health plans to current beneficiaries throughout 2014 with the approval of state insurance regulators.
Americans are split on whether Obamacare's initial difficulties will doom it permanently and 71% want the administration to delay the individual mandate.
This comes on the heels of yesterday's Gallup poll that found 56% of Americans do not believe it's the government's responsibility to ensure Americans have health coverage, compared to 42% who believe it is the government's duty.
Jon Stewart has been uncannily critical of President Barack Obama on the topic of his signature health care law's disastrous rollout, comparing him last week to embattled Toronto Mayor Rob Ford.
To Stewart, it's hard to overstate how bad the rollout's been. Hard, but not impossible. Stewart reserved his harshest criticism on "The Daily Show" Monday night for the media, which has engaged in a comparison frenzy of Obamacare being the political equivalent to Obama what Hurricane Katrina was to President George W. Bush.
"Look, I'm not trying to polish the [dot]turd that is HealthCare.gov," Stewart said of the dysfunctional website. "But comparing the government abdication of responsibility after Katrina, the death of hundreds of people, the displacement of thousands of people to a f— website is offensive."
Stewart then cut to clips of some in the media, and some from the Bush administration, who thought it was offensive — to Bush.
"Are you out of your f— mind?" he said.
Watch the clip below:
The website at the center of U.S. President Barack Obama's healthcare overhaul has security flaws that put user data at "critical risk" despite recent government assurances it is safe to use, a respected security expert said on Tuesday.
"There are actual, live vulnerabilities on the site now," David Kennedy, head of computer security consulting firm TrustedSec LLC, told Reuters before testifying at a congressional hearing on the topic "Is My Data on HealthCare.gov Secure?"
Kennedy, a former U.S. Marine Corps cyber-intelligence analyst, presented a 17-page report describing the problems to the House Science, Space and Technology Committee. It does not go into specifics in some areas, he said, because that could provide criminals with a blueprint for launching attacks.
The website is an online exchange that allows consumers to shop for insurance plans under Obama's Affordable Care Act, which mandated that Americans have health insurance and created new marketplaces to buy and sell policies.
The site has been bedeviled by technical glitches since its launch on October 1, although Obama administration officials have said they are getting on top of the problems.
"There is a lot of stuff that we are not publicly disclosing because of the criticality of the findings," Kennedy said. "We don't want to hurt people."
When asked to describe the severity of the threat that they posed to the public, he said it was a "critical risk."
The HealthCare.gov site collects data including the names, birth dates, social security numbers, email addresses and healthcare information about its users that criminals could use to engage in a wide variety of scams.
"The Obama administration has a responsibility to ensure that the personal and financial data collected by the
"Unfortunately, in their haste to launch the HealthCare.gov website, it appears the administration cut corners that leaves the site open to hackers and other online criminals."
The Obama administration said on Tuesday the website was safe to use.
Kennedy was one of the first security experts to identify vulnerabilities that the site poses to the security of user data, describing them on his company's blog shortly after its October 1 launch.
The site lets people know invalid user names when logging in, allowing attackers to identify user IDs for the site, according to the report prepared for Tuesday's hearing. It also describes more technical bugs that could lead to attacks.
Kennedy said in making his assessment he had used tools that allowed him to remotely view the site's software, code and architecture without needing credentials to log on to its server.
In October, a September 27 government memorandum surfaced in which two Department of Health and Human Services officials said the security of the site had not been properly tested before its launch, creating "a high risk."
HHS spokeswoman Joanne Peters said then that steps had been taken to ease security concerns since the memo was written, and that consumer data was secure.
Peters reiterated those assurances on Tuesday.
"When consumers fill out their online Marketplace applications, they can trust that the information that they are providing is protected by stringent security standards," she said.
"Security testing happens on an ongoing basis using industry best practices to appropriately safeguard consumers' personal information," she said.
The Department of Homeland Security said last week that authorities were investigating more than a dozen cybersecurity incidents targeting HealthCare.gov.
(Reporting by Jim Finkle in Boston; Editing by Michele Gershberg, Jeffrey Benkoe, Ross Colvin and Jim Loney)
For the last six weeks, Republicans have been full of nothing but sympathy for the approximately 5 million Americans who have gotten notices that their health insurance plans that are getting canceled.
These people — they are having difficulty with their access to health insurance! How can we tolerate such a situation for our fellow citizens?
Indeed, many of these people have legitimate grievances: In some cases, they will have to pay more for equivalent coverage. In other cases, they should have better deals coming to them, but the problematic rollout of Obamacare's insurance exchanges has made it difficult for them to sign up for those deals.
But here's the thing: To Republicans, 5 million cancellation notices is an outrage, even though the people getting the notices will have other options for coverage, and in many cases those options will be cheaper and better.
But 47 million people without coverage, in most cases because they can't afford it is not outrageous at all. In fact, it's a desired policy outcome.
I can hear the shouting now. How dare I say that Republicans want the uninsured to stay uninsured? I'm being unfair! Republicans have their own policies for expanding access to health care! Haven't I heard how they are for tort reform? They want to cover the chronically ill through high-risk pools! They are just awash in conservative health reform ideas and legislation!
This is a load of crap.
Republicans do not favor any sort of health care reform. They do not favor policies to expand health insurance coverage. They do not even favor their own ideas about high-risk pools.
If Republicans had the least bit of interest in fixing America's trainwreck of a health care system, they would have done it when they ran the federal government.
The only thing Republicans can agree on as a party is that they hate the president, they hate Obamacare, and they therefore want to defend the pre-Obamacare status quo. That is, America spending twice as much as our peer countries to achieve the same health outcomes they get, all the while leaving one-seventh of the population uninsured.
Obamacare is a mess. It's such a mess that it should be vulnerable to attack from a party with a better, cleaner, more efficient set of ideas about to reform the health care system. But as Republicans have nothing to replace Obamacare with, and the pre-Obamacare status quo can no longer be recreated, it won't be repealed or replaced.
In some sense, that means the president is lucky. But the country is not.
I've been pretty down on the idea of fixing "rate shock." When Obamacare causes people's health insurance premiums to rise, that's mostly a result of two well-considered policy choices:
That said, here are three ways we could combat rate shock without undermining either of those goals, in increasing order of political difficulty.
(1) Allow more age-based rating.
The go-to example of someone facing rate shock is a young, healthy man with a moderate or high income who buys health insurance through the individual market. One main reason his premium is going up is that Obamacare limits age-based premium variation to a 3:1 ratio: an insurer may only charge a 64-year-old three times as much as an 21-year-old, even though older people consume much more health care.
Why not just allow unlimited age-based premium variation? If the variation weren't regulated, actual variation would be a little more than 5:1, according to an estimate from the Kaiser Family Foundation, and young people wouldn't face so much rate shock.
The usual answer is that, without the cap on age-based rating, insurance would become too expensive for some adults in the 50-64 age bracket. But it's important to remember that, under the ACA, premiums are already capped as a percentage of income for people making less than 400% of the federal poverty line (about $46,000 for a single adult). Because of the subsidies, older adults making under 400% of FPL will be held harmless from any premium increases: Added subsidy payments will fully offset any premium increase.
Here's whose premiums would change if we got rid of the cap on age-based premium variation: Older adults making over 400% of FPL would pay more, and young adults would pay less. In other words, we'd be repealing an implicit transfer program created by Obamacare from moderate- and high-income young adults to moderate- and high-income older adults. What was the policy justification for that transfer?
(2) Extend subsidies to more middle-income people.
Because of budgetary constraints (i.e., the political desire to hold down the explicit fiscal cost of the law) Obamacare creates a subsidy cliff. People making up to 400% of FPL receive generous premium subsidies, and people making more receive none.
Consider a married couple with no children living in Queens, New York. If they make $62,000 a year, just below the 400% of FPL cutoff, the second-cheapest "silver" level health plan available to them on the New York health insurance exchange will cost $6,371 a year. If they make $63,000, just over the cutoff, they'll have to pay $9,247 for that same plan.
This creates perverse incentives: That couple faces an implicit tax rate of 300% on that extra $1,000 of income, which will encourage them to try to keep their earnings just below 400% of FPL. It's also not fair: Different people in extremely similar financial situations are given wildly different levels of government benefits.
But then, unfairness and distortion are hallmarks of the ways America subsidizes health care. The pre-Obamacare Medicaid system is designed such that returning to work can mean a loss of health insurance. Tax subsidies for employer-provided health care provide the most generous benefits to people with high tax rates and free-spending employers, that is, the people with the least need for insurance subsidies.
I've said before that our health care system is a thicket of subsidies and transfers and I think of Obamacare as an effort to "make the thicket of subsidies and transfers more sensible." One way to do further that would be to extend the premium subsidy range higher (say to 600% of FPL) and offset the cost by restricting the value of the tax subsidy for employer-provided insurance, for example by turning it into a fixed-dollar tax credit.
(3) Allow some middle-income people to buy a Medicaid-based public option.
This is by far the most radical of the three ideas. Medicaid is cheap: Just $3,000 per adult enrollee as of 2010. And that's even though its cost is inflated by the fact that its beneficiaries are very poor and cannot afford significant co-payments or deductibles. We could offer a Medicaid-based option to middle-income adults for whom exchange plans are not affordable, but with added co-payments and deductibles to further reduce the cost.
This would make all sorts of groups go crazy: providers, insurers, pharmaceutical companies, moderate Democrats and of course Republicans. But I include it here because it's a good policy idea and a fairly obvious way to offer an affordable insurance option to people feeling squeezed by what's offered in the ACA.
(Reuters) - President Barack Obama's HealthCare.gov site is riddled with security flaws that put user data of millions of people at risk and it should be shut down until fixed, several technology experts warned lawmakers on Tuesday.
The testimony at a congressional hearing could increase concerns among many Americans about Obama's healthcare overhaul, popularly known as Obamacare.
Opinion polls show the botched rollout of the online marketplace for health insurance policies has hurt the popularity of the effort.
The website collects personal data such as names, birth dates, social security numbers, email addresses and other information that criminals could use for a variety of scams.
In a rapid "yes" or "no" question-and-answer session during a Republican-sponsored hearing by the House of Representatives Science, Space and Technology Committee, Republican Representative Chris Collins of New York asked four experts about the security of the site:
"Do any of you think today that the site is secure?"
The answer from the experts, which included two academics and two private sector technical researchers, was a unanimous "no."
"Would you recommend today that this site be shut down until it is?" asked Collins, whose party is opposed to Obamacare and has sought to capitalize on the failures of the website since it opened for enrollment on October 1.
Three of the experts said "yes," while a fourth said he did not have enough information to make the call.
"When consumers fill out their online marketplace applications they can trust that the information that they are providing is protected by stringent security standards."
HealthCare.gov allows consumers to shop for insurance plans under Obama's Affordable Care Act, which passed in 2010 and mandated that Americans have health insurance. It also created new marketplaces to buy and sell policies.
The portal has been bedeviled by technical glitches and reports of security bugs, although officials say they are making progress with repairs and that it should be accessible to the "vast majority" of consumers by November 30.
"The Obama administration has a responsibility to ensure that the personal and financial data collected by the government is secure," said Representative Lamar Smith, the Texas Republican who chairs the House science panel.
"Unfortunately, in their haste to launch the HealthCare.gov website, it appears the administration cut corners that leaves the site open to hackers and other online criminals," he said.
The experts said the site needed to be completely rebuilt to run more efficiently, making it easier to protect. They said HealthCare.gov runs on 500 million lines of code, or 25 times the size of Facebook, one of the world's busiest sites.
"When your code base is that large it's going to be indefensible," Morgan Wright, CEO of a firm known as Crowd Sourced Investigations, said in an interview after testifying at the hearing.
"Do you want to defend the Great Wall of China or a very small line?"
David Kennedy, head of computer security consulting firm TrustedSec LLC and a former U.S. Marine Corpscyber-intelligence analyst, gave lawmakers a 17-page report that highlights the problems with the site and warned that some of them remain live.
The site lets people know invalid user names when logging in, allowing hackers to identify user IDs, according to the report, which also warns of other security bugs.
Avi Rubin, director of the Information Security Institute at Johns Hopkins University and an expert on health and medical security, said he needed more data before calling for a shutdown of the site.
"Bringing down the site is a very drastic response," he told Reuters after the hearing.
But he would not use it because he is concerned about security bugs that have been made public, he said.
In written testimony, Kennedy said it would take a minimum of seven to 12 months to fix the problems with the site shut down, given the site's complexity and size.
In October, a September 27 government memorandum surfaced in which two Department of Health and Human Services officials said the security of the site had not been properly tested before it opened, creating "a high risk."
HHS spokeswoman Joanne Peters said then that steps were taken to ease security concerns after the memo was written, and that consumer data was secure.
Peters said on Tuesday the government has been making improvements to the site as it has learned of specific problems. In late October technicians fixed a security bug in the password reset function, she said.
(Reporting by Jim Finkle in Boston and Alina Selyukh in Washington; Additional reporting by Mark Felsenthal; Editing by Ross Colvin and Grant McCool)