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The latest news on Obamacare from Business Insider

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    bloomberg businessweek obamacare coverWASHINGTON (Reuters) - Up to 40 percent of the technology needed to run the new Obamacare health insurance marketplace has not yet been built and will not be ready when insurance companies start sending in bills when coverage begins January 1, the project manager of HealthCare.gov told the U.S. Congress on Tuesday.

    The missing "back-end" technology may not be ready until mid-January, Henry Chao, deputy chief information officer for Centers for Medicare and Medicaid Services, told a House of Representatives oversight subcommittee.

    If the business functions are not in place on time, it could create havoc with a system through which billions of dollars in federal tax money will flow to subsidize coverage for consumers who otherwise could not afford it, insurance industry officials said. The first payments are due in mid- to late January.

    The disclosure added to an atmosphere of uncertainty that has engulfed President Barack Obama's signature domestic policy achievement since HealthCare.gov crashed soon after its October 1 launch.

    The absence of the back-end technology behind health care marketplaces that have sprung up in all 50 states and the District of Columbia does not prevent consumers from enrolling for coverage through market portals such as HealthCare.gov.

    Administration officials said the technology was set aside in the run-up to Obamacare's October 1 rollout, so that CMS could concentrate on the consumer features of the troubled federal website, HealthCare.gov.

    Obama's Patient Protection and Affordable Care Act requires most Americans to be at least enrolled in health coverage by March 31 or pay a penalty.

    CMS spokeswoman Julie Bataille told reporters that technology for those functions would not be needed until January.

    "The back-end financial management systems are something that we do not believe are essential until 2014 and we'll roll those out in those timeframes," Bataille said on a conference call with reporters.

    But a program needed to confirm the identities, subsidy levels and coverage choices of individual plan enrollees would have to be in place in December, if coverage is to begin on time on January 1, said an insurance industry official who asked not to be named.

    A CMS official warned as early as July that the financial management project was short staffed, weeks behind schedule and the target of a bureaucratic tug-of-war over resources and priorities, according to internal CMS emails.

    "The upshot is that the (financial management) build appears to be way off track and getting worse," said a July 8 email from Jeffrey Grant of the CMS unit, Center for Consumer Information and Insurance Oversight.

    The document, provided by Republican investigators in Congress, said staff had been transferred to other projects leaving only one highly skilled developer.

    (Reporting by David Morgan; Additional reporting by Susan Heavey; Editing by Sandra Maler, Fred Barbash and Lisa Shumaker)

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    Barack Obama

    Another day, another "record low" for President Barack Obama in a new poll. 

    This time, it's in a CBS News survey released Wednesday. Obama's approval rating sits at an all-time low of 37%, a 9-point drop in only a month. His disapproval rating, meanwhile, is 57% — the highest of his presidency. 

    The poll comes at a time when the launch of his signature federal health-care program has been a full-fledged disaster. And for the Affordable Care Act itself, the numbers are bad, as well. 

    Only 31% now say they approve of the law known as Obamacare, a new low in CBS polling. That's down a whopping 12 points from last month. And a new high of 61% disapprove, including 46% who disapprove strongly. Just one-third of respondents say they are at least somewhat confident the dysfunctional HealthCare.gov website will be fixed by its target of Nov. 30. 

    And just 7% think that the law should be kept in place without any changes. If there is a silver lining in the poll, it's that a majority (48%) think there should be some changes to make it work better, while only 43% support full repeal. 

    A key asset for Obama has always been the perception that he's trustworthy and honest, as well as likable. During last year's campaign, 60% of respondents in a CBS poll said they thought Obama was honest and trustworthy. Only 49% say the same today. 

    The CBS poll mirrors other plunges in Obama's approval ratings amid a bevy of setbacks since the summer. According to the Real Clear Politics average of seven recent polls, Obama's approval-to-disapproval split sits at 40.4-55.1.

    Here's a look at how it's moved in 2013:

    Obama poll

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    Time magazine calls the Affordable Care Act a "broken promise" on the cover of its latest issue. The image splits a pill with "Obamacare" inscribed on it in half, separating "Obama" and "care."

    The cover story, by Nancy Gibbs, looks at how President Barack Obama needs to fix what has been a disastrous rollout of the federal health law — and fix it fast:

    So the sign that the Obama presidency had reached a turning point came not when his poll numbers sank or his allies shuddered or the commentariat went hunting for the right degree of debacle to compare to the rollout of Obamacare.

    It happened when he started apologizing. In triplicate. For not knowing what was going on in his own Administration. For failing to prevent his signature achievement from detonating in prime time. For not telling the whole truth when he promised people that Obamacare would not touch them without permission: "If you like your health care plan, you can keep your health care plan."

    Here's the cover:

    Time cover Obamacare

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    obama

    Conservatives need to stop comparing the fight against Obamacare to 19th century efforts to resist slavery.

    This comparison isn't just inapt (and offensive to those it attempts to persuade), it misses the point. There are much better current-day examples conservatives can use to explain why they're so passionate about stopping the law.

    Unfortunately, the "slavery" talking point keeps coming back.

    Rush Limbaugh compared the "it's the law" argument surrounding Obamacare to the "it's the law" argument fighting slavery. George Will's comparison was more insightful, but still unhelpful: "the Fugitive Slave Act was the law, separate but equal was the law, lots of things are the law and then we change them.”

    Conservative stalwart Richard Viguerie compared the Supreme Court decision upholding Obamcare to the Dred Scott decision (and Jim Crow): "Today, a 5-4 majority of the Supreme Court of the United States ... has chosen to join infamous courts of the past, such as the Taney Court that made the Dred Scott v. Sanford decision finding that slaves had no rights and the Fuller Court that ruled to institutionalize Jim Crow discrimination in Plessy v. Ferguson in stripping Americans of their freedom."

    And by far the least helpful was rising conservative darling Ben Carson, who made the direct comparison at the Conservative Political Action Conference: "Obamacare is really the worst thing that has happened in this nation since slavery. It is slavery, in a way."

    Here's a better Obamacare analogy: a hypothetical elimination of the payroll tax—coupled with a moderate privatization of Social Security (Let's call it the "Cruz Plan"). Such a reform would almost certainly require a filibuster-proof GOP majority, would spur radical opposition from the left, and would be opposed for years by the Democratic Party—whether or not it could actually be repealed.

    As a result of Democrats not participating in the passage of the law, core GOP constituencies (investors, businessmen, and the upwardly mobile) receive the preponderance of benefits. (By extension, Democratic constituencies will not). Moderate Democrats, like moderate Republicans post-2010, find themselves swept from power as party hardliners demanded fealty to maximal opposition to the law. By virtue of the law's existence, the party is less capable of accepting the law in the future. 

    Democrats sweep back into control of the House following the law's passage (even if the law itself is not—cough, cough, economy—the primary reason for the surge), yet despite repeatedly sending repeal bills to the Senate, nothing happens. To add to the misery, the party runs on a platform of repeal in the following presidential campaign—and loses badly.

    The law takes effect, and as workers instantly see a real-time increase in their paychecks, the chances of repeal dim. This is compounded as workers also see their retirement savings - perhaps subsidized for lower-income workers—grow in real time. (Constituencies are notoriously tough to unwind). Prominent liberals have spent years decrying any attempt to slash payroll taxes as a step in eliminating Social Security, and now they feel impotent to obstruct further reforms. 

    To further pile on, the moderate voices crucial to finding a middle-way have long since been shown the door. Party leadership is fatally weakened, control of messaging and legislative tactics has been decentralized, think tanks have been purged, and the loudest elements of the hardline are now in charge. 

    And even worse, substantial elements of the Democratic party faithful fairly question why voter discontent with policies a president of theirs pursued, against their will, were responsible for the creation of a law they deeply despise. 

    You'd feel like your back was against the wall, no? 

    That's precisely where the GOP is today.

    Because the truth is painful: even a disastrously functioning Obamacare will be incredibly difficult to repeal. Hundreds of thousands have signed up for Medicaid (with many more to come), subsidies will go out to numb rate-shock for poorer workers, and those with pre-existing conditions will have access to insurance.

    Here in Wonkistan (a.k.a. Washington, D.C.), conservative policy thinkers see a law that deeply frustrates, if not outright dooms, their own ideas for reform. These new Obamacare constituencies will resist—like constituencies before them—efforts to change the system for the better. 

    And thus conservative reforms—such as better funding high-risk pools, unwinding the tax exclusion for employer-based insurance, and/or subsidizing Medicaid patients to enable them to participate in the insurance market—are less likely because Obamacare is "the law."

    That's not as dramatic as slavery, but it's a pretty rough spot all on its own. And who knows ... maybe a story a 21st century liberal can actually relate to may convince enough people to change the law.

    Justin Green is the Social Media Editor at the Washington Examiner.

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    obama

    Last week President Obama announced that he will try to keep his oft repeated promise to Americans in the individual market that they can keep their plans if they like them … for a year.

    The media have done an excellent job explaining why President Obama’s temporary patch to the ACA may endanger its existence; in the process the American public has learned more than it ever wanted to about adverse selection, cream skimming, and most importantly crass politics.

    Though the full costs of adverse selection will be muted in the first year by risk corridors and reinsurance, it is clear that the failing website, the bad press, and the recently announced delay are placing maximal stress on even those backup provisions of the bill.

    Even if the ACA survives this additional insult against the economics that support its very existence, we have witnessed yet another missed opportunity for positive reform to President Obama’s signature legislative achievement. And this time we can’t just blame intransigent tea-party Republicans and their quixotic efforts at repeal; here the buck stops at 1600 Pennsylvania Ave, NW.

    While many of the plans that are affected by the President’s temporary patch might actually be plans that don’t qualify as “insurance” (i.e. they have low lifetime caps on expenditures or don’t cover hospital services), numerous others actually offer quite good coverage that just don’t meet the exceptionally high standards of the newly developed minimum essential health benefit (EHB). In many ways, the first dollar coverage for preventive care and the wide ranging number of services covered by the ACA aren’t truly insurance either. Instead, these features amount to a very generous pre-payment plan for medical services supported by the United States treasury.

    These elements of the EHB are too costly and unnecessary. Perhaps even more concerning, they are just the ante. As time goes on, vested interests for everything not included in the EHB will work tirelessly to insure that their favorite benefits are included. If you want evidence of this eventuality, you need look no further than the remarkably long and growing list of benefits mandated by most states. Keep in mind that as the EHB grows more generous the premiums and subsidies on the exchanges will also grow. And we know who will pay their “fair share” of those increases.

    Given these facts, the President should have used the recent attention on the individual market as an excuse to pause, and carefully reconsider whether the EHB has actually been set far too high. Doing so would allow insurers to develop innovative benefit designs to create health insurance plans that provide quality coverage without exacerbating the growth of medical spending.

    Instead, the President chose the easy path. Let’s kick the can down the road and perhaps we can delay the next round of news stories about policy cancellations in the individual market until after the 2014 mid-term elections.

    Beyond simply delaying the inevitable, the “policy” change announced last week could threaten the very existence of the ACA. To understand why, we provide a short history lesson.

    Stanford Professor Alain Enthoven described a prototype for health insurance exchanges in 1978. Over the next two decades, the idea for exchanges was fully developed; the estimable Jackson Hole Group of leading academics, policy wonks, and industry executives produced at least two serious national health insurance (NHI) proposals centered on exchanges. A bipartisan NHI proposal featuring exchanges was debated during President Reagan’s tenure, and again at the time of President Clinton’s ill-fated NHI proposal. Finally, in the mid-2000s, Massachusetts launched its exchange.

    During this time, academics came to understand what it would take to have a viable exchange. The young and healthy would have to participate, which in turn meant there would have to be a complex system of subsidies and penalties. And while it would do a world of good to end employer-sponsored insurance (see our previous blogs), the short term disruption and political roadblocks would be severe. So exchanges would have to compete side-by-side with other insurance options, which would have to be regulated lest bare bones plans skim the healthy enrollees from the exchanges.

    This, in turn, would surely force many individuals to lose their current coverage, and a number of those individuals who don’t qualify for subsidies will likely face much higher premiums. This is how we ended up with the hybrid ACA proposal and, because the plain economic truth was hidden from us, the broken promises.

    From the beginning, opponents of the exchanges fell into two camps. The first and by far the larger camp offered a purely political reaction to any proposal offered by President Obama. We could expect such a reaction from tea party Republicans who are still searching for the President’s birth certificate.

    But we are disappointed by the moderate, supposedly pro-business Republicans who failed to see how moving away from employer-sponsored insurance could unshackle America’s businesses, especially small companies and entrepreneurs. We would have hoped that the establishment members of the Republican Party would have taken the opportunity then, or at least now when President Obama appears to be more amenable to compromise, to make the exchanges into a positive economic force. For example, they could have crafted a compromise to lower the EHB and expand the availability of high deductible health plans on the Bronze tier of the exchanges.

    Exchanges and their many rules may sound crazy, but there is method to the madness. The President may have lied about the implications of these rules, but they are at least internally coherent. At least they were internally coherent before the latest delay.

    And that brings us to the second camp. From the beginning, we joined with many free-market economists and other skeptics in opposing the ACA because we feared that ugly politics would trump sensible economics. The heavy hand of politics appeared early on, when a variety of budgeting tricks were employed to make the ACA appear to be revenue neutral. (Does anyone recall that the tax increases to fund the exchange subsidies began fully three years before the first dollar in subsidies would be paid out?) States were supposed to launch their own exchanges, but the federal option was introduced to deal with political realities. Efforts to rein in spending on high cost/low value medical technologies were abandoned to avoid any notions of “death panels.”

    Finally, and more recently, the employer mandate for insurance was delayed by a year because of difficulties in implementation. We can now add to this list the “you can keep your plan” lie and the temporary patch for those who did not keep their plans. All of these are example of how the ACA has become much more about politics than about sensible policy. Both sides must take the blame for this result.

    And so the greatest danger of large scale government intervention is laid bare for all to see. We greatly admire our colleagues who have diagnosed the ills of the U.S. health insurance system. We agree with them that “properly implemented” exchanges can assure that nearly all Americans obtain insurance coverage, promote competition among insurers, and liberate Americans from the yoke of tying insurance to employment.

    But in a two party system, especially with today’s two and a half (we can’t count the tea party as a distinct party but it is hard to lump them in with more sensible Republicans) parties, national politics continues to trump economic theory. Exchanges may be working reasonably well in Massachusetts, but nationwide? Good luck to that. (Wasn’t that Romney’s message? Like him or not, he sure got it right that solutions that work well in one state might not translate to the nation.)

    As each day brings sadder news about the exchanges, we are reminded that it is easier for a camel to pass through the eye of a needle than it is for politicians to properly implement complex economic policies.

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    lake powell

    The year is winding down, so it's time to take stock of where America is heading.

    Last year's inaugural U.S. 20 list featured things like the end of retail, the revival of manufacturing and the shale revolution.  

    Believe it or not, it wasn't difficult at all to come up with 20 brand new trends this year that will dominate headlines over the next decade. 

    It's not that all of last year's forces have already dissipated.

    But new movements have already sprung up.

    The 2013 list includes two new geographic centers of the American economy, evolving patterns of relationships, robots, and the changing energy landscape.

    Check it out.

    1. The Bay Area Is Now The Center Of The Universe



    1. The Bay Area Is Now The Center Of The Universe



    1. The Bay Area Is Now The Center Of The Universe



    See the rest of the story at Business Insider

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    Boehner Obamacare sign up

    House Speaker John Boehner has officially enrolled in a D.C. insurance exchange under the Affordable Care Act, he said in a blog post on his website Thursday evening, after having some difficulty signing up earlier in the afternoon.

    "Like many Americans, my experience was pretty frustrating," he wrote of his experience at first, a reference to the dysfunction that has plagued the exchange websites since their launch

    "After putting in my personal information, I received an error message.  I was able to work past that, but when I went to actually sign up for coverage, I got this 'internal server error' screen."

    In his original blog post, he wrote that he had put a call into the help desk. A short while later, he added an update: 

    "Kept at it, and called the DC Health Link help line. They called back a few hours later, and after re-starting the process on the website two more times, I just heard from DC Health Link that I have been successfully enrolled."

    Brendan Buck, Boehner's press secretary, joked that "sure didn't take long after the blog post."

    The federal health care law requires members to enroll in D.C. exchanges. 

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    healthcare.gov obamacare website

    WASHINGTON (Reuters) - In the last days before the botched October 1 launch of President Barack Obama's healthcare website, the team in charge was seeing alarming results from performance tests, according to internal emails released by Republican lawmakers investigating the rollout.

    HealthCare.gov was unable to consistently handle 500 users at once in the testing, and tests failed with 2,000 users over a three-day period, according to a series of emails between members of the information technology team at the Centers for Medicare and Medicaid Services, or CMS.

    "I do not want a repeat of what happened near the end of December 2005 where Medicare.Gov had a meltdown," Henry Chao, the website's project manager at CMS, wrote in capital letters in an urgent message on September 26 to his team and contractors.

    Chao was referring to the disastrous launch of the Medicare Part D prescription drug program under President George W. Bush's administration. Technical woes prevented many seniors from initially gaining access to the website.

    The emails, released by the Republican-led House Energy and Commerce Committee, are the latest to illustrate the depths of problems with the Obamacare website, which has frustrated millions of Americans with error messages and slow responses as they try to shop for health insurance.

    The troubled rollout has been deeply embarrassing for Obama, who had promised up to the launch of the website that it would make shopping for plans as easy as buying televisions on Amazon.

    It has also raised questions about the management of his signature healthcare reform program.

    White House spokesman Eric Schultz said the "cherry-picked" emails did not reveal anything new.

    "To the extent that CMS had identified capacity issues, we of course sought assurances that they were getting addressed," Schultz said. "But, as is well-known, nobody anticipated the severity of the problems we experienced once the site launched."

    In a statement, a CMS spokeswoman said the agency previously admitted it underestimated the volume of users who would try to log onto the system at the same time.

    "It is important to remember that these emails are one piece of a number of ongoing discussions up to the launch of HealthCare.gov on October 1," the statement said.

    Obama has said his team would not have launched the site had it known how badly it would perform.

    'THE RESULTS ARE NOT GOOD'

    The emails show that behind the scenes, information technology officials were raising numerous concerns. On September 26, Chao said the site needed to be able to handle at least 10,000 or more users at a time.

    But three days of testing showed the system flopping at levels well below that.

    "The results are not good and not consistent at all," wrote Akhtar Zaman, a system integrator at CMS, describing in detail the hang-ups and errors.

    On September 27, David Nelson, director of the office of enterprise management at CMS, said the system was failing because of issues like defective code.

    "We have not been successful in moving beyond 500 concurrent users filling applications" he said. "We must give ourselves the ability to work through these tuning issues."

    Hemant Sharma, a contractor with CGI Federal, the U.S. subsidiary of Canada's CGI Group Inc, which is helping to build the site, downplayed Nelson's concerns. Sharma said adding additional servers would help performance.

    "The defects enumerated above are very typical in any performance test and part of the tuning exercise," Sharma wrote the team.

    On September 29, Todd Park, a top technology adviser to Obama, asked Chao whether his team was sure it had found the correct bottleneck in the system and was confident in its testing results. The emails did not include an answer from Chao.

    "Massive kudos again for the incredible progress the team is making!" said Park.

    But by September 30 - the day before launch - Zaman reported to Chao there was still a lot of work to do. The system was running very slowly at low test levels of 1,100 to 1,200 concurrent users, and a part of the website allowing the user to compare plans had not yet been tested.

    "Our goal is to hit 10,000 concurrent users at first, and then keep shooting for the 50,000 concurrency limits," Zaman said.

    But as many as 250,000 users at a time visited the site at launch, far surpassing the site's limits.

    Republican lawmakers investigating the website woes said the emails show the administration knew enough to put a hold on the launch.

    "What we are learning is that the administration went out of its way to hide the chaos behind the scenes," said Fred Upton, chairman of the House energy and commerce panel.

    (Reporting by Roberta Rampton; Editing by Fred Barbash and Peter Cooney)

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    Blue Cross Blue Shield wants consumers to know there are other places to buy health insurance as the Obamacare fiasco continues. Sure, a client will miss out on government subsidies available only through the federal marketplace, but they are hoping the (probably) higher prices will offset fears of compromised information and other complications found at HealthCare.gov.

    The insurance company's Iowa/South Dakota branch, Wellmark, has a campaign proclaiming "Things don't always work like they're supposed to. Thankfully, there are other places to buy insurance." Ouch.

    Watch this ad featuring a helpless man unable to open a urine sample cup despite his bursting bladder: 

    Agency Campbell Mithun produced the campaign, which also includes a spot where our hero's reflex test goes wrong and one where a blood pressure pump makes a farting noise. They'll run until mid-December.

    Wellmark covers almost 2 million people in its market, and is the biggest healthcare provider in Iowa and South Dakota.

    SEE ALSO: Colorado Nonprofit Sells Obamacare As 'Brosurance' With Cringeworthy Viral Ad Campaign

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    In the aftermath of Senate Democrats going nuclear yesterday (changing the filibuster rules), some forecasters have looked ahead to its effect on the continuing resolution to fund the government, which expires on January 15.

    Some analysts believe that increased animosity between senators could make it harder to strike a deal. In Morning Money today, Guggenheim's Jaret Seiberg put the odds of another government shutdown happening at 40 percent. However, such analysis ignores the incentive structure for Republicans.

    Here are 5 reasons why another shutdown isn't in the cards:

    1. It was a colossal failure the first time. This is stating the obvious, but the public rightly blamed the Republican Party for the shutdown. Their poll numbers cratered and political commentators began seriously talking about the chances of the Democrats taking over the House, something that had been unthinkable just a month earlier. They already tried this strategy and it blew up in their faces. They won't do it again.

    2. It would distract from Obamacare. This was one of the main mistakes Republicans made in October. Conservatives thought the shutdown would shine a light on Obamacare just as it launched. Instead, the light was cast on the asinine strategy to defund the law. Now, Obamacare is in an even worse position. The website is still not working, Obama's "if you like your plan you can keep it" promise has proven false and he was forced to make an administrative fix to his bill that has infuriated insurers. Republicans need to do everything they can to keep the focus on Obamacare.

    3. Most conservatives don't want another shutdown. Many Tea Partiers have learned their lesson this time. One of the leaders of the first shutdown, Senator Mike Lee (R-UT) has already come out and said that he does not think that passage of the next continuing resolution should be tied to Obamacare. Given Lee's prominent role in the first shutdown, his pivot is important.

    4. Republican leadership won't allow it. Senate Minority Leader Mitch McConnell (R-KY) told reporters that there would not be another government shutdown. He more than anyone was aware of the damage it caused the Republican Party. Given the tough reelection fight he faces next year, McConnell will avoid a second shutdown at all costs. For his part, House Speaker John Boehner (R-OH) is already drafting legislation for a continuing resolution that funds the government at sequester levels until mid-April to give the budget negotiators more time. Democrats won't like this, but if push comes to shove, they won't shut the government down over it.

    5. It's an election year. It will only be two weeks into 2014, but many moderate House Republicans will be looking ahead to their re-election campaigns. A government shutdown would be a disaster for them. Some Republicans may feel pressure to move right from primary challengers, but many others will be worried about their poll numbers cratering yet again. These are the Republicans who were bystanders in the previous fight. They won't be this time around.

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    obama

    The Obama administration on Friday extended a key deadline to sign up for health insurance under the Affordable Care Act. 

    The Centers for Medicare and Medicaid Services said Friday that people signing up for coverage that starts on Jan. 1 now have until Dec. 23 to sign up for the coverage. That's an eight-day extension from the previous Dec. 15 deadline. 

    CMS spokeswoman Julie Bataille said that the move was made in consultation with insurers. It's an important one for people who have been unable to sign up for health insurance under the law due to the dysfunctional federal HealthCare.gov website.

    Jeff Zients, the official charged with leading the "tech surge" to fix HealthCare.gov, said the administration is still on track to meet an end-of-November goal to have the website work "smoothly" for the "vast majority" of users. Still, it experienced at least two unplanned outages this week.

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    obama

    Comparing the failed rollout of Barack Obama's signature health care legislation to President George W Bush's bungled handling of Hurricane Katrina is, how shall we say, problematic.

    The most obvious reason is that 1,800 people lost their lives during Hurricane Katrina.

    Thankfully, no one has yet lost their life because they couldn't log on to healthcare.gov.

    And for those who were able to navigate the site and buy coverage, they can now look forward to additional years of good health and economic security. That's a very different outcome – and a much more positive one – then what one might expect from one of the worst natural disasters in American History.

    But the crassness of persistent Obamacare-Katrina comparisons is only one part of the problem. When political observers argue, as the New York Times did, that President Obama's website issue "threatens the rest of his agenda but also raises questions about his competence in the same way that the Bush administration's botched response to Hurricane Katrina undermined any semblance of Republican efficiency", they are making an argument that is grounded almost entirely on a myth.

    Hurricane Katrina didn't destroy George W Bush's presidency. Iraq and a faltering economy did. Along the same lines, Obamacare's woes are highly unlikely to destroy Barack Obama's presidency. An economy that continues to putter along with high unemployment and mediocre growth will keep his approval ratings in negative territory. And truth be told, that agenda wasn't going anywhere anyway.

    To understand why the "Katrina moment" argument is such a fallacy the above chart, which aggregates Bush's second term approval rating, provides compelling evidence. A Category 3 storm hit the Gulf Coast in August 2005, thousands died, many others were uprooted from their homes or lost everything. The New Orleans Superdome became a house of horrors, the country was introduced to the over-his-head Fema director Michael Brown ... and yet George W Bush's approval ratings barely moved. Instead, they simply continued the downward spiral that had begun just a few months after his second term inauguration.

    If there was a more visible drop-off in Bush's support anywhere, it comes in the spring of 2006.

    What happened then? War deaths in Iraq increased dramatically, both among US troops and also Iraqi civilians. That is very much consistent with political science research, which, as a general rule, finds that economic factors, major scandals, wars and battle deaths move approval ratings, as opposed to one-off events, no matter how much pundits want to hype them.

    Ironically, Bush was a beneficiary of these exact factors. His approval ratings shot up after September 11th (it was both the strongest polling rally in Gallup's history– 35 points – and the longest lasting). They remained high through the initial stages of Iraq War. By 2005 into 2006, as the conflict worsened, his numbers began to plunge, particularly as violence in Iraq increased. They took an even further hit when the economy started to go south at the end of his presidency, finishing up at a extraordinarily dismal 26%.

    So while the response to Hurricane Katrina might have been poorly handled, it was hardly Bush's undoing as president.

    So what about Obama? How have Obamacare's problems affected his public approval?

    A recent Politico article captures a flavor of the political zeitgeist:

    "President Barack Obama is suffering the worst season of his presidency because people are mad that critical parts of the Affordable Care Act are not working the way they are supposed to work."

    Not so fast.

    According to the most recent aggregated polling data at Huffington Post's Pollster, Obama's disapproval currently stands at 52.5% and his approval at 42.1%. Pretty bad. But here's where it stood on 1 October, the day Obamacare went on-line (ish): 51.2% disapproval and 43.3% approval. Also pretty bad – but not much different.

    Obamacare's problems were initially overshadowed by the government shutdown and debt limit fight. If one starts from that vantage point, Obama's numbers have moved less than 1pt in either direction. It's possible that there is a polling lag and his numbers will shoot down further, but the evidence that Obamacare has resulted in a major downturn in the president's public approval simply isn't there – yet.

    Moreover, Obama's public approval numbers have been on a downward trend since the middle of May. Guess what happened in May 2013? Americans' confidence in the economy fell off a cliff. Gallup's Economic Confidence Index stood at -3 in May (a rather sad high point for Obama's presidency) and fell to as low as -39 during the government shutdown. Even though Obama is perceived to have "won" that showdown with Republicans, it negatively affected his ratings – just as it did during the previous debt limit showdown in the summer of 2011. This suggests that dramatic examples of government dysfunction should perhaps be added to the short list of events that decisively affect presidential approval.

    In fact, one of the realities of Obama's presidency, all too rarely mentioned, is that he is a fairly unpopular president. Aside from his first few months in office, the first few months after his re-election (when economic confidence was particularly high) and the two months following the Democratic National Convention in September 2012, his approval rankings have consistently been in the red. So while his rankings are worse today than pretty much any point in his presidency, his unpopularity should not necessarily come as a complete surprise. After all, he's presided over an economy that has been either mediocre or terrible since he took office.

    This isn't to say that the rollout of Obamacare has been anything less than a colossal screw-up.

    In a country already abnormally suspicious of its federal government and thoroughly convinced of its incompetence, the failures of healthcare.gov have compounded the already significant challenges facing progressive reformers. While it's not hard to imagine a future in which comprehensive health care reform becomes something of a political boon for Democrats, we're rather far off – and now further off – from that point.

    Nonetheless, barring a complete inability to fix the health care website, this too shall pass. Healthcare.gov will get fixed, millions of Americans will be able to buy health insurance … and Obama's approval ratings will improve a smidgen – and probably not much more than that. Like pretty much every other president, Obama is at the mercy of the country's economic performance.

    Of course it may not matter much anyway. Obama's political agenda – with a 70% approval rating or a 30% one – is destined to remain on life support as long as Republicans are in control of the House of Representatives. With Speaker of the House John Boehner making clear that he has little intention of moving forward with immigration reform and the likelihood of a major budget deal even more remote – Congress's deep legislative slumber is almost certain to continue for the foreseeable future.

    So fix that website stat Mr President; dabble in foreign policy a bit, maybe get the Iran nuke deal done or make a big push on Arab-Israeli peace talks; take a few trips overseas, spend time with the family, maybe get in a fight with Republicans over judges. But those lousy poll numbers and those big legislative initiatives, they probably aren't going anywhere for awhile.

    This article originally appeared on guardian.co.uk

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    No matter how old people get, they still turn to their moms for advice when they're stuck in a difficult situation. There is actually research backing this up, and now insurers and advocacy groups are targeting mothers in an attempt to get more young people enrolled in health insurance plans.

    The New York Times investigated the trend, and found that insurers are desperate to enroll young, healthy people to offset the costs of the sick. And with Obama's proposal that may extend existing health plans for adults, the young and healthy are more valuable than ever.

    Here's what some of the insurers and advocacy groups are doing:

    The AARP made a series of e-cards that offer a compromise on motherly nagging in exchange for getting an insurance plan:

    aarp ad thumb

    aarp 2

    Obama's election campaign team, now called Organizing for Action, made this spot to get parents to have a talk with their kids about getting insured. The ad's main character is relieved to find out "the talk" is just about health insurance and not a revelation that his parents are in a cult, or got matching tattoos, etc.:

    The Thanks Obamacare campaign from a couple of Colorado nonprofits (responsible for the infamous "Brosurance" ad) also released this gem. A bro is thankful his mom got him to sign up for health insurance after his buddy somehow managed to accidentally bash his skull in with a golf club:

    brosurance never ends

    It's not the first time moms have been the target of an insurance campaign for young adults. In 2007, the Massachusetts government mailed out greeting cards around Mother's Day promoting the state health care plan.

    These Obamacare ads will be in circulation throughout the holiday season, banking on the Obama campaign's promise to clean up the mess from the Affordable Care Act's disastrous launch that has kept most Americans from using the federal insurance marketplace.

    Read the full Times piece here.

    SEE ALSO: How Blue Cross Blue Shield Is Taking Advantage Of The Obamacare Rollout Disaster

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    Barack Obama

    The Supreme Court has agreed to review two cases involving the Affordable Care Act's contraceptive mandate, setting up a high-profile showdown next year. 

    The decision to take up the challenge to the contraceptive mandate was expected. It will certainly reignite what has been a fierce debate over the provision of the federal health care law that requires employers to provide health insurance covering birth control and family-planning methods. 

    Hobby Lobby, a craft chain with about 13,000 employees, as well as at least 30 other for-profit companies, have filed lawsuits claiming that the mandate violates their religious beliefs and the First Amendment. They are suing under a 1993 federal law called the Religious Freedom Restoration Act.

    The Supreme Court is taking up suits brought by Hobby Lobby and Conestoga Wood Specialties Corp.

    Lower courts' decisions in Sebelius v. Hobby Lobby Stores Inc. were mixed. In June, the Denver federal appeals court, ruled that religious freedom "can be communicated by individuals and for-profit corporations alike." A Philadelphia federal appeals court had ruled in July that "for-profit, secular corporations cannot engage in religious exercise."

    The Obama administration is now seeking for the Supreme Court to reverse the Denver court's ruling.

    The cases are expected to be taken up in the spring.

    The White House released a statement on the Supreme Court taking up the case, from press secretary Jay Carney:

    The health care law puts women and families in control of their health care by covering vital preventive care, like cancer screenings and birth control, free of charge. Earlier this year, the Obama Administration asked the Supreme Court to consider a legal challenge to the health care law’s requirement that for-profit corporations include birth control coverage in insurance available to their employees. We believe this requirement is lawful and essential to women’s health and are confident the Supreme Court will agree.

    We do not comment on specifics of a case pending before the Court.  As a general matter, our policy is designed to ensure that health care decisions are made between a woman and her doctor. The President believes that no one, including the government or for-profit corporations, should be able to dictate those decisions to women. The Administration has already acted to ensure no church or similar religious institution will be forced to provide contraception coverage and has made a commonsense accommodation for non-profit religious organizations that object to contraception on religious grounds. These steps protect both women’s health and religious beliefs, and seek to ensure that women and families — not their bosses or corporate CEOs —c an make personal health decisions based on their needs and their budgets.

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    Oregon Senator Jeff Merkley

    Oracle is being publicly flogged for Oregon's dysfunctional Affordable Care Act website. The website has been called "the worst disaster zone" in the Obamacare’s roll out," by the Washington Post's Ezra Klein.

    That's because the state's website cost $43 million ($1.7 million over budget) and hasn't been able to sign up a single person. Worse still, it might not be working until after the March 31 deadline for enrolling in health care. So said the Oregon executive responsible for the state's rollout, Rocky King, in a hearing last week, as reported by Blue Oregon's Kari Chisholm.

    Cover Oregon board member Ken Allen blasted Oracle at the hearing, saying:

    This is their failure. ... Their dates have shifted and shifted and shifted. ... The Cover Oregon staff are tremendously dedicated folks who have worked really hard ... All of that good will and support from the business community is being frittered away because Oracle didn’t get it online. It’s 98% Oracle’s screw up.

    Meanwhile, Oregon hired 400 temp workers to process paper applications by hand, so that people who apply for coverage by December 15 will have coverage by January 1, Allen said.

    Oregon Senator Jeff Merkley blasted Oracle on television, too.

    When NBC's Chuck Todd asked him on Friday if he could explain the problems with Oregon's health care rollout, he answered  "Yes. Oracle."

    And he let that word hang in the air until Todd asked him for details. Then Merkley said:

    Oracle was contracted to write the exchange. They promised it would be fully delivered on time, it would be beautiful and do more than any other exchange in the country, and it's in complete dysfunction. So we had to return to paper applications.

    The irony of this situation is that Oracle is one of the Silicon Valley companies that the Obama administration has called in to help fix the disastrous federal website.

    We asked Oracle if it had any response, or explanation for Oregon's website's problems. Oracle had no comment.

    Watch Sen. Merkley blame Oracle (at 5:05):

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    A lot of the recent complaints about the Affordable Care Act go back to one theme: The law makes health care more expensive for some people with moderate incomes. This is true and it's a design feature of the law. And Democrats didn't want people to understand this about the law, so they lied.

    The question for conservative critics is, what's the alternative?

    The coverage expansion provided by Obamacare is expensive, and in part it's funded through higher insurance premiums on healthy people. If you dislike that, you either have to abandon certain goals of Obamacare, or you have to come up with another way to pay for them. That's the "replace" component of "repeal and replace," and ugly though the politics of Obamacare are, Republicans haven't come up with a good answer for it.

    First, let's look at what the ACA seeks to do. It has three key objectives, and it's objective (2) that's leading to cost increases for some middle-income people:

    1. Help people with low incomes afford insurance. The law expands Medicaid to people earning up to 133% of the poverty line and offers subsidies on a sliding scale to help people making up to 400% of the poverty line buy health insurance. This is all paid for with tax dollars, and therefore mostly financed by rich people.
    2. Equalize insurance costs across people, so sicker people don't have to pay extra for health insurance. People pay the same premium regardless of whether they have pre-existing conditions and regardless of sex. Premium variation based on age is limited. This makes insurance available and affordable to people who have a lot of medical expenses, and is an implicit fiscal transfer towards them. This isn't paid for with tax dollars; instead, it tends to raise premium costs for people who are relatively healthy.
    3. Control overall costs. The law does this by reforming how doctors and hospitals are compensated for the care they provide; holding down reimbursement rates paid by Medicare; imposing an excise tax that will discourage employers from offering extremely comprehensive health insurance plans; and other mechanisms, though it probably does not do as much to control costs as it should.

    For many healthy people, the added costs created by (2) will be offset by subsidies made available under (1). But for families earning over 400% of the poverty line (about $90,000 for a family of four) there will be no subsidy. And as David Freddoso points out, while people in this position aren't poor, they often aren't exactly rich either.

    Designing health reform so a significant part of its costs would fall on households with modestly above average incomes probably wasn't ideal. But what are the alternatives? When we walk through them, we find where the conservative objections break down.

    1. Instead of sending the bill to middle-income healthy people, send it to richer people. Single payer is the most obvious way to do this: Instead of using premium cross-subsidy to fund the sick, the government levies a broad-based tax to pay for health costs and therefore most of the costs accrue to the people with the highest incomes. Of course, conservatives don't want to do this.
    2. Don't bother equalizing insurance costs across people. Maybe we shouldn't view it as a public policy problem that being sick is expensive. This is most commonly the position of conservative health care wonks, who want to turn health insurance into a true insurance product (covering only expenses that would be financially ruinous) rather than a comprehensive product covering most medical expenses. This approach might well encourage cost savings and entail less public expenditure than Obamacare, Medicaid and Medicare. Coupled with the right subsidies, it would achieve some kind of universal coverage and protect people from medical bankruptcy. The problem is that the high deductibles this approach entails would be a real problem for people with chronic medical conditions. They would suddenly find themselves spending 15% or more of their incomes on medical care every year, on top of their insurance premiums. Today, conservatives are fretting about the plight of the middle-income healthy. What about the middle-income sick who would be screwed by these plans? Oh also, this approach costs money so actual Republican elected officials will never go for it.
    3. Save money by not expanding health insurance to so many poor people. This is the de-facto position of most Republican electeds, who know the catastrophic-insurance approach favored by their policy wonks would be a political disaster. So they resist spending money on subsidies for poor and middle-income people, leaving them uninsured. But they still usually can't quite bring themselves to say they oppose universal coverage as a matter of policy, because universal coverage is popular. And then they do a certain amount of mumble-mumble-mumble about cost equalization, often saying that they too favor rules that bar insurers from charging more for pre-existing conditions, even though such a rule does not work without the surrounding Obamacare apparatus they oppose.
    4. Control costs better so that the goals of Obamacare can be achieved more cheaply. This is a great idea. But here's the problem it creates for conservatives. The sort of cost control they like comes from turning insurance into a catastrophic product and making individuals bargain for lower costs from providers. This approach, which focuses heavily on shifting costs to the patient, screws the chronically sick. Conservatives tend to oppose top-down cost controls that don't involve screwing the sick, such as lower Medicare reimbursement rates. They even have opportunistically opposed cost controls they should support, such as the Cadillac Tax on high-cost health plans which mimics a proposal John McCain ran on in 2008.
    5. Mumble mumble mumble tort reform sell insurance across state lines and empty hand wave in the direction of high risk pools. Given conservatives' dislike of the Obamacare approach and the unpalatability of their alternative approaches, this is the point they tend to land on, and it's not a real health policy agenda.

    That's a long tour but it helps explain why we're in such a mess on health policy. Both parties implicitly realize that the American public is completely nuts on this issue. It is the official position of most politicians in both parties that the pre-Obamacare status quo needed sweeping reform, whether in a conservative direction or a liberal direction, while most voters just didn't want their cheese moved.

    Both parties favor big reform because America's health care system sucks: We have astronomically high costs, outcomes no better than countries that spend half as much, and tens of millions of people with no insurance coverage.

    And yet, most Americans seem to inexplicably like the coverage they have today, and want any reform to the health care system to proceed with minimal disruption to them personally so they can keep the high-cost, middling-quality products they currently enjoy.

    The huge disconnect between public preferences and partisan preferences on health care has led politicians in both parties to lie constantly, but about different things.

    Democrats chose to lie about how disruptive their proposed reforms would be. The president reassured people that they could keep their plan (which sometimes, oops, they can't) and that premiums would fall by $2,500 per family (the savings were never supposed to be specific to premiums, and the projected savings in overall costs haven't fully materialized). He probably lied about this stuff because he saw what happened to Bill Clinton when he didn't lie about it enough in 1993.

    Republicans instead lie about whether they are interested in implementing the reforms they propose. Republicans have spent the last two months crowing about how disruptive Obamacare has been. This had led to warnings from conservative policy wonks that conservative health policy plans are disruptive, too, so Republicans should avoid staking out the position that disruption is bad per se.

    But Republican electeds need not heed these warnings because they never have any intention of implementing health reform in a conservative direction. When Republicans have changed health policy, it has been in the direction of more public expenditure (Medicare drug benefit), more tax subsidies (Health Saving Accounts as an add-on to our system of health care subsidies rather than a substitute), and more comprehensive insurance (Medicare drug benefit, again).

    Politically, Republicans have come up with the smarter set of health care lies. But Democrats, because their political coalition includes the people who are most acutely screwed by the American health care status quo, had to pick a set that actually led to policy change. And that's how we got to where we are today.

    SEE ALSO: Here's Why Health Insurance Is So Weird

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    Obama press conference obamacare sad

    (Reuters) - President Barack Obama's healthcare law is facing its biggest test this weekend since its disastrous October 1 launch, as Americans find out whether the administration has met a self-imposed deadline to fix its insurance shopping website.

    Another major outage of glitch-ridden HealthCare.gov could spell more political trouble for the president, who was forced to apologize for the botched rollout and admit burdening Democratic Party allies in their bids for re-election to Congress in 2014.

    If the website does not work on Saturday's deadline, that could turn off millions of uninsured Americans, especially young and healthy consumers whose participation in the new insurance exchanges are critical for keeping costs in check.

    Democratic leaders in Congress might also find it necessary to extend open enrollment beyond the March 31 deadline and delay fines mandated by the law for people who do not have insurance by that date - a prospect that insurers warn would destabilize the market.

    Obama officials are confident that this second coming of HealthCare.gov will be much improved from the October 1 debut. Millions of people looked into the website in its first month, but only about 27,000 cleared the gauntlet of technical obstacles to sign up for insurance.

    The portal is the gateway for health insurance plans in 36 states under the Patient Protection and Affordable Care Act, commonly called Obamacare, which was passed in 2010. It is intended to move the United Statescloser to universal care by subsidizing insurance sold by the private sector for less affluent families.

    Officials have said that by Saturday the website will be able to load quickly and work accurately for at least 80 percent of users. They have said it will be able to handle 50,000 simultaneous visitors, for a daily total of about 800,000, twice the capacity seen even on Wednesday before a final flurry of hardware and software fixes over the Thanksgiving holiday.

    And officials have warned that the website will still suffer some delays and outages in the weeks to come. To help consumers left hanging when traffic exceeds capacity, they have created a new "queuing system" to tell consumers when to come back.

    Short of a major outage, it may be difficult to immediately measure the administration's success because officials only release enrollment figures once a month. That will make anecdotes from consumers and enrollment groups all the more important.

    "Even if it's working well, people will encounter problems," said Mark Hall, a Wake Forest University professor of law and public health. "You hope there's more good stories than bad stories."

    OBAMA'S APPROVAL RATING DROPS

    The abysmal launch of Obamacare has hurt the president and congressional Democrats, with Obama's approval ratings dipping to the lowest point of his presidency. A Reuters/Ipsos poll this week showed 56 percent of Americans disapprove of how Obama is doing his job, while 38 percent approve.

    If the situation worsens, Democrats could risk losing control of the Senate in 2014, when 20 Democratic senators face reelection, and many are in tight races. Republicans have called for the law to be scrapped because they consider it an unwarranted expansion of the federal government and believe it will push up insurance costs.

    Obama's chief of staff Denis McDonough now meets every other week with Democratic senators running in 2014 to reassure them Obamacare is on the mend, a White House official said.

    The administration has prioritized fixes that consumers see, leaving other parts of the system for a later date. On Wednesday, officials said they would delay online enrollment for small businesses for a year.

    Obama issued a rare apology earlier this month for mishaps with the rollout.

    But as November 30 has drawn closer, Obama has become more assertive. "The website is continually working better, so check it out," Obama said in a speech on Tuesday.

    Kathleen Sebelius, secretary of Health and Human Services, told a group of state and local officials on a call this week that "we are definitely on track to have a significantly different user experience by the end of this month."

    Insurance companies have also noticed the difference.

    "I don't expect this to be an overnight change because it appears they have been making improvements as they go," said J. Mario Molina, chief executive of Molina Healthcare Inc, a company offering plans in nine states, including California.

    "It is easier to navigate. It's working better. It's faster," Molina said.

    Even if the website does stand up to increased traffic, there are issues on the system's "back end" that need to be addressed.

    As much as 30 to 40 percent of the site still needs to be built to handle payments and federal subsidies, a federal official told lawmakers earlier this month.

    And the administration is planning a "soft launch" with small volumes for long-delayed Spanish language enrollment tools for more than 10 million uninsured Latino Americans.

    Once the website is fixed, the White House also faces the challenge of raising awareness about the law. More than 35 percent of people without insurance say they have heard nothing about the new marketplace, according to polling by the Kaiser Family Foundation.

    (Additional reporting by David Morgan and Caroline Humer; Editing by Karey Van Hall and Grant McCool)

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    Barack Obama Iran

    WASHINGTON (Reuters) - A crucial weekend for the troubled website that is the backbone of President Barack Obama's healthcare overhaul appears to be off to a shaky start, as the U.S. government took the HealthCare.gov site offline for an unusually long maintenance period into Saturday morning.

    Just hours before the Obama administration's self-imposed deadline to get the insurance shopping website working for the "vast majority" of its users by Saturday, the Centers for Medicare and Medicaid Services (CMS) announced that it was taking down the website for an 11-hour period that would end at 8 a.m. EST on Saturday.

    It was unclear whether the extended shutdown of the website - about seven hours longer than on typical day - represented a major setback to the Obama administration's high-stakes scramble to fix the portal that it hopes eventually will enroll about 7 million uninsured and under-insured Americans under the Patient Protection and Affordable Care Act, also known as Obamacare.

    At the very least, the shutdown suggested that nine weeks after the website's disastrous launch on October 1 prevented most applicants from enrolling in coverage and ignited one of the biggest crises of Obama's administration, U.S. officials are nervous over whether Americans will see enough progress in the website to be satisfied.

    For the administration and its Democratic allies, the stakes are enormous.

    The healthcare overhaul is Obama's signature domestic achievement, a program designed to extend coverage to millions of Americans and reduce healthcare costs. To work, the program must enroll millions of young, healthy consumers whose participation in the new insurance exchanges is key to keeping costs in check.

    After weeks of round-the-clock upgrades of software and hardware, Obama officials said they were poised to successfully double its capacity by this weekend, to be able to handle 50,000 insurance shoppers at one time.

    But if the website does not work for the "vast majority" of visitors this weekend as the administration has promised, uninsured Americans from 36 states could face problems getting coverage by an initial December 23 deadline.

    It also could create ripples that extend to the 2014 elections when control of the U.S. House of Representatives (now controlled by Republicans) and the Senate (now led by Democrats) will be up for grabs.

    Obama's fellow Democrats who are up for re-election in Congress already have shown signs of distancing themselves from the president and his healthcare program. If the website does not show significant improvement soon, some Democrats - particularly the dozen U.S. senators who are from states led by conservative Republicans and who are up for re-election next year - might call for extending Obamacare's final March 31 enrollment deadline for 2014.

    That would delay the fines that are mandated by the law for those who do not have insurance by that date, a scenario that insurers say would destabilize the market. It also would fuel Republicans' arguments that Obamacare, and its website, are fatally flawed and should be scrapped.

    In broader political terms, the website's immediate success has become vital to Obama's credibility, which polls indicate has been tarnished by the site's problems as well as Obama's admission that he overreached in promising that everyone who liked their healthcare plan would be able to keep it under the new law.

    Obama has been forced to apologize for oversimplying how the law would affect certain Americans, and has acknowledged being embarrassed and frustrated by the website's failures. Recent polls have shown that Obama's approval ratings are at the lowest point of his presidency.

    "It is a lot harder to reboot public trust than it is to reboot software," said David Brailer, chief executive of the Health Evolution Partners private equity firm and a former health official in George W. Bush's administration.

    "But the good thing about when you're down is that usually, you got nowhere to go but up," Obama said in an interview that aired on Friday on ABC.

    IS IT FIXED? HARD TO TELL

    Several technology specialists told Reuters that it will be difficult to independently assess on Saturday whether the HealthCare.gov site has met the administration's goals of functioning for most users most of the time, including handling 50,000 users at once.

    "There won't be anything you can tell from the outside," said Jonathan Wu, an information technology expert and co-founder of the consumer financial website ValuePenguin.

    When the site opened for enrollment on October 1, many users found that they could not complete the simple task of creating an account. Now, the website is functioning better but any remaining problems lie much deeper within the site, Wu said in an interview.

    Eleventh-hour checks were not encouraging, said Matthew Hancock, an independent expert in software design who said he could tell within hours of the site's launch that its problems were the results of poor system design and bugs, rather than the heavy traffic that the administration blamed initially.

    "I have tested the site every several days trying to buy a health insurance plan, but haven't been able to," Hancock said.

    "I think the issues the site faces now are more complex to diagnose from the front end, whereas before the site was immediately failing and returning error details," he said.

    Questions also remain about the website's ability to direct payments to private insurance companies when consumers enroll in their plans. Portions of the system handling those functions are still being built, officials say.

    "The real tests are: Were my premium payment and subsidy accurately calculated? Am I getting the coverage I signed up for? If my income situation changes, will the reconciliation occur in a timely fashion?" said Rick Howard, a research director at technology consultant Gartner.

    A DATE AND A NUMBER

    Heading into this weekend, administration officials tasked with rescuing Obamacare showed signs of confidence that the series of fixes by tech specialists would work.

    The officials gave a "virtual tour" of what they had branded the "tech surge" to a group of White House reporters.

    The White House also invited a group of IT specialists to tour the website's "command center," where an engineer on unpaid leave from Google Inc directs disparate contractors and monitors their progress.

    It was a convincing show that the team had the crisis under control, said John Engates, chief technology officer at Rackspace, a web hosting firm in San Antonio, who participated.

    Engates, who had been publicly critical of the launch, said he felt it was likely the website would be able to handle 50,000 concurrent users on Saturday, although he did not know for sure.

    "Whenever you have a date and a number, you need to be pretty sure that you can hit that date and that number," Engates told Reuters.

    "It's just another loss of confidence if you don't make it."

    (Editing by David Lindsey and Lisa Shumaker)

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    obama, thinking, april 2011

    WASHINGTON (Reuters) - Two months after Obamacare's disastrous launch, senior administration officials on Sunday will seek to showcase the repairs to the government's troubled website meant to sign up millions of people who need subsidized health insurance.

    President Barack Obama's specially appointed adviser, Jeffrey Zients, is expected to describe the results of a five-week emergency effort aimed at making the federal HealthCare.gov website more accessible to users, more responsive and less prone to errors, according to officials.

    "We will be providing an update on the progress made to date, so that the website works smoothly for the vast majority of users, including updated data on capacity, response time and error rate," said an administration official who spoke on condition of anonymity because he was not authorized to speak publicly about the effort.

    The administration's weekend deadline could mark a new chapter for Obama's signature domestic policy if HealthCare.gov has improved well enough to handle millions of potential applications for health coverage from the uninsured as well as others whose current insurance policies face cancellation at the end of the year.

    But a repeat of the Oct 1. launch, when the site crashed as millions of visitors flooded in, could leave hundreds of thousands of people without coverage and deal a staggering political blow to the president's legacy and the 2014 election prospects of congressional Democrats.

    Basic account creation and log-in functions appeared to work smoothly on Saturday, the deadline set by Zients, but groups helping the sign-up effort described other errors in the process. Health insurance companies warned much work remained to allow seamless enrollment.

    HealthCare.gov will face increasing pressure in the days and weeks to come, as consumers who want benefits in time for the new year have a December 23 deadline to sign up. Republican lawmakers, due back in Washington from a holiday weekend, are prepared to seize on any new technical woes as they campaign to derail the law.

    Zients is due to host a teleconference with reporters at 9 a.m. ET, just hours after government contractors are expected to complete the latest batch of fixes. The administration's goal is to handle 50,000 users simultaneously, or about 800,000 visitors a day.

    Administration officials say HealthCare.gov, which serves consumers in 36 states, will continue to be prone to outages and delays and predict that fixes will continue for months.

    As late as midday ET (1700 GMT) on Saturday, officials were still describing 50,000 simultaneous users as a goal they were making progress toward and said upgrades overnight on Friday, followed by hardware and software fixes early on Sunday, would put the administration on track to achieve intended capacity.

    ENOUGH TIME TO ENROLL?

    The Obama administration had hoped to enroll about 7 million people in 2014 under the Patient Protection and Affordable Care Act, also known as Obamacare. Many of those consumers are expected to qualify for subsidies.

    To work, the program must get millions of young, healthy consumers to sign up by March 31. Their participation is key to keeping the program's costs in check.

    "There's still plenty of time to reach people who are now uninsured, and especially the young and healthy who are key to keeping the insurance market stable," said Larry Levitt, a senior vice president at the Kaiser Family Foundation.

    But groups helping consumers navigate the site said some problems continued over the weekend that suggested deeper troubles.

    In PennsylvaniaTed Trevorrow works for a nonprofit group called Resources for Human Development. He tried to help a man on Saturday who created two applications because of technical snafus - one by phone, and one online - and cannot access either of them.

    "He ran into some sort of technical glitch, and now it will require the intervention of a programmer," Trevorrow said.

    Another client hit an inexplicable wall in the subsidy eligibility process. "The system just stopped and wouldn't go any further," said Trevorrow. "It just plain doesn't work and it needs to be fixed."

    Republicans have argued that Obamacare is fatally flawed and should be scrapped, and have brandished stories of Americans who are unhappy with losing old health plans or seeing higher costs for new ones.

    "Americans are far less concerned about a website than they are about the availability and affordability of their health care," said Mitch McConnell, the top Republican in the U.S. Senate, in a statement.

    The administration said on Saturday that 90 percent of website users can now create an account on the system - a statistic that some information technology experts said sounded rosy but was impossible to verify.

    "It prevents anyone from the outside from contradicting them," said Jonathan Wu, co-founder of the consumer financial website ValuePenguin.

    (Additional reporting by Roberta Rampton in Washingtion and Sharon Begley in New York; Editing by Eric Walsh)

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    Barack Obama

    The Obama administration is out with a progress report on HealthCare.gov, the federal health care website that it pledged in late October would be fixed for the "vast majority" of users by Nov. 30. 

    The report declares that it has "met" that goal, two months after the disastrous launch of the website.

    "While we strive to innovate and improve our outreach and systems for reaching consumers, we believe we have met the goal of having a system that will work smoothly for the vast majority of users," the progress report says.

    Some key points from the report:

    • The site will now be able to support a maximum of 800,000 visitors per day, including a target of 50,000 concurrent visits.
    • The site is now online 90% of the time, according to the The Centers for Medicare and Medicaid Services.
    • The "tech surge" that came to the site in late October has helped to fix 400-plus bugs and glitches on a "punch list."
    • The average response time of the site is now less than one second, an improvement from about 8 seconds in late October.

    Here are the charts showing the progress:

     

    Obamacare chartsObamacare chartsObamacare chartsObamacare chartsObamacare charts 

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