Obamacare bombshell: IT official says HealthCare.gov needs payment feature

[FarCenter]

Another day, another big, bad black eye for HealthCare.gov.

A crucial system for making payments to insurers from people who enroll in that federal Obamacare marketplace has yet to be built, a senior government IT official admitted Tuesday.

The official, Henry Chao, visibly stunned Rep. Cory Gardner (R-Colo.) when he said under questioning before a House subcommittee that a significant fraction of HealthCare.gov—30 to 40 percent of it—has yet to be constructed.

"We still need to build the payments system to make the payments [to insurance companies] in January," testified Chao, deputy chief information officer of the Centers for Medicare and Medicaid Services, the federal agency that operates HealthCare.gov.

That so-called financial management tool was originally supposed to be part of HealthCare.gov when it launched Oct. 1, but officials later suspended its launch as part of their effort to get the consumer interface part of the site ready. The tool will, when it works, transmit the subsidies that the government is kicking in for many enrollees to offset the costs of their monthly premiums.

http://www.cnbc.com/id/101211556

"It's something we do not need online until the middle of January," she said. However, for people's insurance to kick in by Jan. 1, they need to make payments for their Obamacare insurance policies by Dec. 15.

Chao on Tuesday said other areas that need to be built include "the back-office systems, the accounting systems."

[BlueStreak]

1. For F###'s sake. This isn't an essential part of the system

If I understand it correctly, once you enroll, your application is transmitted to THE FREAKING INSURANCE COMPANY you select, and THEY COLLECT THE PAYMENT. There is no necessity for healthcare.gov to collect anything.

Perhaps it would be a "nice to have" to go ahead and take the first monthly payment right at the healthcare.gov website. But it most certainly is not essential. And yes, if healthcare.gov starts collecting the first payment, then obviously they will have to have an accounting system to settle up with the insurance companies. This seems like a really good thing to plan for the 2015 open enrollment and a really lousy thing to make a priority for 2014 with all the real issues that are on the table.

What is wrong with these morons? Why do they play defense of every damned issue? Isn't there a single person in this administration that can state the facts clearly and positively without being bullied by a bunch of Republican assholes?

[Glitterati]

3. I think you missed something......

The tool will, when it works, transmit the subsidies that the government is kicking in for many enrollees to offset the costs of their monthly premiums.

It's only the subsidy payments they are discussing, NOT the portion the consumer is spending.

[BlueStreak]

4. Then the article/argument is grossly misleading. THis is not a "bombshell"

It is just a mundane back office process that can be managed manually for a period of time if necessary. In a couple of hours, they ought to be able to generate a report of subsidies due by insurance company. They could initiate bank transfers manually. There couldn't be more than a few hundred payees. Damned alarmists, and again I repeat, this administration has been horribly inept in addressing these issues head on and putting this in perspective.

[ananda]

19. More like a nutshell.

..

[FarCenter]

33. I think that the payments are made monthly per policy, and accounted per SSN by the IRS

The subsidies are essentially an advance against your payment of 2014 income taxes which is paid to the insurance company. For example, if the unsubsidized policy is $500/month and the subsidy is $400 / month, the policy holder pays the insurance company $100 and the IRS pays the insurance company $400.

In April 2015, you will compute your actual subsidy based on your actual 2014 income and then remit to the IRS any shortage between the actual subsidy and the amount advanced.

If your estimate of income was too high, you will get a tax credit. If your estimate of 2014 income was too low, you will pay additional tax.

So all this has to be accounted for on a per taxpayer and per policy basis for the period during 2014 that the policy was in effect.

[BlueStreak]

34. It is freaking BACK OFFICE. It doesn't have to be done before January 2015

As long as the insurance companies get their cash flow, it will be fine. It doesn't have to be done in 2014. It just needs to be done by early 2015 as the 2014 returns are filed. And it will be done long before that.

This hysterical "Bombshell" stuff is complete bullshit.

[FarCenter]

42. It needs to be done by January 2014 when the payments begin to the insurance companies.

Unless you trust the insurance companies to each send one large bill to the government in January 2014, and hope that the per taxpayer accounting can get straightened out later.

Auditing that would be a nightmare.

[BlueStreak]

47. You don't have to have an elegant solution in place in January

As long as the insurance companies get their money, it will work.

And none of the affects the consumer.

Plus we are 70 days away from the end of January anyway. Have you ever heard of the concept of critical path? Have you ever been a project manager?

[FarCenter]

48. Yes I've been a project manager, and I know what a disastrous IT project looks like.

Chao actually said 60% to 70% of the total system is still to be built.

[B2G]

53. None of it affects the customer?

It damn sure will when the insurance companies start refusing to authorize services because they aren't getting paid.

[BlueStreak]

67. That isn't going to happen. Stop being hysterical.

The fact that there isn't a 100% finished, elegant system in place mid-November, for a function that won't impact anybody to another 70 days, is damn near meaningless. 70 days is plenty of time to get a solution in place, even if the first iteration involves some manual effort and patchwork. It is just not a big deal.

[B2G]

74. 70 days is plenty of time

to code 40% of the system and test it all? Now where have we heard that before...?

Alrighty then. Over the holidays. Not to worry. One Chinese Death March, comin right up.

[CreekDog]

49. If people knew your posts, they probably wouldn't bother:

FarCenter

54. No money, no lunch

Why give them tuna sandwiches, which are actually quite good?

http://www.democraticunderground.com/?com=view_post&forum=1002&pid=2447982

[lumberjack_jeff]

73. If the insurance company isn't paid, they won't provide insurance.

The subsidy is the main part of the premium. If the subsidy doesn't get to the insurance company - no insurance.

It's a big fucking deal.

[Rstrstx]

5. Io capisco

It sounds like something that will never really catch the public's notice unless those first bills arrive in the mail asking for a $295 payment instead of a $35 payment, in which case holy hell will break loose.

[RBInMaine]

9. And they will get their subsidy, and it will be worked out. GIVE IT TIME.

[Yo_Mama]

46. They have to get this or some way of paying the subsidies worked out in less than two months

Unless the first premium subsidy payment is completed, these people won't have insurance.

I think they need to do it with the insurance companies - the insurance companies will have to bill the government. But what happens if the government pays and the person doesn't?

[Rstrstx]

64. I don't know if everything will technically be worked out in time..

..but I'm pretty sure they'll at least have some arrangement worked out with the insurance cos. that will let them get their checks even if a few things still need to be ironed out. It's beneficial to both parties: the insurance cos. don't want to lose new clients or all those checks and the gov't sure doesn't want another fiasco, esp. one that would make the October rollout look like a walk in the park.

So yeah, the subsidy checks to the insurance cos. will get done one way or another, the consequences of it not happening are too great. If the gov't has to pull a few tricks to do it the Rs might balk and feign shock and utter some bile, their usual grandstanding.

[Yo_Mama]

43. There has to be some mechanism to make the premium subsidy payments

Most of the people who sign up with the exchanges are doing so because they need the premium subsidy, and they won't be insured unless that is paid to the insurance company January 1st.

[NYC_SKP]

2. Solution: Paypal.

You're welcome, ObamaCare!

(others can use Credit or Debit cards. These can also be set up in one day)

[FarCenter]

37. The IRS would use Paypal to make the per policy subsidy payments to the insurance companies?

[NYC_SKP]

50. Insurance companies would have to wait. I'd make them fill out a 42 page application for payment.

They'd have 90 days to submit it, after which time IRS requires them to start again.

Of course they would be missing a detail and have to resubmit over and over again.

And miss the deadline.

That would serve them right, that's how they treat their victims.

[scheming daemons]

6. you Better Believe It, dkf!

Your slip is showing

[SunSeeker]

7. LOL. nt

[treestar]

11. lol

Exactly the type of article!

[Pretzel_Warrior]

57. No kidding. And this poster is consistently negative

[uponit7771]

8. The payments can be maid via other means... this is misleading

[treestar]

10. That's not a bombshell

Why was it all supposed to be perfect at the start?

If is it, how come there's no criticism of Apple, for instance?

[Nuclear Unicorn]

12. "how come there's no criticism of Apple, for instance?"

Did iTunes allow people to download tens of thousands of dollars worth songs without paying for them?

[treestar]

13. No but they put that Maverick system out

And when you download it, there are tons of undesirable effects.

Still waiting for a new scanner app - for one which no longer works once you download Maverick.

[Nuclear Unicorn]

14. "when you download it, there are tons of undesirable effects."

And was there a law that canceled your old "junk OS" and mandated you download Maverick? I bet if there was there would have been a lot more public outrage -- albeit directed more at the government that wrote such a law rather than Apple.

[treestar]

15. My real point is there are a lot of computer and web site

problems in the world. But people act like this one had to be perfect, because it helps their political agenda.

And it overlooks you can apply by mail, phone, or go to the office.

[Nuclear Unicorn]

16. "people act like this one had to be perfect"

It did have to be perfect. Without it 1) you're in violation of the law and 2) you have no insurance if you need it.

[geek tragedy]

18. Have you ever paid a bill in your life without using a government website? nt

[Nuclear Unicorn]

22. Yes, but that was predicated on all parties knowing the terms of the contract.

That can't be said in this case.

[geek tragedy]

23. What terms are unknown? nt

[Nuclear Unicorn]

24. Apparently --

everything; because now they're taking about by-passing healthcare.gov entirely and farming this out to the private sector --

WASHINGTON -- People interested in buying health insurance under Obamacare could soon skip the HealthCare.gov website and apply for coverage and financial assistance directly with private insurance companies and online brokers, the Obama administration said Tuesday, in its latest effort to work around the faulty website.

Health insurers and online brokers like eHealth have always sought the ability to let consumers to apply for subsidies to cut their health insurance costs without using HealthCare.gov, the online portal to health coverage in more than 30 states. But technological snafus with the system linking insurers to the federal government ruled out that option, even as HealthCare.gov itself has remained problematic.

http://www.huffingtonpost.com/2013/11/19/obamacare-enrollment_n_4304818.html

[geek tragedy]

28. that's always been an option for people not getting subsidies nt

[Nuclear Unicorn]

29. Re-read the article. They're cisidering privatizing the subsidy portion as well.

[FarCenter]

38. This is a good solution.

There is no reason not to have the insurance companies have their web sites access the back end systems of the government in order to validate and compute the subsidy amounts.

Then the functionality of the marketplace can be limited to identifying the plans available in each county, the summary of benefits per plan, and the unsubsidized cost of each plan.

Armed with this knowledge, the consumer can then go directly to the insurer to apply for the policy and get the subsidized price through the insurance company.

[treestar]

58. LOL so true. When Medicare or Social Security first started

There were no web sites, so how did they do it?

[treestar]

56. The web site doesn't have to be

And you can apply other ways.

And not everyone had web site troubles, the M$M simply highlighted whoever did.

[Nuclear Unicorn]

63. "you can apply other ways."

Yes. Instead of personally going to healthcare.gov you can visit/call a navigator who will attempt to access the same busted website on your behalf.

[GladRagDahl]

30. Apple works

That's why people buy it

[Demo_Chris]

41. Because the TAXPAYERS didn't give Apple a hundred million and five years to get it working...

And yeah, incompetence of this magnitude is damn sure a bombshell. People should be packing their bags in preparation for prison after negligence like this.

[Romulox]

44. LOL. Maybe we didn't *want* it to work. Ever think of that, huh? Huh?? nt

[Revanchist]

55. You mean like this?

But the app is already facing criticism from users globally for a number of geographical errors, missing information and because it lacks features that made Google Maps so popular, including public transit directions, comprehensive traffic data or street view pictures.

http://in.reuters.com/article/2012/09/21/us-apple-maps-backlash-idINBRE88J19U20120921

[treestar]

61. Maybe. My point is there are a lot of web site issues world over

And this one was really big.

Apps get updated all the time.

I just think the M$M is making the most of this, and if they turned their focus on any other entity, they'd be able to trump up similar stories.

[Revanchist]

62. I think the cause of concern for many

Is what is at stake. A person's health is more important than being able to play World of Warcraft (at least it should be, I wonder about people sometimes). What I find amusing is the people who think the problems are either a) the result of a vast right-wing conspiracy or b) was because too many were trying to log in at once. In my opinion, this is a text-book example of project management gone bad and I wouldn't be surprised if it is a case study in a few years. In between have the project spread out among too many contractors and requesting changes to the site up until the eleventh hour it's shocking the site works as well as it does.

[joeglow3]

66. Why does Apple get more attention than my neighbor?

He created an App that fucked up. Do you think it may be directly related to the size of the organization. Said differently, it effects a much larger percentage of their viewing/listening audience. Thus, it IS a bigger issue.

[geek tragedy]

17. DKF was much better at trolling than you are.

Insurance companies have been able to collect premiums without the ACA website for centuries. I imagine they'll figure out how to send bills to people.

[FarCenter]

39. This is the payment of the subsidy from the IRS to the isurance company

It is not about the payment by the insured to the insurance company.

It needs to be accounted for per person because it will figure into the insured's income tax return for 2014.

[HERVEPA]

52. Well said. His time will come.

[Doremus]

20. RW smear.

Why are we reading it here is the question.

[CreekDog]

21. because the OP wants us to

again and again.

FarCenter (15,582 posts)
4. Prior to the Civil War, it was the North that was attempting to impose its values on the South

Slavery had been legal, if not very common, in many of the northern states in the early 1800s.

The attitudes towards slavery changed first in the northern states because of the abolitionist movement. Then the northern states attempted to prevent the establishment of slavery in the new states in the west, even when those states were populated by settlers from the south.

So the imposition of values came from the north. The values in the south had not changed much at all.

http://www.democraticunderground.com/?com=view_post&forum=1002&pid=1123907

[FarCenter]

40. Here it is from the NY Times - "Health Insurance Marketplace Is Still About 40 Percent Incomplete"

http://www.nytimes.com/2013/11/20/us/politics/health-insurance-marketplace-is-still-about-40-percent-incomplete-official-says.html

[Doremus]

80. BFD

Give it up.

No one here wants to read RW smear, whether it's in the NYT or World Nutt Daily.

[Capt. Obvious]

25. And it only accepts Bitcoin

[tridim]

26. Any reason why you posted this RW FUD again?

I bet Savannahmann knows why.

[chillfactor]

27. this is no "bombshell"......

good lord .... I thought thought trolling was prohibited on DU.....

[NightWatcher]

31. I keep trying to put quarters into my laptop when I'm on the website

But alas it's not working.

[tibbiit]

32. Maybe heads do need to roll

I mean Jesus God Damnit Fuck@!
tib

[BlueStreak]

36. It is called critical path planning. Those payments are not on the critical path.

Christ almighty. Chicken Little is everywhere.

[B2G]

54. They weren't on the critical path for Oct 1

They most certainly are for mid January.

[BlueStreak]

69. Well, it isn't mid-January now, is it?

And you don't have to have a polished product in place in January. In the worst case, the process could be largely manual for a few months. They could, for example, generate a file of credits due to each insurance company, and divide that up manually if necessary, delivering each company's file via email ir carrier pigeon. And they could issue bank transfers manually to each insurance company.

I have no doubt that with 70 days available, they can come up with an initial process that is a lot better than that.

In any event, it is all behind the scenes. There are plenty of real problems with the ACA. This isn't one of them.

[B2G]

75. You sure do know a lot about

large complex systems & processes. I'm in awe of your expertise.

[BlueStreak]

76. I have been developing large-scale (mainframe-class and server-class) bus apps

since 1973. Yeah, I know a little about it. And I have dealt with plenty of projects that were time constrained. You do what you have to do to meet the critical path with some kind of workable solution, even if it is not the most elegant answer.

[B2G]

77. And I have been managing large IT projects for 20 years

And I would have been fired by now if I'd managed this project.

The worker bees have probably been screaming bloody murder for a year now about the timeline, changing specs, test results, etc. I'm sure they still are. And they're being summarily dismissed by those at the top.

For those who think it's bad now, I have just one message. You ain't seen nothin yet. Check back in a couple of months.

[BlueStreak]

78. I agree that there has been plenty of bad management. But from where we stand

I just don't see the Apocalypse that you are describing. Certainly people could drop a lot of balls from here and return to a real mess of things, but I believe there is a lot of higher-quality attention on this now and that isn't a likely outcome.

There are some huge problems with the ACA, primarily the lousy / inconsistent provider networks, lousy / inconsistent pricing across the markets, and the overall sabotage efforts by Republicans, especially the Republican governors. Those things can really sink the whole endeavor. The IT issues aren't the main hazards at this point, IMHO. Had they not brought in a more focused team, I would be a lot more concerned about the IT stuff. But so far, the new team is making all the right moves.

[Puzzledtraveller]

35. Our application program has a payment system

If during the application you are eligible for expanded medicaid it will automatically enroll you, if due to income you are not it will prompt us to ask the client if they wish to shop for insurance. It will automatically check for subsidies and apply them then calculate their payment, if their are no subsidies granted then they can still purchase through the market place at that time. The system accepts and processes payments. Many co-workers are not too thrilled about having to ask for and process payments. We are state medicaid workers and requesting and processing payments is very foreign to us.

[Romulox]

45. Only 10 days left... nt

[HERVEPA]

51. Thank you for your FarCenter post which is far enough from center to please a teabagger.

[Arkana]

59. Oh my, shock and awe.

A website has NEVER added things before! Whatever shall we do?!

[Pretzel_Warrior]

60. BOMBSHELL Prediction!!

BU-bye!!

[Marrah_G]

65. Why would they need that? The citizen pays the company, they don't pay the ACA.

[Pretzel_Warrior]

68. Bravo, DU! As of my posting at 11am PST, scores of replies and zero rec's

[BlueStreak]

71. That's only because there is no "You gots to be kidding me" button.

[TroglodyteScholar]

81. If only!

[dionysus]

70. trying to top the last RW hit piece you posted?

[lumberjack_jeff]

72. three and a half years.

Three and a half friggin years. This is a country which put men on the moon only 8 years after JFK's speech.

What the fuck happened?

[rudolph the red]

79. It seems pretty clear that the site isn't going to be completed by the end of Nov,

but I don't think that will be the end of the world like the pubs and the media want us to believe.