I’m not particularly tech savvy but, one month into the HealthCare.gov website mess, here’s some of what I think we do know now – and what we are still waiting to find out.
Traffic: Volume was high, and it was one reason for the system’s poor performance. But it was not the only reason, not by any means. Nor have I seen a convincing explanation for why the administration low-balled the traffic expectations.
Code: There are millions of lines of it and it’s a mess. It’s being rewritten/worked-around. We don’t know much more than that. Continue reading
With all the website woes, you are going to hear a lot more about “delaying” the Affordable Care Act.
But what “delay” means is in the eye of the beholder – or maybe in the political affiliation of the beholder. It’s helpful to think about “delaying” the whole law or the mandate (mostly but not only a Republican idea) versus “extending” the enrollment period – but keeping the mandate in force for 2014, although it could be even weaker than it already is for the first year. That’s an idea that we’re beginning to hear from more Democrats – including several senators up for re-election in red states in 2014. Continue reading
The 8th Circuit Court of Appeals held hearings yesterday on a 2011 lawsuit brought by the Argus Leader of Sioux Falls, S.D., over whether data about the payments made to businesses participating in the Supplemental Nutrition Assistance Program, formerly known as food stamps, should be publicly available.
As Josh Gerstein reports for Politico, an attorney for the newspaper argued that “a lower court judge misinterpreted the law by ruling that a confidentiality provision for retailer applications allowed the U.S. Department of Agriculture to withhold all data on payments to those retailers.” Continue reading
As one of my colleagues emailed me the other day: “Life’s a glitch.”
We know we’ll be hearing A LOT more about the health care marketplace glitches, including testimony at some upcoming Congressional hearings.
I have not read every article that has come out about the technical problems but here are some that I think are particularly useful right now; there are going to be a lot of developments in this story so whatever I write now will soon be outdated soon.
The Wall Street Journal, on Friday, had what is probably the most detailed description (in plain English) about what the “glitch” is. Continue reading
This week’s shutdown of the federal government has some very real and immediate impacts on the nation’s older adults. Money funneled through the Older Americans Act for meals, caregivers, legal help, and family caregiver training will soon dry up, according to a report in the Eureka (Calif.) Times-Standard.
Other programs, like energy assistance for low-income families, which help pay heating bills, Temporary Assistance to Needy Families (TANF), which provides cash to the impoverished, and Social Services Block grants, which help states fund initiatives like elder abuse programs and senior services, will be hit hard if the impasse continues for any length of time.
Money for many of these programs ran out at midnight on Sept. 30; because they are either discretionary, or require re-authorization, they’re at a standstill until an appropriations bill is passed. Some local programs which rely on partial federal funding for vital senior services like Meals on Wheels face the daunting prospect of temporarily halting operations. However, spokespersons for other organizations say they’re OK for now. Continue reading
Alice Dreger, a professor of clinical medical humanities and bioethics at Northwestern University’s Feinberg School of Medicine, writes for Pacific Standard Magazine about the public health threat caused by public officials who censor news, fail to respond to press queries or prevent health agency employees from speaking to journalists without a representative from the press office.
Dreger points to the current Middle East respiratory syndrome (MERS) crisis, referring to a piece in Wired by AHCJ board member Maryn McKenna. But she also reminds us that it was journalists who sounded the alarms about the dangers of thalidomide and the Tuskegee Syphilis Study, not to mention the journalists who pushed for more public awareness of AIDS when the Reagan administration was limiting the response to the emerging disease. Continue reading
Image by MapScience via flickr.
The Los Angeles Times today published an op-ed by the co-chairs of the Association of Health Care Journalists’ Right to Know Committee calling on Congress and the U.S. Department of Agriculture (USDA) to end the secrecy surrounding the multibillion-dollar food stamps program.
“The debate in Congress about cutting the food stamp program has sparked predictable clashes between those who want to help the poor and those who want to cut government spending,” the opinion column said. “But strangely missing from the arguments is a shocking fact: The public, including Congress, knows almost nothing about how the program’s $80 billion is spent.” Continue reading
If you had to draw up a list of the five or six states that are likely to have a – relatively – successful launch of the health care exchanges (AKA marketplaces) this fall, Oregon would be one of them.
Gov. John Kitzhaber, a former emergency physician who has done a lot of work on health system delivery reform and quality improvement, is committed to the law’s success, as is much of the state’s political world. Oregon had already been experimenting with coverage expansion, in part through Medicaid. The state is running its own exchange and has already started outreach. On Twitter and online at least the opening ads have been a hit.
While most of the attention is on the individual exchanges, SHOP exchanges also will offer a place for small businesses to get coverage for their workers. Those with up to 50 workers can choose to cover them and certain small businesses may qualify for tax credits to subsidize coverage. Note – this voluntary. These small businesses do NOT have to cover workers, not now and not when the delayed employer mandate begins in January u 2015. Continue reading
How much will the Affordable Care Act affect health insurance premiums in each state when the individual mandate becomes effective on Jan. 1? Journalists are trying to answer this question as reports trickle in from various states about how much health insurers will charge starting next year. Enrollment for next year begins Oct. 1, just 10 weeks away.
To help answer this question, the U.S. Government Accountability Office released a report on Tuesday, “Private Health Insurance: The Range of Base Premiums in the Individual Market by State in January 2013.” It shows the range of base premiums before underwriting for individuals as of January of this year in each state and the District of Columbia. This report was requested by Sen. Orrin Hatch (Utah-R) and the agency made no recommendations.
The report shows the lowest, median and highest base premiums displayed on the HealthCare.gov Plan Finder site for six types of consumers:
- A 30-year-old, single, nonsmoking male;
- A 30-year-old, single, smoking male;
- A 30-year-old, single, nonsmoking female;
- A 30-year-old, single, smoking female;
- A family of 4 with two parents, aged 40; and
- A couple, aged 55. Continue reading
Despite the Obama administration’s focus on cutting health care costs and fraud in the Medicare and Medicaid systems, the office charged with investigating such things plans to cut 400 staffers by the end of 2015.
Fred Schulte at The Center for Public Integrity reports that the news came to light during a June 24 congressional hearing about prescription drug abuse in Medicare.
The Department of Health and Human Services’ Office of Inspector General is responsible for investigating fraud and abuse in the system. Last year the office shut down investigations into 1,200 complaints because of a lack of resources, according to Gary Cantrell, deputy inspector general for the OIG Office of Investigations.
Cantrell blames the cuts on “a mix of budgetary issues which he called ‘expiring funding streams.’” Schulte reports that no one at HHS would discuss the situation.
Schulte has previously reported on electronic health records and linked them to higher health care costs. He points out one potential impact of the cuts:
One major project that’s likely to be scaled back is an ambitious plan to “identify fraud and abuse vulnerabilities” in electronic health records. The federal government is spending about $36 billion in economic stimulus funds to help doctors and hospitals purchase the digital technology in the hopes that it will ultimately reduce waste from duplicative tests and make health care more efficient and less costly.
The OIG’s 2013 Work Plan outlines the office’s focus and new and ongoing projects, including reasonableness of Medicare payments, coding of medical equipment claims, questionable billing patterns, review of claims submitted by “error-prone” providers and more. Meanwhile, ProPublica, the Center for Public Integrity, The Wall Street Journal and other publications have documented fraudulent and wasteful practices in Medicare.