1.01.10 - The Imposition -

[t_host1]

 The distinction is clear and perfect for Obama, the media, rino’s, muslim’s and the atheist - a political war for the power too continued privilege’s and maximum social disruption’ll tumult during the pre-Christmas eve period of time. The privileged are in full assault to acquire all that is possible from the Obama transformation and the Bernanke put' that has brought America to its weakest point since the forming of its existence.

[Kitteh]

 The distinction is clear and perfect for Obama, the media, rino’s, muslim’s and the atheist - a political war for the power too continued privilege’s and maximum social disruption’ll tumult during the pre-Christmas eve period of time. The privileged are in full assault to acquire all that is possible from the Obama transformation and the Bernanke put' that has brought America to its weakest point since the forming of its existence.

Bushie?

[t_host1]

Obama makes tee times, Michelle plans shoe shopping trips and the House passes an amended senate bill with Sen. Cruz saying he will not delay its final passage. And, the beet goes on…   ohh! pay no attention to the Presence of that big eared grin having your wallet - - - using your credit card.


Next, how many days till Americas' last Christmas?

[t_host1]

The Fitch downgrade will be because _____________ .

[t_host1]

 Victory, the evidence continues to be updated that, Harvard and the alike models of democracy are the dependence of the dollar taking a dump of debt creating the necessary manure for the sacks of Wall Street and the carpet bagging buffet’s to blossom. Furloughed autocrats, congress and Obama get their vacation pay, pensions, free healthcare and the bonus of unemployment payments as the salt of sweat, fewer in numbers lay beneath the privilege, as the dirt that provides the only source of real value.

[ilikeverin]

The Fitch downgrade will be because _____________ .

I disagree.  The Fitch downgrade will be because ______________.

[t_host1]

 This mornings Obama monologue is better than a late night with David Letterman.

[t_host1]

 Great news!!! In Arkansas, all furloughed works must repay their unemployment payments – payment plans are available.
 Also, my $600,000,000.00 website just enrolled its first patient in the state of Delaware. Just think, in less than 90 O-Day’s that patients’ body, mind and soul will be under the protection of me ---well, not actually me, it will be the same over worked and under paid folks that are giving you the outstanding pricing and service of enrollment to my world. Additionally, I want to thank Gov. Beebe for stepping up to the plate for covering the 50% increase in teacher health care cost and most importantly, explaining to the payers of the extra cost that it was not because me, my Obama Caring Procurement Project -Obamacare.

[jaichind]

From Bloomberg BNA

AHIP State Issues Conference

Issues Discussed: Rising premiums, high out-of-pocket costs, limited provider networks, lack of subsidies for dependent coverage.
Employer Issues: Many are planning to cut hours and reduce workforce levels, a health insurance broker says.

No health insurer has received confirmation that anyone has enrolled in a health plan through the insurance marketplaces in New York or Minnesota, insurance industry lobbyists from the two states said Oct. 18 at a conference.

“We still don't have a number of enrollees,” Leslie Moran, senior vice president of the New York Health Plan Association in Albany, told the 2013 States Issues Conference, sponsored by America's Health Insurance Plans.

Moran and Julie Brunner, executive director of the Minnesota Council of Health Plans in St. Paul, said no benefit enrollment transaction forms, known as 834 forms, have been transmitted from their state-based marketplaces to health plans. The online health insurance marketplaces that opened Oct. 1 under the Affordable Care Act are also called exchanges.

Early the week of Oct. 14, insurers in New York were told by the state's marketplace officials that about 2,700 834 forms were ready to be transmitted, “but they found a significant error in half of them, so they were going to hold them,” Moran said. An estimated 2.7 million people in the state are uninsured, she said. Sixteen plans are being offered in the state's marketplace, she said.

Despite insurers not receiving confirmation of enrollments, Minnesota officials announced Oct. 16 that 406 commercial applications had been completed, Brunner said. Another 3,500 people in the state are likely to be enrolled in Medicaid under the ACA, and Minnesota marketplace officials are expecting to enroll 1.3 million uninsured people in 2014, she said. Five health plans are participating in the state's marketplace, she said.

Higher Premiums Likely in New York

Despite initial announcements by New York officials and President Barack Obama touting sharply declining insurance premiums, Moran warned that more people in the state are likely to see premium increases for plans purchased through the marketplaces than will see premium decreases. “We don't like to promote that too much,” she said.

Programs for “navigators” and assisters to conduct ACA education and outreach aren't fully functional yet in Minnesota, Brunner said. “The biggest challenge that the health plans have is managing the expectations that people have that ‘once I go on the website and enter my information, I'm in a health plan,' and that's just not true,” she said.

“People are actually calling health plans in Minnesota now saying, ‘I enrolled in you yesterday. I need to schedule surgery in January. Can you tell me if my physician's in the network?'” Brunner said.

A major concern of health plan executives in Minnesota is that “we're going to lose a lot of Medicaid enrollees in the process,” she said. “We're going to have people start falling through the cracks.”

Nevertheless, Brunner said, “The message that we really stuck to with the exchange organization at this point is that this is proceeding as we had basically expected; we did not expect to have a fast start out of the gate; that doing it right and having secure data transferred is the most important thing.”

California Brokers Unhappy

In California, health insurance brokers and agents are unhappy with the marketplace, Bill Hammett, president of Hammett Health Insurance Services, a health insurance brokerage firm in La Mesa, Calif., told the conference. Hammett is president of the San Diego chapter of the National Association of Health Underwriters.

“We were told coming into this that we were a totally invaluable resource to the exchanges, and we were going to be relied on very heavily, and as it's rolled out, that's just not the case,” Hammett said. Millions of people use agents for help to find plans, “yet the exchanges have given us only lip service,” he said.

About 17,000 licensed insurance agents are in the state, and only 1,200 are signed up to sell products through Covered California, the state marketplace, he said. At the same time, 5,400 “community organizers and union participants” are authorized to help people find coverage in the marketplace, he said. Including applications still being processed for brokers and community organizations, “Those people are going to outnumber us almost five to one,” he said.

“There is growing unrest in the agent population with the exchanges and how they're working with us,” Hammett said.

Affordability Problems Cited

Potential marketplace enrollees are beginning to discover problems with the ACA, Hammett said. If an employer offers coverage that meets ACA requirements for affordability, the employee's dependents aren't eligible for subsidies, he said. The ACA requires employers with the equivalent of at least 50 full-time employees to provide self-only health insurance plans that cost employees no more than 9.5 percent of their salary, and the cost of family plans isn't taken into consideration.

“People are very upset about this, because they're looking at the exchange price with no subsidy,” he said. “They can't afford that,” and they are unable to afford the cost of the employer's group policies covering dependents.
Hammett also warned that there might be potential problems with the level of income people report in applying for subsidies for marketplace plans. “Some of these people will just do what they have to do, and they'll get the subsidies they don't deserve and buy insurance plans, and they're going to have to pay for it later,” he said.

The agreement reached Oct. 16 to end the government shutdown and potential default included a provision requiring the Department of Health and Human Services to ensure that state marketplaces check the eligibility of people who apply for premium subsidies (201 HCDR, 10/17/13).

High Out-of-Pocket Costs

High out-of-pocket costs also are likely to come as a surprise, even though premiums seem low, and the public is also unaware of highly restrictive medical provider networks for some marketplace plans, Hammett said. “There are some major hospital providers that are just not in the networks, and that is something that will boil over very quickly when people start realizing that they bought a plan that was moderately affordable, but there's really only [the equivalent of] a Medicaid network they can go to,” he said.

Further, Hammett said, the low levels of penalties for not having coverage—the higher of $95 or 1 percent of income in 2014—compared with the higher cost of coverage is likely to lead to many young, healthy people going without coverage. “The fears that we're all thinking about the young, healthy people not enrolling in the plan, I'm seeing a lot of that,” he said.
In addition, Hammett said he is seeing that many employers with whom he works are reducing employee hours to below 30 hours per week or staying below the 50-employee threshold in order to avoid coverage requirements under the ACA. “They're just playing the system,” he said.

[t_host1]

From Bloomberg BNA

AHIP State Issues Conference

Issues Discussed: Rising premiums, high out-of-pocket costs, limited provider networks, lack of subsidies for dependent coverage.
Employer Issues: Many are planning to cut hours and reduce workforce levels, a health insurance broker says.

No health insurer has received confirmation that anyone has enrolled in a health plan through the insurance marketplaces in New York or Minnesota, insurance industry lobbyists from the two states said Oct. 18 at a conference.

“We still don't have a number of enrollees,” Leslie Moran, senior vice president of the New York Health Plan Association in Albany, told the 2013 States Issues Conference, sponsored by America's Health Insurance Plans.

Moran and Julie Brunner, executive director of the Minnesota Council of Health Plans in St. Paul, said no benefit enrollment transaction forms, known as 834 forms, have been transmitted from their state-based marketplaces to health plans. The online health insurance marketplaces that opened Oct. 1 under the Affordable Care Act are also called exchanges.

Early the week of Oct. 14, insurers in New York were told by the state's marketplace officials that about 2,700 834 forms were ready to be transmitted, “but they found a significant error in half of them, so they were going to hold them,” Moran said. An estimated 2.7 million people in the state are uninsured, she said. Sixteen plans are being offered in the state's marketplace, she said.

Despite insurers not receiving confirmation of enrollments, Minnesota officials announced Oct. 16 that 406 commercial applications had been completed, Brunner said. Another 3,500 people in the state are likely to be enrolled in Medicaid under the ACA, and Minnesota marketplace officials are expecting to enroll 1.3 million uninsured people in 2014, she said. Five health plans are participating in the state's marketplace, she said.

Higher Premiums Likely in New York

Despite initial announcements by New York officials and President Barack Obama touting sharply declining insurance premiums, Moran warned that more people in the state are likely to see premium increases for plans purchased through the marketplaces than will see premium decreases. “We don't like to promote that too much,” she said.

Programs for “navigators” and assisters to conduct ACA education and outreach aren't fully functional yet in Minnesota, Brunner said. “The biggest challenge that the health plans have is managing the expectations that people have that ‘once I go on the website and enter my information, I'm in a health plan,' and that's just not true,” she said.

“People are actually calling health plans in Minnesota now saying, ‘I enrolled in you yesterday. I need to schedule surgery in January. Can you tell me if my physician's in the network?'” Brunner said.

A major concern of health plan executives in Minnesota is that “we're going to lose a lot of Medicaid enrollees in the process,” she said. “We're going to have people start falling through the cracks.”

Nevertheless, Brunner said, “The message that we really stuck to with the exchange organization at this point is that this is proceeding as we had basically expected; we did not expect to have a fast start out of the gate; that doing it right and having secure data transferred is the most important thing.”

California Brokers Unhappy

In California, health insurance brokers and agents are unhappy with the marketplace, Bill Hammett, president of Hammett Health Insurance Services, a health insurance brokerage firm in La Mesa, Calif., told the conference. Hammett is president of the San Diego chapter of the National Association of Health Underwriters.

“We were told coming into this that we were a totally invaluable resource to the exchanges, and we were going to be relied on very heavily, and as it's rolled out, that's just not the case,” Hammett said. Millions of people use agents for help to find plans, “yet the exchanges have given us only lip service,” he said.

About 17,000 licensed insurance agents are in the state, and only 1,200 are signed up to sell products through Covered California, the state marketplace, he said. At the same time, 5,400 “community organizers and union participants” are authorized to help people find coverage in the marketplace, he said. Including applications still being processed for brokers and community organizations, “Those people are going to outnumber us almost five to one,” he said.

“There is growing unrest in the agent population with the exchanges and how they're working with us,” Hammett said.

Affordability Problems Cited

Potential marketplace enrollees are beginning to discover problems with the ACA, Hammett said. If an employer offers coverage that meets ACA requirements for affordability, the employee's dependents aren't eligible for subsidies, he said. The ACA requires employers with the equivalent of at least 50 full-time employees to provide self-only health insurance plans that cost employees no more than 9.5 percent of their salary, and the cost of family plans isn't taken into consideration.

“People are very upset about this, because they're looking at the exchange price with no subsidy,” he said. “They can't afford that,” and they are unable to afford the cost of the employer's group policies covering dependents.
Hammett also warned that there might be potential problems with the level of income people report in applying for subsidies for marketplace plans. “Some of these people will just do what they have to do, and they'll get the subsidies they don't deserve and buy insurance plans, and they're going to have to pay for it later,” he said.

The agreement reached Oct. 16 to end the government shutdown and potential default included a provision requiring the Department of Health and Human Services to ensure that state marketplaces check the eligibility of people who apply for premium subsidies (201 HCDR, 10/17/13).

High Out-of-Pocket Costs

High out-of-pocket costs also are likely to come as a surprise, even though premiums seem low, and the public is also unaware of highly restrictive medical provider networks for some marketplace plans, Hammett said. “There are some major hospital providers that are just not in the networks, and that is something that will boil over very quickly when people start realizing that they bought a plan that was moderately affordable, but there's really only [the equivalent of] a Medicaid network they can go to,” he said.

Further, Hammett said, the low levels of penalties for not having coverage—the higher of $95 or 1 percent of income in 2014—compared with the higher cost of coverage is likely to lead to many young, healthy people going without coverage. “The fears that we're all thinking about the young, healthy people not enrolling in the plan, I'm seeing a lot of that,” he said.
In addition, Hammett said he is seeing that many employers with whom he works are reducing employee hours to below 30 hours per week or staying below the 50-employee threshold in order to avoid coverage requirements under the ACA. “They're just playing the system,” he said.

 A question that I have had since this vote to amend the Obama debt increase with updates – shutdown, is the income verification rule. The original ACA already had such rules; however income verification was waived by Obama. So, how and why would a ACA rule that was law and waived be reapplied as a rule, a law, that already exist, to be any more recognized by the arbitrator of his rules as a rule that must be applied, used, in determining the eligibility for someone else paying the applicants Obamacare premium’s. I mean, if the already Obama enrollment to his world is doing all it can to get you right, and now, must, re-applying a rule that Obama has already waived, how, or which as a question, what rule is in effect?

1. The ACA original income verification rule.
2. The ACA Obama waiver of the income verification rule.
3. The new reapplied ACA original income verification rule as an overrule of the Obama waiver; the income verification part of the Obama debt increase bill, was not to my knowledge, billed as an overrule - or a congressional veto of the Obama wavier.

[Snowstalker Mk. II]

This is my favorite active thread on Atlas.

[jaichind]

See

http://www.gallup.com/poll/165500/uninsured-americans-unfamiliar-health-exchanges.aspx

71% of uninsured still not familiar with health care exchanges.

34% of uninsured  will choose to pay the fine versus 25% in Sept.

If this is the case then I suspect that the massive traffic on Obamacare in the first week or two are people like me, those with health insurance but taking a look at prices to prepare for the day when they might not have health insurance from work.  If this 34% are skewed toward the young and healthy then I the death spiral of Obamacare might be upon us if this keeps up over the next year or two. 

[t_host1]

 The democrat Acceptable Collateral Annoyance (ACA²); ..hum, I wonder what that could be?

[Small Business Owner of Any Repute]

See

http://www.gallup.com/poll/165500/uninsured-americans-unfamiliar-health-exchanges.aspx

71% of uninsured still not familiar with health care exchanges.

34% of uninsured  will choose to pay the fine versus 25% in Sept.

If this is the case then I suspect that the massive traffic on Obamacare in the first week or two are people like me, those with health insurance but taking a look at prices to prepare for the day when they might not have health insurance from work.  If this 34% are skewed toward the young and healthy then I the death spiral of Obamacare might be upon us if this keeps up over the next year or two. 

That 34% will be skewed toward the Republican, not toward the young.  It makes no sense for a young person to pay a fine when they'd have subsidies helping pay for most their healthcare anyway. And spoken from first-hand knowledge: Once someone pays a RomneyCare/ObamaCare fine once, they sign up for insurance immediately the next year.

Paying money to get nothing is dumb when you can often pay less money and get something.

[t_host1]

 
Today, after 3 years and $600,000,000.00 Obama is going to say that this is not acceptable. It has been pointed out before that software is a fixed logic, and that the Presence is governance fixated on the margin of them vs. us.

 I was part of a mock jurist pool on a health insurance policy trial. The argument was in the area of a membership enhancement programs to subsidize what the original primary policy would not cover. As the argument came to a conclusion, my finding was that one entity used the other to give an appearance of an advantage when compared to other competitor programs. In the end, both had a distant relationship with each other giving recognition just enough to make a sale with an uninformed willing buyer. Obama care is of the same model with an informed buyer, despite the media depiction of the public. The public that doesn’t pay for anything and the public that does pay for everything knows exactly what is going on.  The software is of more exceptions to the rule than any rule itself with no regard to if the money works or not, which explains todays extension for more time and money as acceptable to satisfy perpetuity of the progressive democrat. Of course, “them” will remind Obama that amendments, repeals and impeachments are in equal perpetuity to follow the progressive democrat.

 In short, the medical complex had an understanding that Obama would enhance their positions; only in the end, like the trial, those willing to participate destroyed each other. 

[jaichind]

That 34% will be skewed toward the Republican, not toward the young.  It makes no sense for a young person to pay a fine when they'd have subsidies helping pay for most their healthcare anyway. And spoken from first-hand knowledge: Once someone pays a RomneyCare/ObamaCare fine once, they sign up for insurance immediately the next year.

Paying money to get nothing is dumb when you can often pay less money and get something.

You could be right but I have strong feelings that this is not the case.

First, if 71% of the uninsured do not know much about health exchanges it is not realistic to expect them to be able to get enrolled.  I agree there might be a lot of interest in the health exchanges, at least the first few days, but my feelings are that they are mostly people with existing plans but are looking to switch.  The Obama regime reports that 476K people have enrolled in Obamacare.  But that is be clear what that means.  If you cannot see the prices of the plans on the exchange just to check them out then you must enroll just to see what the prices are.  A lot of people that enrolled, like me, are just to take a look at what plans are available and at what price.  Some, like me, are to plan for the future when we might retire early.  Others are people on existing group plans and are thinking about switching.  This explanation can reconcile between why there was so much activity for the few few days yet vast majority of uninsured have no knowledge of health exchanges.

As for the subsidies as an incentive.  Lets look at the numbers after factoring in subsidies.  The penalty for not having an insurance plan is 1% of MAGI.  Lets take a single person having a MAGI of $16.5K.  A silver plan would cost 3.65% of MAGI and even a bronze plan would be 1.03% of MAGI.  If we move that MAGI to $23K, then it would be 6.3% for a silver plan and 4.41% for a bronze plan.  And a MAGI of $34.5K, it would be 9.5% for a silver plan and 6.1% for a bronze plan.  So as long as a single healthy person makes more than $20K the incentive is not that great to pay for a plan if he or she feels that they will most likely not use it and the choice is to pay 1% or 3% of income.  Also do not discount the hassle factor.  The time it takes to enroll, sign up for, and then pay for insurance is significant.  And even after you get it and it gets used, there are a lot of paperwork to get the insurance to pay for healthcare.  The healthy $20K guy would just look at it and say, I will just pay 1% and not put up with this.  That is just as rational as the argument that you are paying 3% for something of value versus 1% that one gets nothing in return.

One way to see this play out is looking at the health providers.  If not enough young healthing people sign up for Obamacare then the insurance companies will lose money and will raise premiums leading to a death spiral.   On Friday UnitedHealth got cut to 'Hold' at Cantor Fitzgerald based on this trend and UnitedHealth stock prices fell 5.4%.  It is falling again today.  This should be a signal that experts on Wall Street are also getting skeptical that all these new young healthing customers will actually show up.  Of course, UnitedHealth will always figure out a way to make a profit and it will raise prices along the way and lead to the Obamacare death spiral.

[jaichind]

See

http://www.nytimes.com/2013/10/21/us/insurance-site-seen-needing-weeks-to-fix.html?_r=0

"One specialist said that as many as five million lines of software code may need to be rewritten before the Web site runs properly."

But as someone with a background in software I see what is below a lot and find it more disturbing than the previous statement.

"Administration officials approached the contractors last week to see if they could perform the necessary repairs and reboot the system by Nov. 1. However, that goal struck many contractors as unrealistic, at least for major components of the system."

When software is not built correctly and there is pressure to fix it by a certain unrealistic date, the chances are they will dig themselves deeper in the hole.  The rush to fix things at a speed which is not reasonable will cause more issues and is for sure never the right approach to solve the problem.  The right approach is to admit that this is a fiasco and it will take several months to fix and be done right.  

[t_host1]

 The conversation swings back to Chief justice Roberts taking a lot of pain for twisting the language of the mandatory fee for service to a taxation position in his ruling of Obamacare. Yet, Obama has ignored the favor and now is in full press to sell a monopolized product by trade as a consumer product to which guarantees litigation jobs from this point on suing ourselves.

[t_host1]

See

http://www.nytimes.com/2013/10/21/us/insurance-site-seen-needing-weeks-to-fix.html?_r=0

"One specialist said that as many as five million lines of software code may need to be rewritten before the Web site runs properly."

But as someone with a background in software I see what is below a lot and find it more disturbing than the previous statement.

"Administration officials approached the contractors last week to see if they could perform the necessary repairs and reboot the system by Nov. 1. However, that goal struck many contractors as unrealistic, at least for major components of the system."

When software is not built correctly and there is pressure to fix it by a certain unrealistic date, the chances are they will dig themselves deeper in the hole.  The rush to fix things at a speed which is not reasonable will cause more issues and is for sure never the right approach to solve the problem.  The right approach is to admit that this is a fiasco and it will take several months to fix and be done right.  

 I concur, it has been my experience also that any scripting must know of its ending first, to which in the scripting of Obamacare, rather it be data base functional or in its principle, has no possible use of any standard weight or measurement of legal standing to the civil rights, due process and equal protection that could avoid being a total fraud.
 I'd like to see the contract of the writers. I'd would be looking for a clause of no responsibility, immunity to the outcomes of any transactions committed on a script that I would of wrote in such an environment. Not a lot different than that of our military operating in a foreign country.
 

[Beet]

As a 7-year web developer, programmer, software engineer and infrastructure architect with 4 1/2 years in the Federal sector, I am not optimistic about this web site. When I was a government contractor the primary problem was not the technical side but the bureaucracy.

For example, to order a new set of servers would often take 5 months, from allocating the money, making the order, taking delivery, acquiring physical space, setting up the connections, migrating the data, and so on. Each step required lengthy approvals and audits, not to mention tests. Something that we could do in maybe two or three weeks thus was stretched out to months or even years. And this was within one agency.

There might be a configuration change that I could do that would take 15 minutes. However this was impossible because of the rules. This task might be stretched out over 4 hours, including the creation of a test plan for environment 1, a test results report for environment 1, a test plan for environment 2, a test results report for environment 2, a written justification of the change, a back out plan, and so on. Then it goes to the change control board, which meets once a week. At the board any one of maybe 10 people can reject the change. If it's rejected, I have to start over. If it's accepted, then I schedule the change during a maintenance window, which is again usually a prescheduled time, once a week.

Hence a 15 minute technical task can get stretched out to 2 weeks due to bureaucracy. God only knows what they are dealing with in rewriting 5 million lines of code.

[Beet]

The problem is in government everyone is trying to cover their ass. That's it. In the private sector there is high level demand for efficiency across the organization, because if a company isn't adapting, then it's going to sink. But in the government there is no imperative to adapt. If it ain't broke, don't fix it, is the motto. Which generally works. Government usually survives by doing the same thing today as it did yesterday. There's no downside to that. That's why making a change is so hard in government- it always introduces more downside than upside.

Except here, it is broke, and needs to be fixed, and fixed fast. This is totally alien to government. You have private sector imperatives in a system whose culture is totally against that. I can guarantee you that the top directors of this project are shoving the timeline down as hard as they can and they're getting massive pushback from all the little chieftains who have to do the implementation. The question is whether they can somehow fast-track it, whether political imperatives will be strong enough to somehow bring implementation entirely outside the existing culture.

[opebo]

Sounds like a good argument for ditching the web site and just giving everyone full Medicaid coverage using their social security card.

[jaichind]

Sounds like a good argument for ditching the web site and just giving everyone full Medicaid coverage using their social security card.

And the GOP can run against the Communist Obama next election.

[opebo]

Sounds like a good argument for ditching the web site and just giving everyone full Medicaid coverage using their social security card.

And the GOP can run against the Communist Obama next election.

Ah c'mon, just call it an 'Emergency Measure', send out the national guard, and cancel the elections.

[Beet]

Actually, I don't think that working out some sort of temporary hack (or a series of them) should necessarily be ruled out. The problem is they don't have six months. If they can't fully integrate systems, then they need to put the data into a temporary dump and then work out the integration later.