This article has opinions from the author based on his findings and research on this controversial issue.
The Affordable Care Act, the ACA, or Obamacare as it has been called, has been in the news quite a bit recently — but unfortunately for President Obama and his sweeping insurance solution, the reasons have been mostly negative. The first of October marked the anticipated debut, the day when potential insurance buyers could use the government websites to navigate plan options under the new healthcare regime. It’s safe to say very few were successful as the websites have been plagued with glitches and long waits, resulting in many unhappy people. Before these hiccups, The Affordable Care Act already made many Americans uneasy — the poorly functioning sites, along with the rest of the negative news has done nothing to soothe any discomfort.
Off the bat in October, the glitchy federal site, and some of the poor functioning state sites, were said to be improperly working due to the flood of users all flocking to the healthcare websites at the same time. It’s odd to think the government would not foresee this problem and be prepared for millions to seek out the sites — it is, after all, a soon-to-be active law that citizens must have health insurance — and not to mention the fact the administration put forth a very expensive promotional campaign for the ACA, October 1st was the day citizens were bombarded with for months. How is the high volume of traffic on the first days, unexpected?
President Obama addressed this concern in a public statement last month, reassuring the American people this was just a minor problem and permanent fixes were on the way. The Wall Street Journal however, reported prominent design flaws in the system as the cause for error, not only the overwhelming traffic. And even despite the President’s assurances properly functioning sites were on the horizon, weeks later Americans were still seeing a myriad of usability issues.
The orchestrator behind this healthcare startup is Health and Human Services Secretary Kathleen Sebelius — because of the rocky rollout, she has been under quite a bit of scrutiny. A handful of Republicans called for her job last week, but President Obama defended his appointed healthcare leader.
“I think Kathleen Sebelius, under tremendously difficult circumstances over the last 4½ years, has done a great job in setting up the insurance markets so that there is a good product out there for people to get,” Obama said. “You know, Kathleen Sebelius doesn’t write code.”
I understand the President standing behind Sebelius, but what he’s saying here doesn’t quite matchup with the results produced. It is a tremendously difficult task, but so far, almost all would argue Sebelius and her team have not provided a good product, reasonable access to the health care exchanges. And while the President is right, Sebelius doesn’t write code, she is in charge of those who do — just like the captain of a ship, or the coach of a team, she is responsible for all those under her. Just because she doesn’t write code, it doesn’t mean she is not to blame for the rollout not going according to plan.
Even aside from the disastrous start to the ACA websites, both state and federal, the more information to come out about the healthcare exchanges, the less confident citizens are in the program. CNN revealed the federal ACA site, Healthcare.gov, has more than just the reported headaches, but also gaping security flaws. Though the security issues have now mostly been fixed, the fact there were security issues is not reassuring.
A software tester in Arizona, Ben Simo, discovered just how easy it was to gain access to registered accounts. This type of unwarranted access didn’t take elaborate hacking — even someone with a simple understanding of how to read code could create problems for users who thought their information was safe. After the healthcare site claimed to have fixed the errors, CNN attempted to repeat Simo’s actions — they discovered some of the issues had been fixed, some, not all. Simo and many other experts have expressed concerns about the overall security of the site despite these fixes.
“This seems really sloppy,” Simo said. “Either the developers were incompetent and did not know how to do the basic things to protect user information, or the development was so fractured that the individuals building the system didn’t understand how they fit into the bigger picture.”
With so many patches and fixes to this fractured federal site, who is to say these solutions will work permanently? Trying to create a bunch of patches to fix a hole doesn’t work as well as simply building the site correctly the first time around. It’s like trying to fix a crashing plane in flight. Many experts are reporting these problems cannot be reasonably fixed before the end of 2013 — those same authorities are recommending a whole new website, starting completely from scratch. That doesn’t bode well for all those needing insurance, the deadline to enroll in these exchanges is December 15th.
Part of the problem with fixing the federal site lies in the 500 million lines of code, an excessive amount by almost all standards. A typical online banking system usually ranges from 75 to 100 million lines of code — a project like this would usually require around 25 to 50 million lines.
CEO of information-security company Trusted Sec, Dave Kennedy states:
“The [500 million lines of code] says right off the bat that something is egregiously wrong,” said Kennedy. “I jumped back when I read that figure. It’s just so excessive.”
Part of these persisting problems come from the federal site being rushed to meet the October 1st deadline. The ultimate goal wasn’t to create a perfect site, it was to meet the deadline. Quality is never assured when a deadline quickly approaches, and Healthcare.gov is no different.
Even more, it was revealed last week that state-run health care exchanges were allowed to launch without undergoing an independent security assessment as required by OMB guidelines and federal law. A published document from the Center for Medicare and Medicaid Services was discovered and “raises serious questions about the security and privacy of the state health insurance exchanges.” This was clearly a deliberate attempt by the administration to circumvent federal requirements to allow the websites to launch in time. As tech experts continue to rip on the exchange sites, it’s not encouraging Americans to trust any of these sites with their personal information.
Apart from the many shortcomings of the websites alone, many Americans are now discovering what President Obama promised about his new healthcare law is simply not true. At a rally in 2009, the President specifically remarked on the notion of Americans with insurance keeping their insurance.
“First of all, if you’ve got health insurance, you like your doctors, you like your plan, you can keep your doctor, you can keep your plan,” Obama said. “Nobody is talking about taking that away from you.”
While this promise sounded great at the time, and the hundreds of other times the President has recited this line, this has proven to not be true at all. According to healthcare expert Bob Laszewski, approximately 16 million Americans will lose their current healthcare plans because of the Affordable Care Act. These numbers alone are staggering.
One of California’s largest insurance providers, Kaiser Permanente, is canceling 160,000 of their current private healthcare plans, half of the individual insurance plans in the state. Blue Shield of California was reported to have canceled 119,000 plans as of mid-September. Florida Blue sent out 300,000 cancellation notices to customers, 80% of the state’s individual coverage policies. The two major insurance providers in Pennsylvania, Independence Blue Cross and Insurance Highmark, plan on canceling 20-40% of their total plans. More than 250,000 Coloradans are losing their health insurance policies. In New Jersey, 800,000 plans will no longer exist in 2014 because they do not meet the mandated regulations laid out by the Affordable Care Act.
Many of these plans are being canceled for the very reason that they do not meet the high standards for more comprehensive care set forth by the ACA. Key elements to the new healthcare law include provisions requiring coverage for mental health, maternity care, and other very select components that do not apply to all applicants. Many coverages are running out because the basic plans do not cover all of the new ACA provisions.
It should also be noted that health insurance providers cancel plans all the time — but this many plan cancellations, all for one reason, is surely a first. It should also be noted that many politicians on both sides of the aisle have misstated facts about the Affordable Care Act (mostly Republicans). But for the President, the guru behind all of this, to consistently misrepresent this “keeping your plan” as truth, it surely is the worst falsehood of all. So many with insurance were sold on this very law based on the notion of “keeping your plan.”
President Obama addressed this statement of “keeping your plan.”
“We really believe that ultimately they’re going to be better off…. But obviously we didn’t do a good enough job in terms of how we crafted the law, and that’s something I regret. That’s something we’re going to try to get fixed,” Obama said.
It really is difficult to believe all these crafted statements meant to save face with the public. Believing that people will be better off, once again, is not reassuring. Speaking about fixing the law and regretting it was not good enough, again, not reassuring. This type of speak from those who molded this entire law does not give Americans a comforting notion that the government indeed has this extremely complicated act in hand — nothing that has happened up until this time points to the fact that Americans will be better off under the ACA.
One of the most troubling aspects of the Affordable Care Act is how much it depends on younger and healthier people paying in to be a success. This youthful group joining the pool is crucial to the success of the overall plan to offset the costs of those who are older and those needing more healthcare.
The Affordable Care Act weighs much heavier on the healthy to subsidize the sick and needy. The healthy, middle class, youth of this country need health insurance much less than most — they rarely get sick and need medical attention much less than the elderly, sick, and impoverished people. Yet, this group will be carrying a heavier load, paying much more in most cases, despite using the least amount of health services. Some will be able to manage this higher cost — others, like myself, will struggle to pay the higher prices of a health care plan. And almost certainly, I will not need any of the services offered within my “all-encompassing, covers everything healthcare package,” like mental illness, substance abuse or maternity coverage.
Those who do not sign up will face a fine, eerr, a “tax” as it has been called (it really is not a tax at all). And many young Americans might not sign up due to how much these “cheap” plans could cost. A Manhattan Institute study is reporting that younger-than-average men could see average premium increases of 97-99%, women seeing an average increase ranging from 55-62%. Compared to the cost of the ACA healthcare plans, many may simply choose to pay the “tax” and purchase insurance when they need it (no one can be denied the chance to buy insurance under the pre-existing coverage mandate). The “tax” is said to be much cheaper than actually buying a healthcare plan.
So with higher rates for the middle class, the young and the healthy, wouldn’t it be reasonable to assume many might simply choose to pay the fine, eh, “tax?” If that happens, the costs of the Affordable Care Act will fall right back onto the taxpayers. By the way, the picture above is a real advertisement.
With all that has gone wrong up until this point, and with all those who already think this solution is not the answer to America’s healthcare problem, doesn’t the poor functioning websites, the increased premiums, and all the other negative reports seem fitting? Doesn’t the shoe fit, that the government would take over more of the very complicated healthcare market (they already are the largest purchaser of health insurance in the country) and completely stumble out of the gate? The government already has a very poor reputation, already creating disasters with Medicaid, Medicare, and Social Security — this new healthcare exchange does not appear to be on solid footing, something that does not bode well for this country in dire need of healthcare reform. Not to mention, this is just the start. None of this law has really even been put into practice. We still have not even embarked on how the ACA will work for doctor visits, those who need surgery, and those who need life-saving care — with nothing going right to this point, doesn’t it terrify you thinking that when you are sick or hurt or in need of any medical care that these leaders and their system is in charge of taking care of you?
Do I have an answer to this problem? Not really. I am not well-versed enough in the insurance field to offer a solution. But I am under the opinion that passing this very intricate market even more into the hands of the government is not the solution this country needs. It’s tough to make an argument the federal government has done much right in the recent decades besides foolishly spending a ton of money. They often have the wrong people in charge of their programs. Their sweeping solutions, whether it be the care of the retired (Social Security), the care of our wounded veterans, the war on terror, the war on poverty (Food Stamps, Welfare, etc.) or the war on drugs, nothing up until this point has worked enough to be considered anything close to a success.
No matter your political stance or view of a perfect healthcare system, you have to admit the federal government does not have a great track record with big medical programs or subsidies in general. Medicare and Medicaid are considered a failure almost across the board, costing our country billions and billions driving us deeper into debt. You have to admit the healthcare system is already extremely complex, with or without government intervention. The federal government’s track record does not exactly reflect a “well-oiled machine.” Considering how large the Affordable Care Act is, and how miserable the “Obamacare” experience has been up until this point, why should Americans really believe it will get any better?
I sure don’t.
Images via: Google