Trying to Make Sense of the Covered California Numbers

I've read a number of reports in recent days gushing over the progress Covered California is making leading the nation in signing up people for Obamacare.

But, I am having trouble understanding how the numbers should make anyone gush with enthusiasm.

"If You Like Your Doctor You Will Be Able to Keep Your Doctor. Period"

I think you can guess who said that.

Actually, here is what the President said at the American Medical Association Meeting in July, 2009––and likely lots more times:

"No matter how we reform health care, we will keep this promise: If you like your doctor, you will keep your doctor. Period. If you like your health care plan, your will keep your health plan. Period. No one will take it away. No matter what. My view is that health care reform should be guided by a simple principle: fix what's broken and build on what works."

We have all heard this repeated many times before in recent weeks. But with the front-page story in the Washington Post this morning, "Health Insurers Limit Choices to Keep Costs Down," it's as if somebody rang a new bell this time focused on the "you will keep your doctor" part.

Small Group Health Insurance "Cancellations"––The Next Shoe to Drop But a More Complicated One

Obamacare is impacting the small group insurance market in many of the same ways as the individual health insurance market. While employers with less than 50 workers don't have to provide coverage, if they do they are required to comply with the same essential benefit mandates, age rating changes, and pre-existing condition reforms the individual market faces.

That means essentially all small group policies cannot continue as they are––they have to be discontinued.

Obamacare Rollout Week Seven: Better and Nowhere Near Good Enough

I can provide you with an Obamacare federal exchange rollout update from two decidedly different perspectives:

1. The website is working much better with enrollment increasing at least three-fold over just a few weeks ago with backroom error rates considerably improved; or
2. The enrollment, to give you a general sense of what's happening, for a health plan that might have to sign-up 100,000 people in order to get their share of the 7 million Obama administration's national enrollment objective, has grown from perhaps 10-15 enrollments a day a few weeks ago to 40-50 a day now. If this new higher trend continues, such a plan would sign up only another 12,000 people toward the 100,000 objective by March 31. Backroom error rates being committed by Healthcare.gov, when enrollment data are transmitted to the health plans, are still far too high to transition to high volume processing without serious customer service issues.

So, pick your perspective.

Obama Pushes the Cancellation Mess to the Health Plans

Read my Op-Ed at USA Today: Insurance Industry Readied While Obama Slept

California's Health Insurance Exchange Enrollment Says a Lot About What Could Have Been and What Still Has To Happen

Covered California, the state-run Obamacare health insurance exchange, announced yesterday that 59,000 people have so far signed up for health insurance.

Given that California amounts to about 10% of the nation's population, this would suggest a smooth running federal exchange might well have enabled the Obama administration to have met its national first month goal of 500,000 sign-ups.

But the California enrollment also points to the real challenge Obamacare faces.

27,000

You know they are in big trouble when they come in at half of my estimates!

The audacity of this administration to continue telling people to keep going back to the website and the call center when they knew full well that only 25 people per day per state were making it thorough the gauntlet that is Healthcare.gov is startling.

This program is in grave danger of collapsing if the administration cannot dramatically grow the size of the risk pool and attract healthy people to it.

The Obama administration doesn't have a hill to climb, it has Mt. McKinley to climb.

The Obamacare Rollout: The Administration Needs a Plan B––Now!

It is now becoming clear that the Obama administration will not have Health.care.gov fixed by December 1 so hundreds of thousands, or perhaps millions, of people will be able to smoothly enroll by January 1.

Why do I say that? Look at this from the administration spokesperson's daily Healthcare.gov progress report on Friday:

Essentially what is happening is people [those working on the fixes] are going through the entire process. As we have fixed certain pieces of functionality, like the account creation process, we're seeing volume go further down the application. We're identifying new issues that we need to be in a position to troubleshoot.

Does that sound like the kind of report you would expect if they were on track to fix this in less than three weeks? Their biggest problem is that they admittedly don't know what they don't know.

The Obamacare Rollout––Week Five

Enrollments continue to trickle in. Health plans, with the kind of market share that would have to sign-up 100,000 to 200,000 people for the administration to hit its goal of 7 million people, are generally reporting they have enrolled only about 100 - 200 people over the first 35 days via Healthcare.gov.