“There’s been a lot of spin coming out of the White House regarding the botched launch of Obamacare’s health insurance exchanges. When it was clear that people were having problems with the healthcare.gov website on its launch day, October 1, Health and Human Services Secretary Kathleen Sebelius called it a “great problem to have.” The “glitches” were great, she said, because they were being caused by the overwhelming interest of millions of visitors to the website. But whenever she was asked how many people had actually enrolled in Obamacare insurance, she claimed she “didn’t know.” But now, thanks to a Congressional inquiry, we learn that she did know how many people enrolled on day one of the federal exchange: six.
White House memo: ‘Direct enrollment is still not working’
The House Committee on Oversight and Government Reform, chaired by Rep. Darrell Issa (R., Calif.), obtained three memoranda from the Center for Consumer Information and Insurance Oversight, or CCIIO, which set up the Obama administration’s “war room” on the exchanges’ launch. The first memo, from the morning of October 2, states that “6 enrollments have occurred so far with 5 different issuers.” By the following morning, total enrollments had increased to 248.
This confirms what insurance executives had told me, and others, on the day after the launch of the healthcare.gov website. “Very, very few people that we’re aware of have enrolled in the federal exchange,” one insurance official told the Washington Post. “We are talking single digits.” At the time, it seemed too crazy to be true. But it was true.
“High capacity on the website, direct enrollment not working, VA system not connecting, Experian creating confusion with credit check information” were among the ongoing issues identified on the morning of October 2. A second memo, published that afternoon, stated that “direct enrollment is still not working.” 100 people had successfully enrolled by then, but “some estimates show 40,000 people in the waiting room” trying to sign up.
Some issues won’t be resolved until ‘Year 2’
The October 3 memo released by Rep. Issa states that website problems had left “some service areas with no [insurance plan] rates,” preventing visitors from shopping for coverage. “The consensus of this group is to allow these service areas to be removed in Year 1, and then to tighten the rules and language around this issue in Year 2.”
The memo says that Obamacare “navigators”—people who the government has hired to help people sign up for coverage—“should not be told to use paper applications until there is approval from leadership,” because the paper applications get fed into the website. “Ongoing issues” included “Experian identity-proofing…for consumers,” “eligibility results are breaking intermittently,” and that the “EIDM [Enterprise Identity Management] servers may have software issue.”
Among the biggest problems is that insurers have not been receiving the standard 834 forms that they use to enroll individuals in their health plans. “Issuers not receiving 834s when they should be,” says the October 3 memo.
HHS to issue enrollment data in mid-November
When Kathleen Sebelius testified before Congress this week, she claimed that she had no idea how many people had enrolled onto Obamacare’s exchanges. “We do not have any reliable data around enrollment, which is why we haven’t given it to date,” she claimed under oath. That never made any sense. On this web page, you can view up top the number of people who have viewed this page, down to the individual. All businesses know exactly how many people have consumed their products.
The only reason Sebelius isn’t giving out the number is because it’s embarrassing to the administration. The House Oversight Committee obtained the real numbers by asking the government’s IT contractors to hand them over.
Sebelius did promise to provide enrollment data in “mid-November.” It will be important to sift those numbers for spin. For example: how many people enrolled in Medicaid, the low-quality 1965-era program that doesn’t require a website, vs. the new Obamacare exchanges? How many young vs. old people signed up, and healthy vs. sick?
Obamacare has botched market-based concepts
It’s a scandal that the administration has botched this so thoroughly. But it should be especially worrisome to advocates of market-based health reform. The single-payer portion of Obamacare—expanding Medicaid—is going just fine, at least in the states that have chosen to participate in the expansion. It’s Obamacare’s attempt at leveraging theoretically market-based concepts, in its subsidized private insurance exchanges, that has been so badly bungled.
Republicans should certainly hold Democrats and the Obama administration accountable for what they’ve done. But they should also remember that market-based health reform also relies on using tax credits to help people shop for private insurance products. They explain why Obamacare’s exchanges don’t work—and what they would put in their place—instead of merely calling attention to their failure.”