The Kick-the-Can Approach to Obamacare

Obamacare problems? The administration will fix them later.

The fight over verification procedures for Obamacare's health insurance subsidies is just one of the many ongoing sub-arguments about implementation of the health law, but it's one that highlights the administration's particular mix of arrogance and ineptitude, as well as the long-term problems with the administration's fix-it-later approach to the health law.

Whitehouse.govWhitehouse.gov

Throughout last year, the Obama administration gave the distinct impression that it was not overly concerned with verifying eligibility for Obamacare's health insurance subsidies. Those subsidies are granted based on household income, with larger subsidies going to those who earn less. The question, then, was how government officials would determine an applicant's income.

Last July, in a holiday-week news dump, The Washington Post suggested an answer when it reported that the administration had written a rule allowing most individuals to self attest projected household income without further verification. In other words, there would be no verification in most instances. As the Post described it, Obamacare would rely on the honor system.

That didn't sit well with some members of Congress. So in September the House, led by Republicans, passed a bill dubbed the No Subsidies Without Verification Act, which would have required the Inspector General (IG) of the Department of Health and Human Services (HHS) to certify that there's a working verification program prior to the payment of subsidies.

Or it would have—if it had passed. But that would have necessitated a presidential sign-off. Instead, the White House threatened a veto of the bill, saying it strongly opposed the legislation because it would delay the payment of subsidies and would impede opening the Marketplaces on October 1st. Besides, the White House argued, the requirement was unnecessary because HHS had already put in place an effective and efficient system for verification of eligibility for premium tax credits.

It was practically an admission that the administration's verification system would not pass the muster of an independent check. If a sufficiently robust system was already being in place, then an independent confirmation shouldn't create a significant delay. It was also implicit confirmation of the low priority that the administration gave to creating a reliable verification system. And it would prove to be false.

Obamacare's exchanges opened in October, and after the initially crippling tech failures were dealt with, people began to sign up for and enroll in subsidized coverage. This year, the administration began making subsidy payments to insurers.

The verification process, however, was stuck in administrative limbo. Last month, the Associated Press and The Washington Post reported that more than a million people who qualified for subsidies had income discrepancies, in which the information provided by the individual did not match records on file. Nearly a million more had discrepancies related to citizenship or immigration status.

The administration had begun the process of sending out requests for more documentation and information from those people, but many weren't responding. Those who did respond were stuck in a long line for processing: The system to automatically enter data from verification documents had not yet been built, meaning that data processors had to type everything in manually.

Contrary to what the White House had asserted in September, the administration had not already put in place an effective and efficient system for verifying subsidy eligibility. The sheer number of inconsistencies—more than two million, counting income, citizenship, and immigration status discrepancies—made it clear that there was no meaningful check on subsidies before they were paid. And the incomplete data-entry system could hardly be described as an effective or efficient method of post-payment check.

To the extent that verification was a priority, it was low on the list, and the administration, after resisting efforts to check their work, had decided to put it off and deal with the problem later.

Well, later is apparently now, and the administration is sending out hundreds of thousands of notices saying that the information they provided does not match other federal records, according to The New York Times. At least some of the automation that was incomplete in May has now come online, but the process is still a mess.

"Even though consumers have sent documents to [document processing contractor] Serco's office in London, Ky., the government cannot always link the documents to applications for coverage filed months earlier," the Times reports. The story also notes that some people remain unable to upload documents electronically. And one source quoted in the article says that people who have already sent in documentation are being asked to send it in again.

Obamacare supporters are downplaying the inconsistencies as minor records mismatches, but the potential for upheaval is significant. What happens, for example, if the people who have been contacted don't send in additional documentation? The letters sent out by HHS warn that they could lose their subsidy, or be dropped from their exchange coverage entirely. We don't know how many people have responded at this point, but last month The Washington Post reported that just a fraction of those contacted had done so. What about those who try and cannot get their documents to upload into the system? And what about the delays caused by the administration's failure to complete the tech systems necessary for timely processing?

It's not clear how this mass of discrepancies gets resolved, but what's obvious is that this is a big bureaucratic mess created by the administration’s incompetence, bluster, and refusal to be transparent. They declined independent checks and insisted they had implementation under control, despite contrary evidence, and now it's abundantly clear that they didn't. It's a kick-the-can approach to administration and implementation.

And despite the too-late verification efforts now in the works, it's a big mess that may not be resolved until tax time next year: Those whose received subsidies for which they were not eligible are, at least in theory, supposed to repay the overage on along with their tax bills. How many people might this affect? So far, no one really knows. As always with Obamacare, it's easier to wait to fix problems until later.

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  • RishJoMo||

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    Battle of the Bots!

  • Swiss Servator, CH yeah!||

    100 quatloos on RishJoMo!

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  • DenverJay||

    no shit! what a waste to go through all the trouble to set up your auto-poster, then use it to send people to a piss-poor website with nonsensical English usage.
    "I no get it, why we no make money?"

  • ||

    Roll that beautiful stretch mark footage!

  • Ted S.||

    Where's our brickbat?

  • ||

    Maybe they could use the same verification process that the VA uses. Since, you know, the VA is so darned efficient.

  • Ted S.||

    I thought this was your last post.

  • ||

    LOL, you know where I borrowed this handle from don't you? One of our leftie commenters of the past - it may have been one of Mary Stack's incarnations - would frequently threaten to leave by saying "This is my last post".

  • Live Free Or Diet||

    Somehow WIndian's threats to gambol elsewhere never bothered me.

  • ||

    What ever happened to him? I know he had a career gamboling in Wikipedia for a while. He was probably one of the reasons we have to register now - with his long diatribes pasted from greenie sites. But the bots still manage to get through.

  • JWatts||

    "But the bots still manage to get through."

    Perhaps the bots are smarter?

  • DenverJay||

    Its just part of the auto-posting software: you make a bunch of email addresses (a process which can also be automated), then you have your software cycle through them. It has a database where you have entered your target websites. The macro registers/signs in, then posts your stuff. You can set it up to click on "reply" if you want, and to cycle through scripts or individual words to change the scripts, for example "every one should..." gets changed to "everybody should.." I saw one somebody else wrote for Craigslist that would post random phrases in white below each post, thus changing the posts so they were different enough to pass Craigslist's filters, but nobody could see the random stuff because it was white on white.

  • Ted S.||

    The one whom I miss for some bizarre reason is Herucles Triathol Savinien (or however it was spelled).

  • Pro Libertate||

    He was the best. Personally trained by the Urkobold, I believe.

  • Emmerson Biggins||

    ya that was quality .... whatever it was.

  • VicRattlehead||

    Road to Mandalay
    any time the argument starts stomping his face in with the cold hard boots of logic he has to take his ball and go home, but then never fucking does.

  • Sevo||

    How can we miss him if he won't go away?

  • sasob||

    Reminds me of Edward... or Max.

  • ||

    "That didn't sit well with some members of Congress. So in September the House, led by Republicans, passed a bill dubbed the No Subsidies Without Verification Act,"

    The idiots! Why not just let the whole thing collapse! The damned thing needs to be REPEALED, not "fixed". And how about not nominating one of the authors of Obamacare as your nominee next time, hmmm?

  • Libertarian||

    The money, favors, kickbacks, and (did I mention money already?), are being spewed from the D.C. pipelines. Don't get your hopes up -- it will NOT be repealed even if the GOP owns the White House and both houses of Congress.

  • ||

    I wonder how much of that money was spewed into Justice Robert's pockets.

  • ||

    I mean Justice Roberts' pockets. Sorry for the misplaced apostrophe.

  • Cap'n Krunch||

    Because like every other time the democrats pass something and the republicans publically cry foul, unconstitutional, unAmerican, in private they're busy figuring out how to use this newly found federal scope expansion for their own purposes.

    The republicans have never met an unconstitutional usurpation of power they didn't love, kind of like those fiscally conservative protectors of the federal wallet never met a debt ceiling they didn't raise.

  • Longtorso, Johnny||

    I'm thinking Roberts was more blackmail than bribery.

  • ||

    Could be, but there was definitely something fishy going on. Someone got to him at the last minute somehow.

  • Libertarian||

    Anyone here subscribe to the theory that Roberts was crazy like a fox? If that decision ("it's really a tax") is correct, then the fact that the legislation did not originate in the House make it unconstitutional? Per George Will:

    The “exaction” — Roberts’s word — “looks,” he laconically said, “like a tax in many respects.” It is collected by the IRS, and the proceeds go to the Treasury for the general operations of the federal government, not to fund a particular program. This surely makes the ACA a revenue measure.
    Did it, however, originate in the House? Of course not.

  • Libertarian||

    Here's the link to Will's column:
    http://www.jewishworldreview.c.....6AslXCbulI

  • steedamike||

    I was not aware how the ACA got snuck in:

    "In October 2009, the House passed a bill that would have modified a tax credit for members of the armed forces and some other federal employees who were first-time home buyers — a bill that had nothing to do with health care. Two months later the Senate “amended” this bill by obliterating it. The Senate renamed it and completely erased its contents, replacing them with the ACA’s contents."

    This totally negates the meaning of the origination clause where taxes must come from the house.

    http://amac.us/sissel-v-hhs-la.....-obamacare

  • ||

    So then why didn't he say it was unconstitutional on THAT basis? Or are you saying someone else could raise that issue in a separate case?

  • sarcasmic||

    Oh great. Another one of those nuts who likes to wave around the Constitution and act like the government actually is supposed to follow it. All thinking people know that it's an outdated document that's only there for show. Modern society has evolved beyond that quaint piece of parchment. Only crazies actually read the thing and believe the government should follow it. Send in the men with the white coats and net. This guy is a loon. It's time to take him away ho ho hee hee it's time to take him away.

  • Pro Libertate||

    No, I think he didn't want to be the guy who killed "affordable healthcare," which shows how confused justices can get.

    The argument that this should've originated in the House is correct, and the attempted stretching to say it did is quite weak.

    That said, even if it's struck down on those grounds, Roberts' decision set a terrible precedent--if the federal government is stymied by the Commerce Clause or other restriction, just call the law a tax. Or, heck, say it isn't a tax and let the court make it one for you.

    One of the worst decisions in a long, long time.

  • OneOut||

    Based on my reading the chink in his armor is a matter that is still "in the closet".

    He didn't marry until very late in life and even then not until just before he was to face Congressional hearings over his nomination for a Federal Judgeship. He then married an older wealthy woman with whom he had not been previously linked.

    Some say it's because of his subsequent adoption of two kids that did not follow the letter of the law.

  • John||

    It was totally driven politically. Now that it is clear what a disaster this is, Roberts is likely to kill it since doing so would be popular.

  • mr simple||

    They get around that by taking a bill from the house and removing all of the language, replacing it with whatever they want. So the bill still has the title that came from the house, just with entirely new words in the actual law part. And since no one cares or is going to stop them, they get away with it. This is why we need a Night's Watch for the constitution.

  • OneOut||

    After it had bounced around a few times only then did they change the name to the ACA.

  • OneOut||

    So what ever happened to the case. That article was posted on April 21 and Will said it was to be heard the coming Thursday.

    Does anyone know ?

  • Pulseguy||

    I think he thought there might be a constitutional crisis if he killed it. He might have been giving the Dems a shot at making it work, or dying by it, rather than having an unelected person kill it.

    On the other hand, he might actually personally favor a universal health care system.

  • mr simple||

    I'm thinking Roberts was more blackmail than bribery.

    I just figured he was a coward.

  • DenverJay||

    yup. He knew the media and dems (same thing, I know), would blame him, not the court in general, and he just wants everybody to like him. The fact that the progs will never like him, no matter how accommodating he is, is something he just doesn't seem to get. How did somebody like that get to be Chief Justice of the Supreme Court?

  • Will4Freedom||

    "As the Post described it, Obamacare would rely on the honor system."

    But there is almost no Honor left. None in Washington.

  • CatoTheElder||

    "Those whose received subsidies for which they were not eligible are, at least in theory, supposed to repay the overage on along with their tax bills."

    In all likelihood, however, ObamaCare will continue to penalize success and indemnify irresponsibility.

    Hope'n'Change. YesWeCan. Forward!

  • OneOut||

    Yes.

    How can they expect to get paid back by a group that already gets free cell phones and doesn't pay any tax in the first place.

  • Rich||

    I trust some Bob Woodward type is definitively chronicling the genesis and "development" of this fucked-up monstrosity.

    And to think that Democratcare has not yet kicked in in earnest. Good Lord.

  • ||

    Those Taboola ads are not as annoying as pop-up ads but they are unintentionally hilarious "shocking", "amazing", "the one thing", "the top ten things", etc. etc.

    "Amazing Top Ten Secrets. They want to hide from 'Dude that is like way cool man.'"

  • sarcasmic||

    Firefox + Adblock = no ads

  • db||

    "Five foods you should never eat if you still have enough intelligence to.not.click on this.ad."

  • Pro Libertate||

    What? Bananas are radioactive? Get it out of me! GET. . .IT. . .OUT.

  • Jackand Ace||

    Fix? Fix problems in Obamacare, Peter?

    That's a hoot. All you and the Tea Party have ever wanted to do was repeal it...never fix anything. You know, take your ball and go home.

    Please...lectures from you on fixing Obamacare are quite shallow.

  • Swiss Servator, CH yeah!||

    Fix, as in castrate it.

  • sarcasmic||

    Repeal and replace, because everyone knows that when you remove cancer you must replace it with something.

  • JWatts||

    "You know, take your ball and go home."

    No one want to take their ball and go home. A lot of us (the majority of the country) thinks that Obamacare is broken. And a plurality think it should be repealed in it's entirety.

    How many people think Obamacare has actually helped them so far? 13%

    How many people think Obamacare has hurt them? 19%

    When the best thing you can say for the law is that it hasn't hurt most of the population, that's a good indicator of a deeply flawed law.

    http://www.gallup.com/poll/167.....e-law.aspx

  • NebulousFocus||

    The latest numbers are even worse.

  • Jackand Ace||

  • Pulseguy||

    I don't see how the numbers can do anything but get worse. All the people it could helped would have been helped right away. The rest end up paying more, or getting laid off at work, or having their hours cut, etc. The bulk, who have neither been helped nor hurt, have their employer pay, and that mandate has not yet kicked in. When it does none of them can be helped. They were already okay.

  • Jackand Ace||

    You're way off saying a plurality want it repealed in its entirety. Way off.

    According to Kaiser, a poll Peter often cites (just never tells you this one response), 58% of Americans want Congress to work to improve the ACA, only 35% repeal (and even that repeal number is repeal and replace).

    And Independents in that poll? 56% want Congress to work to improve it, only 39% repeal.

    The plurality of which you speak is in the other direction.

  • Jackand Ace||

  • Sevo||

    Yeah, dipshit, and a majority of people voted for that lying bastard, too!

  • JWatts||

    "You're way off saying a plurality want it repealed in its entirety. Way off."

    My mistake. You are right about the plurality.

    12% - want Congress to leave the ACA alone
    38% - want to repeal the law
    49% - make some changes to the law in an attempt to make it work better

    So, yes the plurality wants to fix the broken law.

    http://politicalticker.blogs.c.....-repealed/

  • steedamike||

    I wonder what % of slave owners would want to keep owning slaves?

  • ||

    I do want it repealed. The whole damn thing. I don't want wimpy fixes - if it is so badly written let it collapse under its own weight!

  • creech||

    Trouble is, you can easily find Republicans who think guaranteed issue and keeping kids on policies until they are 26 is good law.

  • Sevo||

    "Please...lectures from you on fixing Obamacare are quite shallow."

    As contrasted to the depth of your bullshit.

  • ||

    Not sure why anyone would be surprised at the 'kick the can' approach to the ACA. Obama has spoken favorably about the evolving nature of big entitlement programs. He specifically mentions Social Security as a success story in that it was small and focused as passed, but has grown to become the behemoth we know/love/hate today.

    Obama's detractors will see an incompetent administration. Obama's supporters see a 'fix it as we go' approach that will eventually yield HealthCareTopia.

  • JWatts||

    One positive aspect with the VA scandal is that it puts a large damper on the Obamacare evolving into Single Payer that so many on the Left have been advocating.

  • Sean Heningham||

    Now that we've discovered that government bureaucracy can effectively run our healthcare system oh so efficiently, hopefully they'll allow us to divest more of our rights into their penumbra of control.

  • georgekoch3||

    While the news is down in the weeds nitpicking at all the various little things that are wrong with the ACA, what escapes me is how the conversation hasn't gone back to the fact that the cost of healthcare in America doesn't get addressed in the ACA which states: "...It reduces premium costs for millions of working families and small businesses by providing hundreds of billions of dollars in tax relief – the largest middle class tax cut for health care in history. It also reduces what families will have to pay for health care by capping out-of-pocket expenses and requiring preventive care to be fully covered without any out-of-pocket expense..."

    All the ACA has done is forcing those who didn't have ACA before the ACA to be crushed by costs that those who pay for healthcare already face. We can look at the 2013 numbers that NerdWallet looked at (http://bit.ly/1kb7wlk) to see that the number one reason that millions of American's file for bankruptcy is due to medical bills. What we need is to understand why is healthcare in America so expensive? Only then can we make it affordable--not just for those without insurance, but for all American's. When do we look at making healthcare affordable and reasonable based on the needs of the patient instead of how much revenue it will generate based on the number of procedures billed to insurance companies?

  • XM||

    So let me get this straight, ACA doesn't actually lower the cost of healthcare, but only shift the cost of burden here and there? Subsidies come from someone else.

    If you government haters knew this, why didn't you warn me? Why did keep this a secret!!!

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