Uh-Oh! Building ObamaCare's Health Exchanges Has Already Cost Double the Expected Amount


Credit: WhiteHouse.gov

Here's another ominous sign for ObamaCare's future: The Department of Health and Human Services admitted yesterday that setting up the law has cost twice as much as expected so far. And you can't really blame Republican opposition for the overrun: That's just accounting for the cost of building exchanges in states that said they want to run them.

Here's The Hill with the report:

The Health and Human Services Department (HHS) said in budget documents Wednesday that it expects to spend $4.4 billion by the end of this year on grants to help states set up new insurance exchanges. HHS had estimated last year that the grants would cost $2 billion.

The department also is asking Congress for another $1.5 billion to help set up federally run exchanges in states that do not establish their own.

Just because HHS is asking for the money, of course, doesn't mean it's going to get it. So if not, then what? The HHS has promised it will, er, do something—something!—to make it all work. But it won't say what. At least not yet:

HHS Assistant Secretary for Financial Resources Ellen Murray punted Wednesday when asked about the consequences if Congress also denies the new request.

The department is "determined to make them work," she said of the exchanges.

A big chunk of the grant money doled out so far went to California. It has reportedly received $909 million in federal funding to build its exchange. But even with the hefty funding it's not going smoothly. The state's insurance regulators have warned that residents should expect "rate and market disruption" when the state's health insurance exchange opens. 


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  1. And yet libertarians are happy to have this guy running things because the other guys weren’t true enough scotsmen.

    1. TheIronSheik| 4.11.13 @ 2:51PM |#
      “And yet libertarians are happy to have this guy running things…”
      Is that stuff legal?!

      1. Don’t feed the troll! It’s Thursday

        1. I didn’t know Sevo is a troll.

      2. I imagine if someone were to eat the brain of a conscious human one spoonful at a time a la that scene in Rudy Rucker’s Wetware while he tapped away at a keyboard, you would get something very similar to our poseur Iron Sheik’s comments.

    2. And yet libertarians are happy to have this guy running things because the other guys weren’t true enough scotsmen.

      Ah, so this Tulpa’s brain-damaged brother-cousin I’ve heard so much about.

      1. Brother-uncle-father, I thought it was.

  2. And you can’t really blame Republican opposition for the overrun: That’s just accounting for the cost of building exchanges in states that said they want to run them.

    Bahahahahah, good one Peter. Assuming the unlikely event that the MSM ever reports these cost overruns it’s clear that the liberal punditry and blogosphere will blame the GOP.

    1. Everything bad that happens is the Republicans’ fault for being obstructionists.

      1. Everything bad that happens is the libertarians’ fault, for reasons I can’t quite fathom. But Team Red and Team Blue agree on that.

        1. It’s our fault for being too stupid to realize that if you want to be politically effective you have to vote for people you wouldn’t want elected.

  3. Related:
    “Report: Fewer Californians get health care at work”
    …”receiving employer-sponsored insurance dropped by 1.3 million, or 8.4 percent, over the past decade.”…
    It’d be nice to see whether the drop accelerated since Pelosi’s victory lap.

  4. Over budget?

    YOU LIE!

    1. Just print a few more trillion. That’ll take care of it!

      1. exactly…and take CBO projections at face value, seeing how they’ve NEVER BEEN WRONG

      2. p.s. obviously its because the rich havent paid their fair share

  5. I can’t wait for my health insurance, which covers less and less, to go up even more. The system is broken, all right, but what Obama and his friends have done is enhance the broken parts at the expense of what was left of the parts that sorta worked.

    1. If I didn’t know better, I might think it was intentional!

      1. Nah, that can’t be. It’s just some sort of scam that makes someone rich.

    2. That’s called a market failure, Pro L.

      1. So, if there’s any market element whatsoever, the entire business is horrifically unfair and out of control. So we must stomp out any free market creep.

        1. You know the drill. As long as a tiny atoll of capitalism exists within a sea of socialism, your ills are capitalism’s fault.

            1. Isthmus be nice not having to think atoll about this sort of thing.

  6. Man, when I was saying that this would happen e years ago, I was such a crazy wingnut! Thank God Obama was there to set me straight.

    1. this would happen e years ago

      I really hope this was *not* a typo.

      1. Wouldn’t e years be 2.71828 years?

        1. Indeed. Which is probably accurate; I’ve been saying it for at least e years.

        2. What’s great is that that’s pretty much the exact amount of time I would have been saying this.

          That could have been a pretty solid math joke if I were smarter than I am.

        3. No, e-years are the amount of years someone browses the web while at work.

        4. That’s only accurate to a factor of 100,000. You’re actually off by several seconds.

      2. The e and the 3 line up. I didn’t move my finger high enough to hit the three, and proof reading is for pussies.

        That’s the story of how we ended up at this point.

        1. proof reading is for pussies

          Indeed Irish.

          1. I remember when I used to proofread. I’d do it right between crying about my feelings and spending my nights wondering why no one loved me.

            THEN I BECAME A MAN.

            1. Was the surgery painful? Or are you pre-op?

            2. We should do a total pedantry thread sometime. Any error, however insignificant, is called out.

              1. Which would be different from every other thread how, exactly?

                1. Aw, dear, now we’ve gone and offended the lady.

                  [/sarcasm, although this may be why there are so few female libertarians]

              2. Technically “total pedantry” isn’t really grammatically sound, you FUCKING MORON.

                1. I believe capitalizing entire words also isn’t grammatically sound. You are a filthy hypocrite, undeserving even of my scorn.

                  1. I won’t be insulted by a filthy Mick!

                    1. I’m not insulting you. That would require scorn, of which you are undeserving.

                2. WINNER!

                  (All caps is vulgar. The equivalent of shouting. The exclamation point is superfluous in this instance. The use of superfluous is superflous. I just spelled superfluous incorrectly……hey this is fun!)

                3. A comma after “Technically” would be more apt, Fuckface.

          2. OH MA GERD

            1. Doing a google image search for cats reading made me feel like an old woman.

              1. Good thing I have someone else to do it for me then.

                1. You sicken me, Nicole. You’re not heartless enough for libertarianism. You’re all ‘oh, look at the cute kitty’ when a real libertarian would be like ‘why has the free market not turned it into a meat patty to feed immigrant slave labor as they squat in their cardboard boxes?’

                  1. Don’t be a fool. It’s devoting my few emotions to photos of adorable baby animals that frees me up to be heartless in much more significant ways.

                    1. Here is a site which will allow to maximize your heartlessness for a long time.


                  2. Doesn’t everybody here use child labor for their proofreading needs anyway?

            2. The cat I grew up with used to sit behind me when I was reading, as if reading over my shoulder, and would swat at the pages when I turned them. Presumably because I was a faster reader than she.

          3. I’d like to point out, unless that cat actually wrote that book, he isn’t proof reading. He’s just reading.

            What’s so special about a cat reading? Call me when one of them writes a bestseller.

            1. Actually, it’s usually not a good idea to proof read your own writing. Better to have a fresh set of eyes.

              1. That’s disgusting. What are you, some sort of gay Nazi zombie?

            2. I’m sorry, Irish, I’ll be more specific with my cat pictures next time.

              1. I never understood what was supposed to be funny about the LOLCats meme.

                And I say that as an ailurophile.

                1. Is that like a necrophile but with cats?

        2. I was hoping it was math geekery.

          Oh well.

  7. Remember when Obamacare would be deficit neutral?

    How innocent we were.

    1. I do not remember when it was going to neutral. I do remember when people lied about it being neutral.

    2. I never bought that bullshit.

    3. I remember when they claimed it would be deficit-neutral, but always knew that was just an accounting gimmick.

      So now I can say to them, “I told you so!”

    4. Obamacare was going to be deficit neutral the same way California’s high-speed rail projects are going to cost some finite amount of money.

      1. Technically, there is a finite number of atoms in the universe.

        1. I’m simply assuming that California will always be planning new high-speed rail projects… right up until the state collapses and ceases to exist.

          1. So… up until the rest of the contiguous United States pull a Lex Luthor on the San Andreas fault?

  8. Health care is one of the last meritocratic industries, which is why Obama must destroy it. Otherwise we will never have the appropriate percentages of black doctors.

  9. Does someone have an updated troll list for me? I can’t keep up these days.

    1. There are really only like 5. It’s just that one of them goes off his meds every night around 7, gets all of his posts deleted and returns under a different name the next night.

      1. I have put the mods in a camel clutch, so rest assured I will appear from time to time to remind you libertarians how insignificant you are.

        1. Yeah, racist, so-con homophobes are of increasing significance in American politics.

          1. Did TheIronSheik get laid off or something? He’s not usually this prolific. Or has another troll picked up the mantle?

            1. Today is National Idiot Day, so he has the day off as a holiday.

              1. Makes me regret that I didn’t pursue a career in idiocy.

                1. Makes me regret that I didn’t pursue a career in idiocy.


              2. and the jerk store and they’re running out of him!

                1. What’s the difference? You’re their all-time best seller,

            2. He’s just waiting for you to fuck in the ass and make him humble.

              1. Mount him and display your dominance!

      2. One identifier (but not the only one): the first person to mention race or teh gheys in an unrelated thread about, say, trains or insurance exchanges, is a troll.

  10. Can anyone explain what makes these “exchanges” different than just going to fucking ehealthinsurance.com and picking out a plan for yourself? I have truly never understood what the difference is and why “we” needed to build something that seemed already to exist.

    1. You can’t trust the private sector to do something as efficiently and unbiased as the State. That’s why all of those private DMVs failed.

      1. That’s true. Private companies waste money by giving it to the rich in the form of profits. Because government doesn’t waste money on giving profits to the rich, it has less overhead. That’s why the government does everything more efficiently than the private sector: No profits for the rich.

        1. At some point they will succeed and then the only rich people will be government employees and contractors. Then they’ll need a new excuse.

          1. They know they will never succeed. They don’t intend to succeed. There needs to be someone unpopular they can blame for society’s woes. Otherwise they wouldn’t be able to stay in power.

    2. I had this same question recently. The answer I got was basically “the plans have to meet specified coverage requirements, and will be cheaper because of…uh… competition or something.”

      1. plans have to be approved to be listed on the exchange.

        building the exchanges means I get to bill a lot of hours. so, uh, savings.

        1. that and they’re intended to help enroll the Medicaid population.

        2. Well, yeah, that’s the “meet specified coverage requirements” part.

      2. Yeah, wtf is that? The plans ehealthinsurance.com sells already had to meet specified coverage requirements–specified by the states, just not PPACA. This is a massive source of confusion for me.

        1. This is a massive source of confusion for me.

          Well, good thing they’re hiring a mass of new bureaucrats in order to help you sort it out. Can’t you just feel the savings?

        2. you don’t understand. without the exchanges, we couldn’t have endless meetings about them. and white papers. and more meetings. and regulations.

          1. the other aspect of this is they have to determine the various level of cost sharing and premiums, which is all income based.

          2. Wait, what about white papers about the regulations regarding how to run meetings on white papers? Those would still exist, right?

            1. if they didn’t … Somalia

              1. all this talk about Somalia…at I can smoke in a bar there,can’t be that bad.

                1. *least

                2. Guards! Bring me the forms I need to fill out to have him taken away!

      3. And adding a column to a database table, triggered by a checkbox on a form, is hard!

        By the way, I just filed a patent on this idea, so don’t none of you try to.

        1. Look, Mike–if that’s your real name–schema changes are hard. Wait, no they’re not, they’re just disruptive and annoying.

      4. “The answer I got was basically “the plans have to meet specified coverage requirements, and will be cheaper because of…uh… competition or something.”

        Yes nothing cuts the cost of insurance like mandating coverage for all sorts of things that you don’t need but have to pay for anyway just so that somebody else gets their freebie at your expense.

    3. These exchanges cost $4.4B and climbing. ehealthinsurance probably only cost a few tens of millions.

    4. To take a stab at a possible real answer (not a GOOD answer, just possibly a real one): is the purpose of the exchanges to allow individuals to buy in what is effectively a group market, whereas on ehealthinsurance you would have to buy as an individual?

      1. Yes, but again, I’m confused about why multiple new, state-run systems are needed for that. That’s all behind-the-scenes from a consumer point of view anyway, isn’t it?

        1. I don’t get it either. I know there are all kinds of new restrictions on what has to be covered and how much you can charge, etc., but none of that seems to explain why BC/BS and Wellpoint couldn’t just sell qualifying plans through existing services like ehealthinsurance.

        2. The difference is that with ehealthinsurance each provider has a rate sheet which you enter a few factors into and it spits out a price, with the Obamacare exchanges there is more to it than that because they must corssreference in real time data from your employer and various state and federal databases to determine what level of subsidies you would qualify for before they can tell you what each policy would cost.

          The difficulty lies in calculating the subsidy, otherwise you would be correct, ehealthinsurance.com and similar private organizations are already offering the same service.

          1. Ah of course. When you design a ridiculously complicated system involving information that cannot be released publicly, you need to then design a ridiculously complicated interface that must be run by the government.

          2. Yeah, that makes sense, but then my question is: why aren’t we just sending people checks for whatever subsidy they qualify for? Of course, then it wouldn’t be all statist and awesome, so there’s that.

            1. Then they might not spend the subsidy on the right stuff!

            2. Ultimately because the subsidy would exceed the penaltax in almost all cases and with the shall issue requirement would mean that every person eligible for a subsidy who didn’t already have a chronic condition could use the subsidy to pay the penalty and then buy themselves a new big screen TV while skipping the insurance until they actually got sick.

              That said this is of course all evidence that the entire construct is little more than a giant Rube Goldberg machine which cannot possibly work and will inevitably tear itself apart.

  11. The Department of Health and Human Services admitted yesterday that setting up the law has cost twice as much as expected so far.

    I believe in the world of big-time corporate corporatisms, this is what’s known as an “opportunity”.

    1. If a corporation got its accounting this screwed up, the Feds would be going after them.

      1. If a corporation got its accounting this screwed up, the Feds would be going after them it would fail spectacularly.

        FTFY. Although the feds would probably go after them too, because ENRON, or something.

  12. “We never claimed it was a perfect bill!”

  13. We had to spend it to find out what’s in it.

  14. How… unexpected.

    1. That it wasn’t triple the projections.

      1. give it time…

  15. It was impossible to predict the costs of this program accurately.
    Nobody even knew what was in it.

    1. How are you going to know what is in it before it is passed? Someone could change it!

    2. The Late P Brooks| 4.11.13 @ 3:41PM |#
      “It was impossible to predict the costs of this program accurately.
      Nobody even knew what was in it.”

      But it was INTENDED to help people, lower the deficit, be cheap and find pixie dust.
      So there!

    3. I actually took the time to read this POS bill. It’s absurd how much was left after the fact. There was some oddly specific things though like the elimination of OTC rescue inhalers like Primatine Mist.

      Also, any thing above FDA recommendations won’t be allowed to be covered by insurance. My two daily inhalers to control my asthma are above the FDA approved level of Fluticasone Propionate (the propellant in inhalers) so I have to pay out of pocket for one of them.

      No matter that this regimen controlled my symptoms for the first time in my life and allowed me to live normally. Not only that it was prescribed by the leading asthma expert in the nation and largest recipient of asthma related research grants, the federal apparatus knows better.

  16. when the govt admits to the actual cost being twice what is expected, how much more is it really? In this case, “twice” actually means how many times more expensive than originally lied about?

    1. It’s like when women tell you about how many guys they’ve slept with: always multiply by 3.

      1. What if they’ve only slept with one or two?

        Will they tell you: “I have slept with 1/3 men?”

        1. No, it is a comment on sexual truthfulness. If she says 2, it was really 6. Of course, if he says 6, it was really two.

        2. Clearly Irish is a virgin or he would know that when wimmin vigins graduate to sluts, they do wo with no fewer than 3 men at once.

          1. I’ve had a threesome. But it was the bad kind. 🙁

            1. It’s OK. ‘Cause in a threeway, there’s some leeway.

              1. I was very dark, and he kept to his end of the girl. Still not a fond memory.

                1. *It* was very dark

                  See? I can’t even type about it.

                  1. Still not a fond memory.

                    See, I always figured it would be like watching live porn while getting some. But 2 couples same room might be better, and gives me the chance to brag about having done that.

            2. The bad kind? So, two chicks?

              1. Why would there be chicks in a threesome?

            3. The devil’s threeway

    2. I never ask that question, and I have a policy of never being asked that. In this case the reality of simple math need not intrude on perception.

  17. How are you going to know what is in it before it is passed?

    Excellent question.

    I asked my cat to read it for me, but he was too busy shorting the Euro against the Swiss Franc.

    1. My cat pissed on it and went under the bed with a catnip mouse.

  18. they have to determine the various level of cost sharing and premiums, which is all income based.

    Is that why they structured it on the cost-plus utility model?

  19. A big chunk of the grant money doled out so far went to California


    1. Me too… this is my surprised face


    2. Keep the votes coming boys!

  20. The bad kind? So, two chicks?

    Two lesbian chicks. They made him go to the kitchen and wash the dishes.

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