Obamacare

'Freakishly On Schedule' Obamacare Implementation Effort Has Missed Half Its Deadlines

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Whitehouse.gov

The Obama administration has repeatedly insisted that efforts to launch Obamacare are on track and on schedule. Recent delays of the law's employer mandate, reporting rules, income and health status verifcation requirements, small-business choice provisions, and out of pocket caps for consumers suggest that not everything is going on schedule. But it's hard to know what's really going on inside the implementation effort. Do these delays represent systemic problems with implementation? Or are they isolated issues?

Even well-connected health consulants and reporters appear to be largely in the dark. As Deloitte health care consultant Cheryl Smith said in a July report by The Washington Post's Ezra Klein and Sarah Kliff, "It's pretty much a black box. [The administration tells] us, 'It's freakishly on schedule.' They use those exact words. But only the people who work in this can tell you if it's actually running on time."

A newly public June report by the Congressional Research Service indicates that the implementation effort has consistently struggled to meet deadlines. As of Forbes' Avik Roy, who first obtained the memo, reports, and as Nick Gillespie noted yesterday, the administration apparently missed fully half of the 82 deadlines reviewed for the report. And, as Roy further notes, that's being generous. Ignore the nine deadlines Congress didn't appropriate funds to meet, and the administration missed 41 out of 73 deadlines, a 56 percent miss rate. Granted, the majority of these missed deadlines aren't for integral parts of the law. As Roy says, "the document reads like a kind of caricature of bureaucratic busywork," with a number of deadlines for trivial reports and determinations. 

This doesn't mean that the health law implementation effort won't cross the finish line on October 1, when the exchanges are set to open. But it does mean there's a history of behind-schedule work. And it's further confirmation that federal analysts who aren't actively involved in the implementation effort themselves won't support the administration's public declarations that all is going on schedule. A June report on exchange implementation process by the Government Accountability Office also found missed deadlines. And the only conclusion that report offered was uncertainty.  "While the missed interim deadlines may not affect implementation," it said, "additional missed deadlines closer to the start of enrollment could do so."

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  1. Are these:

    the law’s employer mandate,
    reporting rules,
    income and health status verifcation requirements,
    small-business choice provisions,
    and out of pocket caps for consumers

    isolated, or systemic? Seriously, Pete, I’m going to say you were being facetious.

    And even this understates what’s been delayed. The centerpiece health insurance exchanges aren’t going to be anything like what was promised. What will be launched will be a shell that lists only one or a small handful of policies, not a clearinghouse for consumers to compare and select across the marketplace.

    1. And it won’t have any information on subsidies, which was a key difference between the exchanges and what’s been available for years.

      1. And I doubt they will have working and secure links with state Medicaid systems, the IRS, Treasury, Social Security, DHS, and HHS.

  2. HHS is missing other deadlines, too. They’re shifting everyone from whatever it is they’re supposed to be doing ACA implementation.

  3. The Obama administration has repeatedly insisted that efforts to launch Obamacare are on track and on schedule.

    Of course they have: they’ve successfully scheduled the disaster of its implementation until after Obama was re-elected. On track, on schedule. Who could ask for anything more?

  4. ‘Freakishly’ on schedule?

    These assholes sound like a party shill writing in Pravda asserting that the Central Committee’s 5 year plan predicted everything perfectly.

    1. They’re already trying to establish a “wreckers!” talking point for the inevitable smash up.

      1. Isn’t it widely understood in reich-wing fever swamps like H+R that such a narrative is essential to the path toward single payer?

    2. If you keep changing the schedule to match actual progress (or lack thereof), it’s actually not too hard to stay “freakishly on schedule”.

      1. Yeah, it’s when you compare the revised schedule against the baseline that you start to look bad.

    3. The 5 year plan is always on schedule comrade.

  5. It’s a good thing this administration isn’t populated with known liars, or I would be concerned the implementation of this disastrous law was going to be full of a lot of guessing on the part of business planners.

  6. But it does mean there’s a history of behind-schedule work.

    I don’t understand why you obsess over this. You’re clearly not exposed much to true software development. Guess what software projects are ever on schedule? Just about none. Mostly, as in this case, this is due to the fact that the scheduled dates are arbitrary and have no relationship to the real world complexities of developing the system.

    Frankly, it doesn’t concern me one iota that things are late. The fundamental flaws of Obamacare have nothing to do with its lateness. Even if Congress was able to accurately predict the time and effort required (something entirely impossible) then it would still be fatally flawed legislation.

    So please stop ranting about how late it is. It’s meaningless.

    1. Actually, the lateness is important.

      Because these MIS systems are supposed to be used by people to avoid fines for noncompliance.

      1. Yes, but not having a relief valve regarding implementation time is a defect of the law. The lateness however, is a fundamental truth of systems development. You can’t just go around saying “It’s late, and thus the law sucks!”. It’s more like “It’s late, and you were too stupid to plan for this obvious reality, and thus you suck at drafting legislation.”

        But conceptually, the lateness doesn’t undermine the efficacy of the ultimate execution of Obamacare…although I guess one could argue that the lateness is a function of the gigantic centralized infrastructure which is doomed to fail simply on account of its scale.

        1. “It’s late, and this is more evidence that the law sucks!”

        2. “although I guess one could argue that the lateness is a function of the gigantic centralized infrastructure which is doomed to fail simply on account of its scale.”

          That’s right. Some systems development projects are late because of implementation issues. Others are late because the actual project is effectively impossible to finish, ever.

          Based on what we’ve seen, this looks and feels like the second kind to me.

          You can tell a lot about a development project by what the managers choose to jettison as a deadline approaches. When essential functionality and basic data security requirements are the first things to be struck out, it’s a really strong indicator that the project implementation is fatally flawed. Those things are not optional. You simply can’t have a functional system like this without rock-solid access controls and audit trails. Those layers of the system needed to be well integrated, functional, and thoroughly tested long before now. Yet, they still aren’t. It’s a classic Death March project in the making, and we’re all in for a long walk.

    2. The lateness is also important for a couple of other reasons:

      (1) It highlights the actual idiocy of the people in Congress and the Administration who passed this thing and continue to flog it to the public.

      (2) The HIEs are late in large part because the Administration sat on the specs for them for several months during the 2012 campaign. Politics uber alles, up to and including the implementation of what is supposed to be their signature program.

      1. You know, if this is such a great law, how come it’s going to take a decade to implement?

        1. It takes time to create massive bureaucracies.

          1. I dunno they created DHS and TSA pretty quickly.

        2. “All good things to those who wait.”

    3. The lateness is going to be really important because when this thing doesn’t work on Oct. 1 and continues to not work through the whole benefits season, the administration is going to look really friggin’ stupid to millions of people who haven’t been paying any attention to these issues for years, but are now because they’re trying to sign up for insurance.

      1. And then when the system starts leaking private health information into the interwebs because their database security isn’t up to snuff people are really going to get pissed off.

        1. Will money actually move through those online exchanges? If so, it will be fun if any financial institutions at some point refuse to do transactions on the exchanges because of the fraud. Keerist, it would be like using your credit card to buy pharmaceuticals from Russian smugglers.

  7. The Obama administration has repeatedly insisted that efforts to launch Obamacare are on track and on schedule

    Think of the Federal Government as a big corporation, and think of yourselves (us) as the employees. Obama, sebelius et al are managers.

    Yes… yes… now it all makes sense.

    1. “Stakeholders, not stockholders!”

      1. If I am a stakeholder, can thrust my stake through the heart of the law?

    2. We’re not employees. We’re customers. Customers locked inside a store where the clerk threatens to kill you if you don’t buy stuff, regardless of if you want it or can afford it.

      1. And you’re not allowed to see or even be aware of some of the stuff you buy… for your own safety.

  8. We can either let this law further damage the economy, or we can get rid of it. There really isn’t another option.

    1. Repeal and replace!

      1. “When we run over libraries, persuaded of these principles, what havoc must we make? If we take in our hand any volume of divinity or school metaphysics, for instance, let us ask, Does it contain any abstract reasoning concerning quantity or number? No. Does it contain any experimental reasoning concerning matter of fact and existence? No. Commit it then to the flames, for it can contain nothing but sophistry and illusion.”

    2. I choose further damage.

      1. That’s certainly the winning horse right now.

        Aside from that, the love of this administration for the Big Lie is by far the worst in our history, I think. I mean, “freakishly on schedule?” Could that be more obviously false?

        1. LIke I said, management. I currently sit in meetings and listen to managers high-five and fellate eachother on how well everything is going, while my organization burns.

          I can walk through clinics and get an earful from my clinicians and clinic managers about how nothing associated with [new organization taking us over] works. They describe the “affiliation” as not unlike being attacked by a wild pack of retarded rhesus monkeys.

          Then I go into a meeting and relay these complaints, I get blank stares, then all the managers suck eachother’s dicks pat eachother’s backs on what a good job they’re doing and how well everything is going. Then I’m not asked back to the meetings.

          This post just rang too close to my life right now. “Freakishly on schedule” indeed.

          1. “Then I’m not asked back to the meetings.”

            that’s really the best case.

            1. One of the greatest lines of all time I ran across a few years ago was from some business consultant (surprising, but it tells me there are good ones out there):

              Meetings are the social streetlamps which attract the unproductive moths…

              Like my theory on elections, I want to start a company, call a meeting, and fire everyone who shows up.

          2. LIke I said, management. I currently sit in meetings and listen to managers high-five and fellate eachother on how well everything is going, while my organization burns.

            If they are that happy when things are going that badly imagine what they are comparing your current situation to. They are either completely unaware or they have been part of some epic level screw ups in the past.

        2. Or shorter: There’s nothing more scary than an incompetent workaholic.

          1. Or shorter: There’s nothing more scary than an incompetent workaholic.

            von Hammerstein-Equord’s four officers comes to mind.

        3. Not if they really only expected 1% to be ready, in which case 40% would be freakishly on schedule.

      2. Do the damage til the damage is done

    3. Damn, there are a lot more of you H&Rers; that plan to use the Health Insurance exchange than I thought there would be.

      1. What are you babbling about now?

      2. No, we care about the poor public union folks who are going to be forced into them.

      3. Huh? You’re going to be a user of this debacle whether you want to be or not.

        1. You only have to go to the exchanges if you can’t get insurance elsewhere (like through your employer). I still have no idea what PB is talking about though.

          1. some guy| 8.20.13 @ 4:36PM |#
            “You only have to go to the exchanges if you can’t get insurance elsewhere (like through your employer).”

            I wouldn’t bet on that. Every other Friday, we get a royal decree on how the law really doesn’t mean what it says there on the paper.

  9. Do these delays represent systemic problems with implementation?

    Yes.

    Or are they isolated issues?

    Yes.

  10. And we can’t forget that in the meantime Obamacare is killing jobs: On The ‘Obamacare Effect’; “Anecdote This,” Dr. Furman

    1. No gripe with your link, but it’s incomplete (I think; didn’t read the whole thing).
      Markets do NOT like uncertainties. If I don’t know what something is going to cost X months down the road, I start hedging my prices and right down the supply chain, everyone else does too.
      If that ‘something’ is labor, I’m doubly cautious; it’s getting hard to fire people, so I’m not about to hire up to meet hoped-for demand.
      That disaster-in-process is probably equal to another 4% capital cost.

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