Former HHS Obamacare Official on Exchange Launch: "You may see a redefinition of what 'start' means."



Following The Wall Street Journal's report that the 36 health insurance exchanges being managed by the federal government lack key functionality—the ability to correctly calculate prices for subsidized insurance—The Washington Post's Sarah Kliff talked to a couple individuals who have helped work on the technology that powers Obamacare's exchanges. Both strongly suggested that when the exchanges go live next month, it may be without functionality. Here's the relevant bit: 

The marketplaces are incredibly complex technological systems, ones that have to take in data from numerous state and federal sources and crunch them all together to figure out who qualifies for what health-care programs.

That complexity has proven to be a challenge for building the data hub. So Walsh expects that in some places, it might be possible to download an application and explore rates, but difficult to complete the purchase of a health-care plan.

"If this wasn't such a date-driven project, I think a lot of people would be having discussions about slipping the date," [Xerox health eligibility system director and exchange consultant Kevin] Walsh says. "Instead, you slip out some of the functionality because the go live is so important."

Oct. 1 is increasingly being seen by states and outside analysts as a "soft launch," where they will work out the types of kinks in the system that the Wall Street Journal reported on this morning. Because coverage of the new plans doesn't start until Jan. 1, officials believe they have a three-month period to fix bugs and sort out problems without having a significant impact on Americans' access to coverage.

"Nobody is going to say we're not starting on October 1," says Joel Ario, who previously oversaw health exchanges at HHS, "but in some situations, you may see a redefinition of what 'start' means."

It sounds, in other words, like at least some of the exchanges will be rolled out in what is effectively a demonstration and testing mode. Some functionality will be removed. And the October 1 start date won't be treated or thought of as a real start date. 

And remember, this comes after the federal government has already delayed key functionality in the law's small business exchange and the employer mandate and verification requirements. 

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  1. “Nobody is going to say we’re not starting on October 1,” says Joel Ario, who previously oversaw health exchanges at HHS, “but in some situations, you may see a redefinition of what ‘start’ means.”

    I think it’s as simple as understanding what the meaning of “is” is.

    1. I like that line of argument.

      “I’m not saying I won’t pay my taxes on April 15, but you may see a redefinition of what ‘pay’ means.”

  2. Before your execution, I’d like you to join me for a ceremony that will make this health insurance exchange operational.

    1. You want a target? A military target? Than sign up for the system!

      1. Don’t be too proud of this technocratic terror you’ve constructed. The ability to destroy an economy is insignificant next to the power of the Invisible Hand.

        1. You, my friend, are all that’s left of their religion Dismal Science”

        2. Don’t try and frighten us with your capitalist ways, Pro. L. Your sad devotion to that ancient theory has not helped you conjure up a free market, or give you clairvoyance to find Obama’s hidden for—

        3. ProLib, I’ve flown from one side of this country to the other. I’ve seen a lot of strange stuff, but I’ve never seen anything to make me believe there’s one all-powerful government with the ability to control everything by Force.

          1. No, no, Hugh, you’re doing it wrong. I’m devoted to the spooky Force of Capitalism.

  3. Oh god, everybody in the country’s personal information is going to be extracted in about twenty minutes.

    1. Only the people who are retarded enough to actually sign up for this monstrosity.

      1. This thing has a backdoor into IRS data.

        1. Oh. Well then, we’re all fucked aren’t we?

    2. If it makes you feel any better I can all but guarantee you that the overwhelming majority of federal employees info is floating around out there.

      I used to work for the company that managed flexible spending accounts and eligibility and enrollment for the Office of Personnel Management (which covers most federal workers) and we had dozens of coppies of our legacy database floating around where anyone could grab them at any time, including our Indian partners in Hyderabad. This database was made up entirely of unencrypted flat files (basically glorified tab separated lists).

      The odds that someone hasn’t sold a copy of that to an interested party are close to 0

      1. I think at this point, the only reason your identity hasn’t been stolen is out of luck. A thief hasn’t gotten around to using your info yet and may never do so. Whatever the reason, it is no because your infor is in any way secure.

  4. If I didn’t absolutely know better, I might almost think that this bill was passed and signed into law without a careful and detailed plan involving all of the stakeholders for how to implement it.

    1. That can’t be right, because our best and brightest are running things efficiently and with due consideration of all pertinent issues. I mean, that’s why we’re letting them rule us in every respect without restraint, right?

    2. Maybe the Democrats will learn that you have to have buy-in until the program is fully funded, not just until you can get the authorization through a floor vote.

      1. Politics is the art of the implausible.

        1. One has no rules
          Is not precise
          One rarely acts
          The same way twice
          One spurns no device
          Practicing the art of the possible

          One always picks
          The easy fight
          One praises fools
          One smothers light
          one shifts left to right
          It’s part of the art of the possible

          One always claims
          Mistakes were planned
          When risk is slight
          One takes one’s stand
          With much sleight of hand
          Politics–the art of the possible

          One has no rules
          Is not precise
          One rarely acts
          The same way twice
          One spurns no device
          Politics–the art of the possible

  5. Does anyone here remember the role-out of Social Security, Medicare or Medicaid? Were they also epic clusterfucks at implementation?

    1. As the first recipient of Social Security, Ida May Fuller might tell you the system worked great (if she were still alive).
      She contributed a total of $24.75 to the social security program, and received a total of $22,888.92 in benefits before she died.

      1. Always be at the front of the Ponzi.

        1. Yeah, Relluf Yam Adi contributed $228,889.20 and got $247.50.

          1. In all seriousness, by the time I retire, I’ll get back about 10 cents on the dollar, if the system is there at all. I maxed out before my 28th birthday, for fucks sake.

            1. I have factored in $0 per month from Soc Sec for my retirement plan. If I get anything back, I’ll blow it on any future grandkids or single malt Scotch.

              1. I am operating on the same assumption.

                My grandfather did the same thing. He put his SS checks aside for 10 years, and then took the entire extended family to Europe to show us where he fought and was held captive in WWII.

                1. That is freakin’ awesome!

                  Maybe I could take the family to Afghanistan, the Tagab Valley where they could buy opium and…well, never mind.

            2. playa manhattan| 9.20.13 @ 2:23PM |#
              “In all seriousness, by the time I retire, I’ll get back about 10 cents on the dollar, if the system is there at all. I maxed out before my 28th birthday, for fucks sake.”

              But you’re in the front row for the newest Ponzi; imagine what those born in 2020 are going to get out of Obamacare.

      2. I ain’t sayin’ she a golddigger…

      3. I’m aware of that, but I’m more curious about the logistics of the implementation. Was it a giant screw-up at the beginning with people’s paychecks being deducted incorrectly, people receiving benefits they shouldn’t, or not receiving benefits they should. Were there waivers and delays and special favors flying around?

        1. The SS program began paying benefits in 1940. Mandatary withholding and payroll taxes didn’t start until 1943.
          Plus, no computers, everything was calculated by hand.

          So it likely was not a colossal clusterfuck of the same order of magnitude as obamacare.

          1. It probably was just as colossal of a clusterfuck, it’s just that wasn’t common knowledge because the lack of modern telecommunications and computing made it operate as more of a black box.

  6. The House should start arguing that they’re not actually defunding Obamacare, they’re just extending the run-in period.

  7. Following The Wall Street Journal’s report that the 36 health insurance exchanges being managed by the federal government lack key functionality…

    This is what I don’t understand about people who maintain unwavering devotion to government programs. How many programs can they point to that were successfully managed? I’ve never heard of any that weren’t over budget, wasteful, ineffective or had some other bad outcome. And this doesn’t surprise any private business owner because they understand how incentives work. I can’t keep wasting my breath on this crap. I’ve got to figure out how to pay for Obama’s new Net Investment Income Tax for this year.

      1. Well, that underscores my point. These government buffoons can’t even build the basic exchange website right. Do I need to get them a copy of Dreamweaver?

        If I had the level of faith in Jesus Christ that Progressives have in the Our Cisgender Lady of the Benevolent Government System, I could move mountains into the sea.

        1. Exactly – I suspect you could do a better job with this than the legions of government hacks…on your own.

          1. I am pretty sure from the comments on this thread that me, Brett, and Fist could make a better version of this thing, and it would be more secure because John would advise us on laws and shit.

        2. So another rich repukican thinks he needs moar private islands? Kochtard.

  8. I’m not sure throwing up an “Under Construction” gif counts as “starting”.

    1. “Pardon Our Dust While We Build An Everlasting Edifice to The Greatness That Is Our Most Holy President!”

  9. Communications Chair of Sacramento County Dems Wishes Death on Cruz Speechwriter’s Kids


    @amandacarpenter May your children all die from debilitating, painful and incurable diseases.
    ? allanbrauer (@allanbrauer) September 20, 2013

    Less likely to happen if her boss gets his way and gets Obamacare tossed in the dustbin of history. Why do you hate innovation so much, Mr. Brauer?

    1. Busy blocking the tapeworms that have slithered out of hellspawn @amandacarpenter’s asshole. How’s your day so far?
      ? allanbrauer (@allanbrauer) September 20, 2013

      Yes, your party takes bread from the mouths of starving children and medicine from the sick, and I’m the problem. Got it.
      ? allanbrauer (@allanbrauer) September 20, 2013

      Wow, that’s the butthurt of the year, so far!

      1. They say something outrageous, get called on it, and then play the victim because everyone is just being a big meany to them.

        1. Behavior like this is essentially the Peter Principle of the political world. If you can’t take being called names by the opposition, you can’t be in politics.


          I wonder what Brauer’s reaction would be like if someone from Team Red wished for his children to get thrown in an oven.

          1. We libertarians are clearly smarter, since we prefer to snatch the bread from the pantry BEFORE it gets in the children’s mouths and gets all soggy.

            1. +1 Order of the Golden Monocle for you!

      2. Well, he is “communicating,” so there is that.

      3. Judging from his last tweet, It looks like somebody up the food chain forced him to apologize.

      4. There’s a retweet on his feed from Josh Marshall’s. Holy shit, if that’s really Marshall’s picture, no wonder this guy became a progressive–his whole countenance screams “I WILL PUNISH SOCIETY FOR MY DADDY ISSUES!!”

      5. “Yes, your party takes bread from the mouths of starving children”

        We’d never do that! We’d get our hands all covered with starving child saliva. Eww!

  10. I’m envisioning a lone Commodore 64 at the heart of all this.

    1. “Open the health care exhanges please, HAL.”

      “I’m sorry Kathleen, but I can’t do that.”

  11. “that the 36 health insurance exchanges being managed by the federal government lack key functionality?the ability to correctly calculate prices for subsidized insurance”

    People getting insurance through the federally run exchanges aren’t eligible for tax subsidies to begin with.

    The legislation only permits people who get insurance through state run exchanges to do so.

    1. Was this by design, or just another whoopsie daisy?

    2. I am confuse. How will the 14 state-run exchanges interface with the Federal systems by October 1?

      1. Shriek will be by to tell us how TEAM LIGHTWORKER will have this in place…unless teathuglican obstruction, BOOOSH, or Christianists.

    3. Unfortunately, the IRS rewrote the law after the fact to change that, and no one is capable of preventing them from doing so. Well, except for the American people, but they re-upped BOzo’s contract.

  12. let’s see, no income verification, no pricing, and it’s not funded.

    I’m laughing at the “superior intellect.” Unicorn Theory indeed.

  13. The Ministry of Truth is hard at work redefining the word “start”.

    Why the fuck doesn’t the suffocating stench of failure attach itself to the fucking Democrats the way it rightfully does to the fucking Republicans, given that the Democrats are even more incompetent and useless?

  14. I don’t understand why they don’t hand over the whole thing to Amazon. Problem solved. No one should be pretending personal data will be secure anyway, so no reason not to hand it over to a private party.

    1. If there is one thing the HIPAA/HITECH act has demonstrated to me, it is that sovereign immunity is antithetical to 3rd parties keeping my information private. At least Amazon, Jeff Bezos and the CIO are all liable for demonstrating responsible handling and due precaution for the privacy of my personal information.

  15. It’s stuff like this that make competent dictators look appealing.

    1. Hayek pointed that out. A large number of people like the idea of a central plan for “X” until you get down to the nuts and bolts of which actual plan. Then you end up with a “what to put on the pizza for everybody” argument–this should be familiar to anybody who has ever tried to order a pizza for three or more people to share. In the end, people get tired of the bickering and demand one person just make an executive decision: voila! dictator.

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