Can Obamacare get worse? Yes.

So far, the number of Americans whose health insurance has been canceled because of the so-called Affordable Care Act dwarfs the number of Americans who have actually signed up for Obamacare, let alone the number of Americans who have paid an Obamacare premium.

But we have seen only the tip of the iceberg that is the Obamacare disaster. Peter Suderman points out:

Over the weekend, several reports suggested that, despite continued assurances that Healthcare.gov, the problem-plagued online insurance enrollment portal run by the federal government, would be running smoothly for most users by the end of the month, it increasingly looks likely that the deadline will be missed.

Insurance industry consultant Robert Laszewski, who, thanks to his contacts with his insurers, has been a critical and frequently prophetic source of information about the law’s rollout, opened a blog post this weekend with the following assessment: “It is now becoming clear that the Obama administration will not have Health.care.gov fixed by December 1 so hundreds of thousands, or perhaps millions, of people will be able to smoothly enroll by January 1.” Laszewski says that months, not weeks, of work remain.

The dates he lists are important, and not only because of the administration’s self-imposed deadline of November 30. Anyone who wants to purchase insurance that kicks in at the beginning of next year must complete enrollment by December 15. If the system isn’t working smoothly at least a couple weeks prior to that rapidly approaching date, then large numbers of people simply won’t have a chance to sign up.

That is a potentially huge problem for a law whose central premise and promise was that it would create new opportunities for millions of people to sign up for coverage that goes into effect at the beginning of 2014.

It’s a problem that would be big enough on its own, but is now compounded by the fact that, thanks to rules and regulations built into the law, millions of Americans have already had their existing individual-market insurance cancelled, and estimates say that millions more cancellations are on the way. The end result could be that many people—thousands, perhaps even millions—end up with their current private insurance plans terminated due to the law, but no way to sign up for new coverage.

This is not a problem confined to the 36 states covered by the federally run health exchanges. In the state of Oregon, which has struggled to get its online enrollment system working and has yet to enroll a single person in private coverage, some 150,000 people are losing their existing health plans. A spokesperson for the state’s Insurance Division recently told the Associated Press that, if the state’s exchange isn’t functional soon enough, those people could see a break in coverage.

Translation: If you like your health plan, you can’t keep it. And until the exchanges are up, good luck obtaining a new one.

The administration is looking for workarounds. But the ideas now being floated mostly reveal how bad the potential options are—and how desperate federal officials are for any sort of quick fix.

According to a Washington Post report that ran over the weekend, one of those options would involve relying on the insurers to handle enrollment directly. Right now, health plans can manage most of the application process on their own. But they can’t complete all the steps, because they can’t connect with the federal government system that determines whether an individual is eligible for government subsidies. Even if they could connect with it directly, it’s not clear that the subsidy calculation system is working reliably enough to be useful.

So the insurers have suggested a temporary measure: Let the insurers estimate the subsidies on their own. Any estimates that are too low would be reimbursable, and any estimates that are too high, the insurers would get to keep. In other words, the federal government, backed by taxpayers, would be on the hook for their bad estimates.

Can this possibly be legal? Can the administration seriously be considering this idea, which is potentially costly and politically disastrous? Imagine how Democrats will feel about turning over the central operations of the health law to insurers. Imagine how Republicans will react to a plan that could cost more, and will serve as an implicit admission that the exchanges simply won’t work without a major overhaul. …

The potential problems are not confined to the near term either. Very soon, the short-term technical troubles could begin to have meaningful longer-term policy consequences. Insurers must decide what plans to offer and what rates to charge in the first half of next year. If enrollment is low, if the exchanges are still broken, and if the president and his administration are still losing credibility and popularity as a result of the rollout debacle, how will insurers react? By pulling plans from the market? By raising rates?

Right now it’s clear that many health insurers, having built business plans around Obamacare’s rules and regulations, are trying to work with the administration in hopes of turning the health law effort around. But how long will their cooperation last if the technical problems and administrative bumbling continue? We already know about one insurer that is so far refusing to submit its enrollment information into the administration’s system for fear of further corrupting their data. And insurers can expect more headaches even if the technical issues recede. As Jon Kingsdale, who ran the Massachusetts health exchange and consulted on the federal system, noted in the Post over the weekend, billing and tracking issues for the insurers are likely to be significant. That’s not going to make insurers too happy. …

This could still be turned around, perhaps even soon. But it’s time to start considering the worst-case scenarios: that the exchanges continue to malfunction, that plan cancellations go into effect, that insurers see the political winds shifting and stop playing nice with the administration, and that significant numbers of people are left stranded without coverage as a result. Rather than reforming the individual market, which was flawed but did work for some people, Obamacare will have destroyed it and left only dysfunction and chaos in its wake.

Wait! There’s more! Ed Rogers adds:

Here are six reasons that Obamacare will only get worse for the Democrats:

    1. There will be more canceled health insurance plans.  Every day, more and more Americans are receiving cancellation notices for plans they liked and wanted to keep.  And every day, they continue to hear administration officials and their Democratic allies insist that the president didn’t lie about people being able to keep their health insurance plans.  Dissatisfaction with Obamacare grows exponentially as people witness family members and colleagues being victimized by the “big lie.”
    2. If you like your doctor, you can’t keep your doctor.  Soon the story will break through that a lot of Americans will be losing access to their doctors and will be forced to pick one approved by Obamacare.  Health-care plans are instituting very restrictive provider networks to try to keep down costs in the face of astronomically rising premiums.  In New Hampshire, for instance, only 16 of the state’s 26 hospitals will be in the network of exchange plans approved by Obamacare.  The reaction of voters losing, in some cases, the person who has been their doctor for years could be worse for Democrats than what we are currently seeing in the involuntary loss of insurance plans.
    3. Sticker shock.  Prices for health-care plans are not coming down for many voters.  Once the Web site starts working and Americans can “shop around” for their new health insurance plans as the president instructed they should do, they are going to experience sticker shock.  Premiums and deductibles will be going up for millions of hardworking Americans who can’t afford these increases – especially for coverage they don’t need or want.
    4. Obamacare ads.  Throughout the 2014 campaign, Republicans will use footage of Democrats repeating the “big lie” in ads targeting Democrats.  The search is on for news clips, town-hall meeting videos, and other instances where Democrats have committed on the record and on video that “if you like your health plan, you can keep it.”
    5. Navigators.  If you liked ACORN, you’ll love the Obamacare Navigators.  I’m sure there will be good, sincere people who really want to help people navigate the Obamacare maze.  But there will be enough bad apples employed as navigators to supply plenty of scary anecdotes and weird encounters that will result in a steady ridicule of the overall program.  And there will no doubt be activists with hidden cameras ready to capture a few creepy and outrageous encounters that will grab everybody’s attention and make voters even more skeptical of Obamacare.
    6. Security breaches.  Security breaches will increase.  There have already been so many Web site problems and so many unanswered questions about Web site security that it’s surprising administration officials are still claiming they are “confident” in the system.  A big security breach is inevitable.  It’s just a matter of time.  Even just the few horror stories we have heard so far prove what we all know: The Web site will not protect everybody’s sensitive, personal health care and financial data. Period. You know it and I know it. …

On Wednesday, the president held a meeting with the 15 Democratic senators who are facing reelection, trying to get them to quit whining and get on board with the deceit.  A lot of Democrats wish the White House would come clean, do a mea culpa and ask for forgiveness and patience – instead of issuing half-apologies like President Obama did on Thursday. Then perhaps the president could at least start approaching the problems from an honest place.The White House will tighten its messaging, and it will fix the Web site, but that won’t change the underlying fact that this bill will negatively affect a huge portion of Americans, and superficial fixes aren’t the answer.  Half-apologies and a refusal to hold anyone accountable are causing only more distress within the Democratic Party.  A lot of Democrats are beginning to think a little panic is in order.  The worst is yet to come.

 

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