ObamaCare D-Day in March

Ed Lasky

A document coming from the administration has recently come to light that discloses the entire ObamaCare program is in jeopardy of collapse.  Of course, the White House did not inform the American people of this prospect but was compelled to post the news on a federal website -- away from the inquiring minds of millions of Americans who may suffer even more from ObamaCare.  So much for Barack Obama's boast that his administration would be the most transparent in history.

While the web portal of Healthcare.Gov has received a lot of attention, the true problem lies like an iceberg underneath the public face of the website.  This is the "back end" of the website: the part that transmits information to insurance companies.

There have been scattered reports that there has been "a failure to communicate" between the portal, the insurance companies, and the government, but the scope and the severity of the problem has been barely covered.  The administration and its flacks have routinely dismissed previous problems as "glitches" (see this Monty Python "Just a flesh wound" skit as symbolic of this Pollyannaish strategy), but will have a tougher time downplaying this man-made disaster in the making.

From the non-partisan The Hill in a column titled Document: ObamaCare contractor faces mid-March deadline or disaster:

If the ObamaCare contractor brought on last week to fix the back-end of the HealthCare.gov portal doesn't finish the build-out by mid-March the healthcare law will be jeopardized, according to a procurement document posted on a federal website.

It says insurers could be bankrupt and the entire healthcare industry threatened if the build out is not completed....

"There is limited time to build this functionality and failure to deliver...by mid-March 2014 will result in financial harm to the government," the document says.

"If this functionality is not complete by mid-March 2014, the government could make erroneous payments to providers and insurers," it continues.  "Additionally, without a Financial Management platform that accounts for enrollments and associated program costs that integrates with the existing CMS Accounting platform, the entire healthcare reform program is jeopardized."

Many of those who have signed up for ObamaCare are eligible for federal subsidies, which the government pays directly to the insurers.  The document says that failure to complete the project by mid-March can result in "inaccurate issuance of payments to health plans which could seriously put them at financial risk; potentially leading to their default and disrupting continued services and coverage to consumers."

Subsidies can be completely inaccurate or not processed at all.  The administration not only made a bad choice in giving the original contract to CGI- -- a company that, despite a history of botched prior work (but employing on old friend of Michelle Obama), was given the contract --but then compounded the mistake by again flunking basic management.  The focus of the initial repair effort was making the website functional and capable of running more smoothly, probably because the media and public relations problems were causing too many problems for the image of the White House.

But the more significant problems were left unaddressed.

More from The Hill:

In its "tech surge" effort, the Obama administration focused on fixing the consumer-facing side ofHealthCare.gov and stemming the tide of criticism that engulfed the White House last fall.

This choice was seen as pulling attention from parts of the system where technical problems were serious but less obvious.

National Review has weighed in on the problem in "Krauthammer's Take: If Back End ofHealthCare.gov Isn't Fixed, 'All Hell's Going to Break Loose':

Accenture, the new company in charge of finishing the federal health-care exchange's website, has said that if the back end of HealthCare.gov isn't fixed by mid-March, the entire health-care law will be jeopardized.

The back end of the website "is the essence of the system," Charles Krauthammer said on Special Report tonight [1/22].  "The HealthCare.gov, the signup, communicates with the insurers, and right now what that document was saying in alarming tones is because the back-end wasn't constructed, there's no way to communicate either accurate or any information about who the person is and if that person is insured."

Because that information can't be communicated, there is no way to determine what subsidy should be paid for any one individual.  Wrongly guessing the subsidy could potentially leave insurers in the lurch or stick the government with a hefty bill, Krauthammer said.

"The deadline is mid-March," Krauthammer added.  "If they don't have this in place in mid-March then all hell's going to break loose on this."

The White House took its eye off the ball when problems with the portal arose.  Officials ignored the time bomb ticking away that could blow up the program, leaving millions of Americans adrift and stranded without any idea of the subsidies that may be available to them, insurance companies with no idea how to charge insured people, and basically leaving everyone guessing about their future prospects and ability to get coverage.  The initial focus was on fixing the publicly visible appearance of the website so those pesky and embarrassing drip-by-drip news reports about frozen websites, error messages, crashes, and the dreaded "Error 404" notice would stop.

Those efforts were typical of the White House.  They are all short-term "fixes" whether they are delays on mandates, waivers, decisions to use "executive discretion" not to enforce various provisions of the law.  But they did not address basic problems.  They failed to envision the long-term and direr threats.  They again revealed a basic level of incompetence that is rife within this administration.  The Affordable Care Act, as former Speaker of the House Nancy Pelosi has now told us this program must be called, has long been seen as a disaster by Republicans as well as non-partisan experts.  But the media has smothered their warnings.  Only after the disaster has engulfed Americans has the media started dealing with reality instead of propaganda.

This is par for the course for a White House that willfully averts its eyes from threats from overseas adversaries (Russia, Iran, Al Qaeda -- really just the "Jay Vee" team of terrorists declares Barack Obama -- despite its controlling more territory than ever before) as well as a bottomless pit of deficits, food stamp usage, long-term unemployment, massive disability payments and colossal debts that will eventually need to be paid off by taxpayers.  The leadership principle of the White House is not simply to "lead from behind" but also to "see no evil, hear no evil, speak no evil".  All hands on deck to preserve the image of Barack Obama as the Messiah.  To do otherwise would be sacrilegious as well as lead to more prosaic events-such as being fired.

But the White House can evade responsibility for only so long.  The backend was incomplete from Day One and runs the risk of complete breakdown come mid-March when both insured and insurance companies will be looking for accurate subsidies to be sent to pay for coverage.  They very well may not get that information or money.

Kate Rogers of the Fox Business explored the mechanics that are running awry in ForHealthCare.gov, the Clock's Ticking:

As the new contractor for the federal government's troubled health insurance exchange, Accenture has its hands full.

Even the White House has admitted healthcare.gov has a lot of work and repairs needed to get it fully functioning.

The IT company was recently named the new contractor tasked with fixing the website, ousting former contractor CGI to the tune of $91 million.  In a recently-published contract document, the Department of Health and Human Services wants Accenture to fix healthcare.gov's back-end technology issues by mid-March, weeks before the end of open enrollment on April 1.

The website still lacks back-end mechanisms for insurance companies to receive payment from the government for subsidies and cost-sharing health plans along with a way to deliver 834 forms to insurers.  That form is critical since it details enrollee information to insurance companies, without it, they don't know who is seeking coverage.

If these fixes are not made by this deadline, the document says it will result in "financial harm to the government" and the "government could make erroneous payments to providers and insurers.  Furthermore, these continued issues could make the "entire health-care reform program...   jeopardized."  (snip)

Experts say Accenture faces a heavy task without a lot of time.

Larry Kocot, visiting fellow at the Brookings Institution, says the public perception of Obamacare's woes lean heavily on the fact that Healthcare.gov has struggled since open enrollment kicked off on Oct. 1.  But the issues plaguing the site run much deeper than those experienced during its first weeks in business.

"It's much more than just the website," Kocot says.  "It's a series of business processes to run an insurance program that has never been built before.  It's like [CGI] built the façade of a house with nothing behind it."

ObamaCare is in the process of wrecking the solvency of the health care insurance companies. In the wake of the Accenture disclosures, Moody's Investor Service downgraded its outlook for the US health care insurance sector from stable to negative.

That image of the Potemkin nature of the Healthcare.gov website is one that can be applied to the entire Obama presidency.  It was all sizzle and no substance from day one.  The leadership and management throughout the administration is a litany of failures both domestically and internationally.

Americans will be paying for these mistakes for many years to come.