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Obamacare Application Data Is Wrong For 2 Million Applicants Receiving Subsidies

August 20, 2014

inDisinformation and the healthcare system, Information Technology in Healthcare, Medicine: Healthcare System, Stakeholder Mistrust

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Stanley Feld M.D.,FACP,MACE

The second really big deal is the fact that over two million people lied on their application for Obamacare through the federal health insurance web site www.healthcare.gov.

We do not know how many of the 1.2 million who received insurance through state exchanges lied.

Unfortunately, the Obama administration throws so many numbers out of context at the American public that it is impossible to follow the true facts and subsequent disastrous consequences.

Let us look at the numbers slowly. President Obama was claimed that 8 million people signed up for Obamacare by March 31,2014.

President Obama and the healthcare insurance industry were terrified about adverse selection by the people signing up. Both worked hard to get young people with no preexisting illnesses to sign up so the insurance premiums would not increase next year.

Basketball, baseball and football stars were recruited to advertise Obamacare’s benefits on TV and encourage enrollment.

The population, in the uninsured individual insurance market, was only 14 million out of a population of 350 million people. Three hundred and thirty six million received waivers from Obamacare for one reason or another.

What will happen when 336 million must participate in Obamacare? The percentage of participants in the population will be tiny if the individual market is a guide.

Seven million of the fourteen million lost their healthcare insurance because of Obamacare’s requirements. Eight million signed up for healthcare insurance under Obamacare. This represents an increase of only one million and not and increase of eight million.

Of the 8 million, 85% or 6.8 million people applied and received government subsides. These subsidies were supposed to be tax credits.

The www.healthcare.gov did not have a functional back end to the website to check if these people were lying about their income, job status, and even citizenship.

If people intentionally misstated information, they were warned they could be charged with perjury. I assume President Obama will waive that charge.

Only citizens and legal immigrants are eligible under the law for subsidized coverage.

The government signed up about 5.4 million people, while state-run websites signed up another 2.6 million.

Only 1.2 million of those were not eligible for subsidies.

Are these 1.2 million the part of the 7 million who lost their insurance because of Obamacare? Are the 8 million the people who did not have insurance before Obamacare?

Both are important questions that we have not gotten answers to.

My guess is the people who signed up were people who could not get insurance because of preexisting conditions or people who could not afford insurance in the individual market.

In either case the will be adverse selection and increased healthcare utilization. Insurance premiums will increase for everyone in the health insurance exchanges.

“Some 80% of all those who have enrolled in plans nationwide, according to federal statistics released today, have chosen a silver plan, meaning deductibles of $2,000 for singles and $4,000 for families, or gold or platinum plans, which have no deductibles. “

“Only 18% have opted for bronze plans, which offer lower premiums, balanced by deductibles of $4,500 for singles/$9,000 for families.”

Many consumers can hardly afford the bronze plans with subsidies much less the high deductibles. Those consumers will be forced drop out of Obamacare.

“The Associated Press reports that of the 5.4 million people who signed up for health insurance through the federal marketplace 2 million submitted information that does not match up with federal data.”

The discrepancies could affect their subsidy adversely. Applications were accepted on boy scouts’ honor. The subsidies were determined on the basis of the information on the application. These people will owe the government the difference plus a penalty. They are also liable for perjury.

The back end of www.Healthcare.gov is still incomplete.

“Serco, a foreign contractor already under investigation, was awarded a $1.2 billion contract to process Obamacare’s paper applications, and the AP reports they will be tasked with resolving these application issues. “

Despite having had three years and more than $600 million to work with the federal governmentand its chosen contractor could not build a functional website. It cost an additional $200 million dollars and four months to get the front end to work.

The $600 million to build www.healthcare.gov was more than it cost Apple to develop the iPhone. Apple is an American company with American jobs.

It should be recalled that another foreign contractor (CGI of Canada) got the first contract. Michelle Obama’s Princeton classmate happened to be an executive,

“Serco is a foreign company riddled with a history of transgressions. The most recent transgression was that Obamacare contractors were literally being paid to do nothing.”

The White House has attempted to dispel concern about the website being dysfunctional.

However, the report of over 2 million falsified applications has reignited the questions of government incompetence and misleading information about the dysfunctional website as the enrollment period approached.

“As Americans for Prosperity reported in the Washington Times early last month, “the website was originally intended to function automatically, calculating premium subsidies, making government payments, and tracking enrollment information that would affect future costs.”

“ But the interim system currently in place (that resulted in the newly revealed data discrepancies) is “pretty much a spreadsheet and some informed estimates,” according to Politico.

Compounding www.healthcare.gov problems are a Roll Call report that almost 3 million Medicaid enrollees have not yet had their applications processed.

These issues are all separate issues from Obamacare’s cancelled healthcare plans, physicians opting out or retiring, and the scandal with the Veterans’ Affairs health care system.

In reality all the issues are one with the Obama administration making it clear that a government run bureaucratic healthcare system is a nightmare that will destroy the healthcare system in America.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.  Please have a friend subscribe

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Holy Cow!

August 3, 2014

inDisinformation and the healthcare system, Healthcare Insurance Industry, Medicine: Healthcare System

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Stanley Feld M.D., FACP,MACE

I cannot believe it.

President Obama continues to deceive the America public about his "Accountable Care Act" (ACA or Obamacare). Our elected officials continue to do nothing to stop him. Unelected administrative officials are making spending decisions that neither congress nor the public is aware of until after the fact. A case in point is www.healthcare.gov.

William T. Woods, a senior official at the Government Accountability Office in testimony prepared for a House hearing on Thursday, warned of “significant risks in the next open enrollment period, which begins Nov. 15.”

He said, “the marketplace and its website,HealthCare.gov, were over budget and behind schedule because of “new and changing requirements” imposed by administration officials.”

This is in direct contrast to what Sylvia Mathews Burwell, the secretary of Health and Human Services told the congress and the American people a few weeks ago. She said the problems were mostly solved.

The American people have still not gotten an accurate accounting of how many people have signed up legally through the health exchanges. My best estimate it is less than 3 million and not 8 million.

About 80% are getting subsidies by signing up on the federal government health insurance exchanges. It is also against the law according to the definition for subsidy eligibility as written the law. President Obama said the administration did did not mean what the law says.

Let us concentrate on the costs of the website until this point. Initially it was supposed to cost $56 million dollars.

The cost rose from $56 million dollars to $209 million dollars from September 2011 to February 2014. The Obama administration launched the disastrous web site in October 2013 without having a quality assurance surveillance plan to monitor the work of the main contractor CGI. A principle in CGI was a college buddy of Michelle Obama. A linkage of their friendship and the contract with CGI has never been proven.

On October 1, 2013 the disaster of the web site became apparent. There was confusion within the Obama administration about who had the authority to approve contractor request to expend funds for additional work.

Mr. Woods said,“In 40 instances, the staff members of the federal exchange inappropriately authorized contractors to expend funds, totaling over $30 million.”

Mr. Wood also said, “As the Oct. 1 deadline approached, federal officials identified significant performance problems in computer systems developed by CGI Federal, but “took only limited steps to hold the contractor accountable.”

The administration withheld only $267,000, or 2 percent of CGI’s $12.5 million fee. There is no indication of the profit CGI made on the work done that cost the government $209 million dollars.

It gets more complicated and bizarre.

In January 2014 the Center for Medicare and Medicaid Services (CMS) awarded a contract valued at $91 million to Accenture Federal Services to continue work on the project.

“Accenture Federal Services costs have ballooned to more than $175 million and the marketplace is still unable to perform essential computer functions needed to pay insurers and update information on consumers.”

The question that must be asked is what in the world is going on?

James E. McAvoy, a spokesman for Accenture said that another “task order” had increased the total to $190 million.

Accenture said, “It is helping the government develop an insurance exchange for small businesses, is expanding the federal exchange to serve additional states and is adding new features to verify the income of people seeking federal subsidies.”

The Government Accountability Office, an investigative arm of Congress, said that through March of this year the administration had made formal commitments to spend $840 million on the federal health insurance exchange and marketplace.

The $840 million dollars is a long way from the original $56 million dollar in the original Obamacare budget.

The plot thickens.

Andrew M. Slavitt the No. 2 official at the Centers for Medicare and Medicaid Services told Congress that the agency was changing requirements for its contracts to expand the scope of work that must be done.

Mr. Slavitt said that the administration was making improvements in the federal health insurance exchange’s software , but that the second round of open enrollment, starting in November 2014, would not be perfect. “There will certainly be bumps,” he testified at a House hearing.

Mr. Slavitt avoided answering how much the website should cost.

Mr. Slavitt said, “That’s a really good question.” He did not specify the proper cost, but he said the nation was getting invaluable results, including new insurance coverage for millions of people.

Mr. Slavitt, who joined the government three weeks ago. A congressional panel has questioned his credibility.

Mr. Andrew Slavitt, a former executive at Optum, the technology company tasked with “saving” HealthCare.gov,ran into sharp questions from a House panel about a potential conflict of interest in his new role.

Rep. Morgan Griffith, R-Va., pressed Mr. Slavitt on his previous job at OptumInsight/QSSI. Optum, and its parent company, UnitedHealth Group. UnitedHealth Group, one of the nation’s largest insurers, offers health plans on the federal health insurance exchanges. Optum had a large role in the creation of HealthCare.gov and built the data hub, The data hub is still not working properly.

The Obama administration granted an ethics waiver to Mr. Slavitt so that he could participate in decisions affecting his former employer, Optum, and its parent company, the UnitedHealth Group.

Optum is the tech firm the Department of Health and Human Services picked in October 2013 to straighten out HealthCare.gov. It was awarded an $84.5 million contract with HHS’s Centers for Medicare and Medicaid Services in January 2012 to build the part of HealthCare.gov known as the federal data hub.

The purpose of the data hub is to connect multiple government agencies to streamline verification of crucial consumer information—including Social Security number and immigration status when Americans log into the federal and state exchanges and apply for Obamacare subsidies.

Doesn’t this sound fishy? Can we trust the Obama administration to decide what treatment American should get and what treatment Americans cannot get access to?

It looks like the VA all over again?

Let the buyers beware!

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.  Please have a friend subscribe

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April Fools Day

April 6, 2014

inDisinformation and the healthcare system, Medicine: Healthcare System, Politicians,Healthcare and Vested Interests, Universal Healthcare

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Stanley Feld M.D.,FACP, MACE

On Tuesday April 1,2014 President Obama did a victory lap for Obamacare. April 1^st is April Fools Day.

He stopped calling it the Affordable Care Act and once again called it “Obamacare”.

He announced that 7.1 million American have signed up for Obamacare on the Health Insurance Exchange web site healthcare.gov.

Since October the Obama administration has avoided providing the number of enrollees in Obamacare and its demographic makeup. The administration claimed they did not have the exact numbers.

The public viewed this as the administration’s avoidance of the number of enrollees who have purchased insurance because the numbers were so pitiful.

On April Fools Day one day after enrollment ended, President Obama announced the exact number that has signed up to the exact decimal point. It was 7.1 million.

Is that not strange?

I am publishing President Obama’s entire press conference. It is a must watch.

His words and body language is a site to behold. The audience's body language in also very telling.

http://youtu.be/hmONeJ_j8EU

President Obama is extremely charming. The speech is littered with half-truths, misinformation and lies.

He calls all his critics liars just as Harry Reid did. The president doesn’t point out where they have lied just as Harry Reid did not.

This is a Saul Alinsky tactic.

He is so charming in his delivery that the audience wants to believe him despite the dysinformation.

He even threated the media. He warned them not to headline news of these glitches and problems just because there are some glitches and bad events ahead with Obamacare.

The most transparent half-truth was when he said “we haven’t seen any death panels yet as our opponents predicted.”

He right correct. He postponed initiating his “death panels”, the Independent Physicians Advisory Board (IPAB) himself until after the November 2014 elections.

His message is the Republicans are liars. The Democrats in vulnerable states can run on Obamacare because Obamacare is great for the people. He gave three examples to prove his point. Beware of the man with three cases.

He did not discuss the Congressional Budget Office’s view of Obamacare’s effect on the economy.

In Appendix C of the rather dense document, the CBO concludes that various provisions of Obamacare will “reduce the total number of hours worked,” “will cause a reduction…in aggregate labor compensation,” and most dramatically will result in “a decline in the number of full-time equivalent workers of about 2.0 million in 2017, rising to about 2.5 million in 2024” as compared to employment growth in the absence of the Affordable Care Act.

The Obama administration called the CBO report a lie. It measured the wrong things.

The main cause of this trend is the work-discouraging combination of taxes and subsidies for lower-income Americans in Obamacare. In other words, the implied tax and subsidy penalties for success are so high that it won’t be worth a lower-income person’s effort to try to climb up the income ladder.

There goes the American dream. A dream that has driven America to the success it has achieved.

And while the CBO does suggest that demand for labor will not decline substantially due to the costs imposed by Obamacare, they do say that costs “will be borne primarily by workers in the form of reduced wages or other compensation.” So even the White House’s good news is bad news for working Americans.

Here is what he failed to discuss.

How many of those who signed up have actually paid the premium and purchased the healthcare insurance?

How many of those 7.1 million included the 6.6 million who lost insurance because of Obamacare?

How many were young adults signed up?

How many of the young and uninsured enrolled and paid their first premium?

How many of the older adults signing up had preexisting illness?

What is going to happen to the additional millions who are going to lose their healthcare insurance when their work hours are reduced below 30 hours per week?

How will they afford Obamacare insurance?

How will the McDonald waiver insurance workers afford insurance when the waivers expire?

What will happen to unions when the workers realize they are losing $5 dollar an hour in pay because of Obamacare?

If 7.1 billion people now have healthcare insurance what does it cover?

The are hundreds of examples of cancer patients losing their doctors, buying health insurance care insurance and discovering that their cancer therapy is not covered?

How many of the previously 48 million uninsured now have become insured?

The entire idea of Obamacare is to insure the uninsured.

The Rand Corporation has completed a secretive survey for the Obama administration. The goal was to estimate how many uninsured received healthcare insurance.

Numbers from a RAND Corporation study that has been kept under wraps suggest that barely 858,000 previously uninsured Americans – nowhere near 7.1 million – have paid for new policies and joined the ranks of the insured by Monday night March 31,2014.

Isn’t the price America has paid so far for overturning, uprooting, and revolutionizing 18% of the economy and the medical care ecosystem staggering for only insuring 875,000 of the previously uninsured.

Someone should add up the cost in newly levied taxes, the effect on middle class income and standard of living, the cost of the massive bureaucracy, and the cost regulations as well as the cost of economic growth that Obamacare has had on the American economy.

The bizarre thing is Obamacare does not solve the issue of the dysfunction in the healthcare system. The ever increasing price of healthcare is the result of the misalignment of all the stakeholders' incentives.

The misalignment has increased with Obamacare.

A new business plan that aligns all the stakeholders incentives which is focused on consumers must be developed.

Obamacare does not bend the cost curve no matter how President Obama has lies about it.

President Obama has had no interest in the cost of Obamacare to America. His goal is complete central control over the healthcare system.

His April Fools Day press conference is no joke!

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

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The Next Obamacare Tragedy

March 26, 2014

inMedicine: Healthcare System, Physician's Problems, Politicians,Healthcare and Vested Interests

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Stanley Feld M.D.,FACP, MACE

Late in the afternoon March 25^th the Department of Health and Human Services announced that it is extending the enrollment period for Obamacare to April 15^th from March 31^st.

“The Obama administration has decided to give extra time to Americans who say that they are unable to enroll in health plans through the federal insurance marketplace by the March 31 deadline.”

Those who are going to apply have enough time to apply in seven days if the website and the navigators are working correctly.

It sounds as if enrollment figures are not good.

“Under the new rules, people will be able to qualify for an extension by checking a blue box on HealthCare.gov to indicate that they tried to enroll before the deadline. This method will rely on an honor system.”

“The government will not try to determine whether the person is telling the truth.”

This is not a very good way to run a business.

The next tragedy in the implementation of Obamacare is providers’ participation in the Affordable Care Act. There is so much uncertainty in the Obamacare that many physicians and physician groups have opted out of participation in Obamacare.

In California, independent insurance brokers who work with both insurance companies and doctor networks estimate that about 70 percent of California's 104,000 licensed doctors are boycotting Covered California, the state health exchange.

Dr. Richard Thorp, president of the California Medical Association said, “It doesn't surprise me that there's a high rate of nonparticipation,”

The CMA represents 38,000 of the roughly 104,000 doctors or 20% of the physicians in California. Dr. Thorp said nothing about the California Medical Association doing a study to determine the percentage of physicians who are not participating in Obamacare.

However the Daily Kos ranted about the Washington Examiner story not being true.

“The latest right-wing disinformation campaign, all over the far-right media is that 70 percent of California's doctors are boycotting Obamacare. Is it true? Of course not. Is anything the Washington Examiner, WND, or Breitart publishes true?”

However the Daily Kos did not offer any facts about what is true.

It is a typical Alinsky disinformation tactic. You must freeze your enemy and then criticize and discredit him.

The LA Times reported in December that the state exchange Covered California reported,

In fact, according to Covered California, the only source with verifiable numbers, some 58,000 doctors, or more than 80% of the state's practicing physicians, will be available to enrollees in the exchange's health plans.

First of all, 58,000 physicians are not over 80% of California practicing physicians, if the 58,000 number is true. It is 55.77% of practicing physicians.

“Covered California says that the doctors participating in its exchange plans include 100% of Kaiser Permanente's 14,000 California doctors, 43,000 taking HealthNet patients and 35,000 in Blue Shield's network. (There's probably some overlap between the latter two networks.)”

The twisting of the facts is the method of operation.

On February 7, 2014 the LA Times reported Covered California admitted there are many errors in their physician directory.

“Admitting Covered California gave some consumers bad information, California's health insurance exchange pulled its physician directory for having too many errors.”

It appears that Covered California was not a very good source for the LA Times and Daily Kos to quote. Both media outlets called the Washington Examiner story a right wing lie.

“Covered California made the move late Thursday amid growing frustration among both consumers and doctors over inaccurate information about insurance networks in the state marketplace.”

California patients are discovering that their physicians are not participating in Covered California. Some have discovered that they are not covered by healthcare insurance coverage at all because of computer glitches.

The exchange previously yanked its online directory of medical providers in mid-October after acknowledging there were serious problems then with the data. It published an updated list in November.

The updated list at that time still had some serious problems. The list misled consumers into signing up on the exchange. Covered California is bragging about the number of people they have signed up.

California is supposed to be the star of the state exchanges. Yet they had to close down the exchange in February for repairs and updates. The federal government gave the state exchange an additional $155,000 million dollars to fix the exchange. This is not a small amount of money for a “superb exchange”.

Here are some facts from practicing physicians.

In September 2013 insurance companies disclosed that their rates would be pegged to California’s Medicaid plan, called Medi-Cal. This is contrary to the Daily Kos claim that the physician fees are negotiated.

Dr. Theodore M. Mazer, a San Diego ear, nose and throat doctor is quoted as saying, “In other states, Medicare pays doctors $76 for return-office visits. But in California, Medi-Cal's reimbursement is $24,.” “In other states, doctors receive between $500 to $700 to perform a tonsillectomy. In California, they get $160.

It is logical that physicians in California would say no to the state exchange, Covered California. No matter what lies the spin masters use the facts are the facts.

Physicians say, “We need some recognition that we’re doing a service to the community. But we can’t do it for free. And we can’t do it at a loss. No other business would do that,”

California physicians have protested that the Covered California's website lists many doctors as participants when they aren't. This is false advertising.

“Some physicians have been put in the network and they were included basically without their permission,” Lisa Folberg said. She is a CMA’s vice president of medical and regulatory Policy.

Donald Waters, executive director of the Alameda-Contra Costa Medical Association said. “They may be listed as actually participating, but not of their own volition”.

Waters said. He called the exchange's doctors' list a “shell game” because “the vast majority” of his doctors are not participating.

“This is a dirty little secret that is not really talked about as California promotes Covered California”.

Dr. Sherry Franklin, a pediatric endocrinologist at Rady’s Children’s Hospital, San Diego said, last summer she "got a letter in the mail letting me know if I wanted to participate with Blue Cross through the exchange, which is different from my regular Blue Cross practice, because they are paying les.s

They did not tell me how much less. You had to agree or disagree. So, of course, I said no."

Covered California expects 85% of the physicians in California to participate. So far they have made these statements to the press but have not published any proof of participation.

Covered California asks physicians to participate but does not disclose the reimbursement rates they will pay for participation in Obamacare.

Other state exchanges’ are also in trouble. Oregon and Connecticut are the most outstanding.

This is only the beginning of Obamacare’s provider problems. It is too bad that America is afflicted with this albatross at this time. Obamacare is destroying the healthcare system for consumers and physicians.

President Obama will not be able to charm his way out of the failure of Obamacare.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

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Where’s The Money Going To Come From?

January 22, 2014

inDisinformation and the healthcare system, Medicine: Healthcare System, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust

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Stanley Feld M.D.,FACP,MACE

Where is the money coming from to pay for Obamacare? Enrollment has been terrible from October 1^st 2013 to December 31^st 2013.

The Obama administration has been bragging that 2.1 million consumers who have signed up for Obamacare.

The Obama administration originally estimated Obamacare needed 7.2 million consumers to sign up on the health insurance exchanges to make Obamacare viable. Of the 7.2 million people, the administration needs at least 2.7 million people to be young and healthy 18-34 year olds. These young, healthy people are needed to pay for the sicker, older people who are likely to use the healthcare dollars.

I believe 7.2 million is a low estimate of the necessary participants to make Obamacare viable.

As a result of Obamacare, employers have been converting many employees to part time workers. The employers’ goal is to avoid paying for healthcare insurance while avoiding Obamacare penalties. This has resulted in an undisclosed number of uninsured people.

The cancelation of 6.5 million healthcare policies in the individual marketplace due to non-compliant Obamacare mandated coverage will further increase the number of uninsured.

The Obama administration has spun the numbers to look favorable even though they are terrible.

Kathleen Sebelius released the Obamacare participation numbers for the first two month last week.

“Key findings from today’s report include:

Nearly 2.2 million (2,153,421) people selected Marketplace plans from Oct. 1 through Dec. 28, 2013
These signups in the state and federal marketplaces represent a nearly five-fold increase from October-November, including nearly 1.8 million (1,788,739) people who selected a plan in December (compared with the previous two-month cumulative total of 364,682 through Nov. 30, 2013).
Of the almost 2.2. million:

54 percent are female and 46 percent are male;
30 percent are age 34 and under;
24 percent are between the ages of 18 and 34, and;
60 percent selected a Silver plan, while 20 percent selected a Bronze plan; and
79 percent selected a plan with Financial Assistance.”

Today’s report also details state-by-state information where available. In some cases, only partial datasets were available for state marketplaces.
The report features cumulative data for the three-month period because some people apply, shop, and select a plan across monthly reporting periods. Enrollment is measured as those who selected a plan.

To read the complete report visit: http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Jan2014/ib_2014jan_enrollment.pdf

There are several problems not emphasized by the report.

How many of the 2.1 million applied and were approved and receive insurance?

How many actually received an insurance card?

How many paid the first month’s premium?

How many applying for insurance lost their insurance as a result of the Obamacare change in insurance requirements?

How many of these people have a pre-existing illness and are an expensive health risk?

What is the average amount of financial assistance the 79% will receive?

The young healthy people have not applied because most are facing at least a 50% increase in the cost of insurance premiums along with higher deductibles.

They feel they are being ripped off by Obamacare and refuse to join. Many simply cannot afford it.

“No group has been hit as hard by the Obama economy and Obamacare as America’s young people. After seeing massive premium increases and failed bureaucracy in the Obama administration, it’s no wonder they are staying away,” said Don Stewart, a spokesman for Senate Minority Leader Mitch McConnell.

House Speaker John Boehner’s office said the figures prove the health law has been “a bust so far.” “When they see that Obamacare offers high costs for limited access to doctors — if the enrollment goes through at all — it’s no surprise that young people aren’t rushing to sign up,” said Boehner spokesman Brendan Buck.

How many have tried to apply for healthcare insurance only to have their application kicked back without explanation?

Moises is a case in point. He is a U.S. citizen with a wife and two kids. His kids have SCHIP. He and his wife do not have Medicaid or other insurance.

I volunteered to fill out his application for him. He said he did not want to bother me. He has a friend who knows someone who will complete the application for free.

He friend works for an insurance company. The company has navigators that will complete the application for free for him.

It took 3 weeks to complete the application. How many hours was the government billed to complete his application at $48 an hour?

The October 31^st deadline passed for Moises and his wife to have insurance November 1^St.

He and his wife contracted what sounded like a viral illness on October 30th. They went to the doctor on November 2^nd. They had some lab tests done and were given a “real expensive antibiotic.”

The encounter cost him $200 that he could not afford. I would guess the same transaction would have cost the insurance company $50.

The navigator promised him she would have the application in by November 15^th so that he would have insurance on December 1^st. On November 21^st the application has yet to be accepted by healthcare.gov.

There has been no explanation by the navigator as to why his application did not go through. He has called the navigator at least 15 times. She says she will keep trying.How many more people has this happened to as they have tried to apply for Obamacare?

Last week the Washington Examiner said that the IRS has started bullying young people to sign up.

President Obama is in the midst of multimillion dollar spending public relations campaign to convince young people to sign up for Obamacare.

This bizarre commercial to "Get Covered" by Obamacare received 72,000 hits on You Tube. How many of those 72,000 applied for Obamacare? We will never know.

http://www.youtube.com/watch?v=ZJQXkIEqMMA

Other “Get Covered” bizarre commercials can be seen at the completion of the above video.

Is this a good use of taxpayers’ dollars?

President Obama is spending money like a “drunken sailor.”

After receiving the Obama administration’s original numbers, the CBO’s estimate predicted Obamacare would save $114 billion dollars over the next 10 years.

In May 2013 the CBO revised its estimate of the Obamacare costs. The graph below shows that Obamacare will cost over $140 billion dollars per year over the next 10 years. The net budgetary impact will be $1.4 trillion dollars. The deficit represents an increase more than $1.54 trillion dollars over the cost savings of $114 billion dollars in the original estimate.

This estimate is not even close to what the eventual net budgetary impact will be.

The real cost will skyrocket because of all the defects in the law, terrible implementation of the law, the fraud and abuse that will occur because of implementation of the law and the entire skewed enrollment that is going to take place.

America ought to face reality and ignore President Obama’s rhetoric now before disaster occurs and America is bankrupt.

Americans should insist that Obamacare be repealed now before it is too late!

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.

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President Obama Got The Subject Changed

January 12, 2014

inDisinformation and the healthcare system, Medicine: Healthcare System, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust

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Stanley Feld M.D.,FACP, MACE

I do not know if anyone has noticed that Obamacare has not been discussed in the mainstream media since January 1^st.

Obamacare affects consumers negatively. The anger and resistance will not go away by changing the subject.

Obamacare's problems remain.

Many physicians are running for the exits.

Many insurance companies are trying to figure out their next step. Many hospital systems have not been successful in developing of their accountable care organizations.

Hospital systems have not developed functionally adequate electronic medical records.

Hospital systems have not adjusted to the ICM-10 coding system.

There are still delays in signing up for healthcare insurance on the health exchanges.

People do not know if their applications have been accepted and they actually have insurance.

The minimal numbers of applicants and consumers who actually received insurance is not clear.

The level of mistrust by consumers for the Obama administration continues to escalate.

It is interesting to note the scarcity of articles published about the healthcare system since January 1^st.

The mainstream media is not reflecting the chaos created by Obamacare on the healthcare system.

No matter what the Obama administration does to distract people from healthcare it will remain a main issue. Obamacare is not an abstraction any more. It is an unpleasant reality that is affecting consumers directly. It is having a widespread negative effect on healthcare and medical care delivery. Obamacare is also having a negative affect on economic growth and stability.

Headlines about Obamacare are few and far between. Below are some of the few topics published.

New Health Law Frustrates Many in Middle Class

The cheapest insurance plan they can find through the new federal marketplace in New Hampshire will cost their family of four about $1,000 a month, 12 percent of their annual income of around $100,000 and more than they have ever paid before.

Even more striking, for the Chapman’s, is this fact: If they made just a few thousand dollars less a year — below $94,200 — their costs would be cut in half, because a family like theirs could qualify for federal subsidies.

The Chapman’s are caught in the uncomfortable middle: not poor enough for help, but not rich enough to be indifferent to cost.

Most healthcare experts consider health insurance unaffordable if premiums exceed 10 percent of annual income. Lower income families not qualified for Medicaid (>$21,000 per year) have to pay 10% of their income for subsidized healthcare insurance. This amount could be unaffordable to them.

Obamacare is only affordable for the very poor.

More trouble for CGI, Obamacare website designer

CGI Group is being denied payment by Massachusetts and Vermont as a result of dysfunctional state exchange websites that have yet to be fixed.

Massachusetts (Romneycare) is supposed to be doing great according to the traditional media. Why is Massachusetts switching to Obamacare?

The state is probably getting a bigger subsidy from the federal government by being under federal control. Federal control doesn’t seem to trouble the government officials in Massachusetts.

I was under the impression the Massachusetts web site was working splendidly. The CGI contract for Massachusetts and Vermont cost $69 million dollars.

Obamacare Contractor Blamed for Slow Medicare Payments to Hospitals

In an attempt to make as much money as possible the outsourced administrative services providers are holding onto money as long as possible.

The report appeared only on a local TV station in Houston, Texas. I suspect it is happening all over the country.

“The contractor building the financial management system for Healthcare.gov is being blamed by a Houston hospital for delayed Medicare reimbursements that have caused the hospital to miss payrolls for weeks."

" Novitas Solutions is the federal government's new Medicare payment processor for the south-central region of the country hired by the Centers for Medicare and Medicaid Services (CMS), a division of the Department of Health and Human Services (HHS.) ABC-KTRK in Houston reports:"

"According to the CEO Jason Leday, more than 150 employees haven't been paid in nearly a month."

"I understand that they have children and a house payment, bills. Not getting paid is wow," nearby resident Theresa Gutierrez said.”

The public can only know about these occurrences, if the mainstream media reports it.

Insurance Customers Still Having Problems With MNsure

A local Minneapolis TV station had this story.

"As the New Year began at midnight, so did benefits for thousands of Minnesotans who signed up for MNsure.

It left some people unsure if they completed the process in time. MNsure has had several problems with it’s website from the start this fall.

Late last week, 50,000 people had completed applications to buy private health plans but hadn’t completed enrollment because of website problems or if they just didn’t continue on in the process. Close to 20,000 people had completed enrollment as of Dec. 27, 2013."

This is not a very good showing for Minnesotans. We were told the state exchanges were doing great.

The Obama administration has not verified any actual enrollment in insurance coverage to date. We have been told that things are looking good.

Lousy results are portrayed as good results.

It’s official: Obamacare debuts with more canceled plans than enrollments

Obamacare may have promised health insurance for the masses. But on its first day, it’s left more Americans without coverage than before the law was passed.

More than 4.7 million Americans had their health insurance canceled as a result of any of the thousand-plus-page law’s new rules, The Associated Press reports, but the Department of Health and Human Services (HHS) confirmed Tuesday that between federal and state exchanges, just two million Americans have signed up for Obamacare coverage.

'They had no idea if my insurance was active or not!'

"Obamacare confusion reigns as frustrated patients walk out of hospitals without treatment."

The Mail Online published this story for the American public. It did not appear in the American traditional main media.

MailOnline spoke with patients who were told they would have to pay their bills in full if they couldn't prove they had insurance

One was faced with a $3,000 hospital room charge and opted to leave the hospital after experiencing chest pains
'Should I be in the hospital? Probably,' she said
Another, coughing in the cold, walked out without receiving a needed chest x-ray
Consumers face sticker-shock from medical costs under the new Obamacare system, made worse if they can't prove they're insured
As many as one-third of new enrollees' applications have seen problems when the government transmits them to insurance companies

The group market, the union insurance market, Medicare, the low paid wagers market (MacDonald’s and other fast food chain market) all received waivers from Obamacare for one year. Only the individual healthcare market was not exempt from Obamacare.

The recent Obamacare headlines have not been popularized. Most Americans can conclude that nothing in healthcare has changed.

Americans should be made aware of the things going on in healthcare under Obamacare. They will be shortly. Obamacare is going to affect all Americans directly.

Obamacare is only affecting 5% of the population today. However the public needs to be made aware of what is going to happen to everyone because his or her waivers will expire shortly.

The Obama administration has not been transparent about anything including costs and cost overruns.

The lack of transparency has made everyone suspicious and mistrustful of President Obama and his administration.

It is going to be a rocky year for both healthcare and medical care.

Obamacare is facing headwinds that the Obama administration will not be able to hide from the public.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.

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Insurers Wary of Obamacare Administration

December 15, 2013

inMedicine: Healthcare System, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust

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Stanley Feld M.D.,FACP,MACE

The government is dependent on the healthcare insurance industry for administrative services.

Obamacare’s success is dependent on the healthcare insurance industry selling insurance to consumers who buy insurance from the healthcare exchanges.

Several insurance companies have opted not to participate in the health insurance exchanges.

The companies that are participating are the companies that have figured they will make a killing. The killing will come if there is a minimum of administrative services and a maximum of consumers who present little risk.

The government has a commitment to the insurance industry to pay the total cost of healthcare insurance to the healthcare insurance companies for all subsidized consumers.

If partially subsidized consumers do not pay the insurance company their premiums the lag time before the insurance company can drop that consumer can be up to a year. The consumer can enjoy the coverage benefits of the policy at a loss to the healthcare insurance company.

It is almost impossible to know whom to believe or trust.

Is the Obama administration lying or is it the insurance companies?

What are the real numbers?

Who is insured?

How many people have applied through the health insurance exchanges?

How many people have been approved for coverage by the Obama administration?

How many are approved for Medicaid?

How many people of the 5.5 million who lost coverage are now covered under Obamacare?

What percentage of Obamacare covered consumers will have a preexisting illness?

How many people have paid their premium and will have insurance January 1, 2014?

How many people who have lost their insurance have signed up and paid their premium?

How many people are getting subsidies?

How much is the subsidy?

How many people have bought non-subsidized private insurance from the health insurance exchanges?

None of the answers are easily available.

If President Obama didn’t exempt group insurance policy holders’ from Obamacare for one year, the nation would be experiencing a greater disaster.

The public is becoming wary of the misinformation. President Obama has lost the public trust.

The news of increasing problems with implementation of Obamacare is becoming boring. People are becoming more frightened.

This is just where President Obama wants us. He wants us to give it over to the government.

Can we trust government to run the healthcare system? The answer is no!

America cannot afford this incompetence medically or financially.

The attitude of Obamacare fans is that it happened, the President is trying to fix it. Let’s live with it. It is the law of the land?

President Obama has even blamed the structure of government agencies for the screw up. It is not his fault.

This should be the precise argument for why the government should not run the healthcare system.

He might have found a way to shift the blame. A New York Times/CBS poll said President Obama's approval rating is improving at the same time all the other polls said it has fallen below 39%.

Both the NYT and CBS are big Obama fans. Again, what is the truth?

The healthcare insurance industry is screaming bloody murder. There is no back end to the web site. There are errors in applications. One error begets another error. The insurance companies, rather that make a killing, will lose their shirt.

President Obama promised to make them whole without the companies providing evidence of loss.

Insurers say they don't know the full extent of back-end problems with healthcare.gov and are wary of the Obama administration’s claims they are fixing the issues quickly.

President Obama and White House officials are trumpeting new fixes to the Obamacare website, saying they met a self-imposed Nov. 30 deadline to deliver a smooth user experience to the vast majority of Americans trying to enroll in the online insurance exchanges.

As of December 13,2013 at least 20% of the applications have been plagued with problems.

“Insurers and federal officials sifting through insurance applications under the health-care law have identified a raft of errors, including missing customers and inaccurate eligibility determinations that mean people may be enrolled in the wrong coverage.”

“In some cases described by a state official with knowledge of the matter, legal immigrants who aren't yet eligible for Medicaid in were nevertheless told they would be enrolled.”

The Obama administration has provided few details on the remaining back end technical bugs. These bugs are preventing insurance brokers from enrolling people in coverage. There is a great difference between applying for coverage, enrolling in coverage and finally obtaining coverage.

www.Healthcare.gov is supposed to transmit 834 forms to the insurer of the consumer’s choice by computer.

Insurers have either received these forms riddled with errors or not at all. They cannot possibly issue insurance to people who have applied and have sent incomplete or inaccurate information to the insurer.

The Department of Health and Human Services urged insurers to help avoid Jan. 1 mix-ups. The Obama administration modified coverage rules. Officials asked the healthcare insurance industry to cover people retroactively who missed paying for the premiums by January 1 because of defective applications. The Obama administration has asked the insurance industry to pay for drugs next month, even for customers who haven't yet fully enrolled.

This is not a good way to run a business. The Obama administration seems to be playing it by ear. They are changing the requirements of the law daily. Obama fans say it is a pragmatic adjustment. Others say it is unconstitutional. President Obama, you cannot play both sides of It’s “the law game.”

“Insurance-industry executives warn, that some of these data problems will only emerge once customers begin seeking care in January at physicians' offices, pharmacies and hospitals.

The result could be bureaucratic chaos as doctors and patients storm insurers' phone banks and federal officials work to clean up the inaccuracies.

The National Association of Health Underwriters sent a letter to President Obama on Tuesday asking him to fix a bunch of back-end obstacles.

“We want to make it clear that a number of back-end technical obstacles still exist for health insurance agents and brokers trying to actively support the federal marketplace,” she wrote.

“Agents and brokers would like to help increase marketplace enrollment as much as possible over the next few months, but technical barriers prevent them from doing so.”

I think everyone gets this point.

However, a more important point is that if this has happened with the web site can we trust the government to have control over the large slice of our economy that healthcare represents?

More importantly, can we trust the government to make our medical care decisions for us?

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.

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Is This A Lie?

December 4, 2013

inDisinformation and the healthcare system, Medicine: Healthcare System, Stakeholder Abuse of the Healthcare System, Stakeholder Mistrust

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Stanley Feld M.D., FACP,MACE

In the last ten days before the November 30 deadline to fix healthcare.gov President Obama dialed down his definition of fixing www.healtcare.gov.

http://youtu.be/mr_bHZbqqhU

President Obama knew at that time that the back end of www.healthcare.gov was not completed. He knew a security was not built into the system. Yet he is telling the people it would not work perfectly.

At the same time he made this promise he was fighting the reality. It looked like the traditional media was finally presenting reality and not President Obama campaign hype.

Obamacare is directly affecting them. Over 5 million people, in the individual market have lost a healthcare insurance policy. They could not get on healthcare.gov to buy insurance from the health insurance exchange.

I would expect at least 5 million more to lose their individual insurance. It is predicted that at least 80 million more will lose their group policy under Obamacare.

The premiums for new policies are skyrocketing because of the required Obamacare coverage mandate.

On Sunday, as a Nov. 30 deadline set by the administration for improvements to the web site had passed.

CMS issued a report concluding: "We believe we have met the goal of having a system that will work smoothly for the vast majority of users."

On October 5, we were told that healthcare.gov would be completely operational by November 30^th. Would that statement be considered a lie given the result?

Federal officials have acknowledged they had only begun to make headway on the biggest underlying problems: the system's ability to verify users' identities and accurately transmit enrollment data to insurers.

Insurers have complained they have not gotten accurate data to do their due diligence. There is no mechanism for payment of premiums or subsidies. The insurance companies have not issued insurance policies.

Many people think they have signed up for insurance. They do not have an insurance policy that covers their healthcare.

They have not been issued insurance policies because of the lack of the health insurance exchange transfer of accurate verified data nor have they paid the premium.

Once a person applies for insurance, income must be verified, subsidy calculated and a premium must be paid before insurance is in effect.

Much of this data collection and transfer has not been built into the healthcare.gov system.

Many software programmers claim the software used by CGI makes the integration impossible to do effectively.

Insurers do not want to take the risk without verification of the criteria for qualifications or premium collection.

Insurers and some states are continuing to look for ways to bypass the balky technology underpinning the health-care law despite the Obama administration's claim Sunday that it had made "dramatic progress" in fixing the federal insurance website.

The Obama administration has not released the number of people who have applied, been approved and have paid their premiums.

Only 26,000 people signed up and think they “got” insurance coverage by November 2 according to data released November 15^th.

The November 30^th numbers have not been officially released.

I do not blame the healthcare insurance industry for doing business in a business like way.

Obamacare is facing these and other giant issues.

Another big issue is the security of personal information issue an applicant enters on the web site. The security of information has not been addressed. In fact, hidden code in the web sites code releases www.healthcare.gov from responsibility for maintaining privacy.

The application process is still complex. This is a glimpse of the steps necessary to complete the application. Double click on the image to enlarge the image.

http://online.wsj.com/news/articles/SB10001424052702304355104579231870862102710

As far as President Obama is concerned he has delivered on his promise to make www.healthcare.gov functional by November 30 even if he modified his promise along the way.

The traditional media is cheering for him on his delivery of his promise.

Can anyone believe this?

After spending two months of defending www.healthcare.gov and his ill advised promises about “keeping your healthcare insurance and doctor period”, President Obama figured it is time to change the subject and go on the offensive since he has delivered as promised on the web site.

President Obama, starting Tuesday, will hold an event a day that will emphasize a different benefit of the law and try to remind Americans why Democrats pushed the law through Congress in the first place, according a White House official.

The plan is to have an event-a-day push to extoll the virtues of Obamacare. It will continue through much of the holiday season until the Dec. 23 enrollment deadline for January coverage.

The Obama administration coordinated the promotional blitz with Democratic allies on Capitol Hill and the party's campaign committees, all of which will be involved in pitching the daily message through press events and social media.

The idea of this campaign is to refocus the media and citizens away from the upcoming problems with www.healthcare.gov and emphasize the core principles of Obamacare.

President Obama has used the same strategy many times with healthcare, and his other scandals as he pursues his transformational agenda. It is called a diversion.

He plans to make clear the direct benefits Obamacare has provided to millions of Americans already.

Americans are starting realize Obamacare has meant more taxes,( to everyone including the poor, middleclass and wealthy), tremendous increases in healthcare insurance premiums, less full time jobs, less access to care and glimpses of the upcoming torrent of rationing of medical care.

Democrats and consumers are realizing the sham of this promotional campaign.

Many congressmen are running for the exits because they are up for reelection in 2014. They are trying to avoid the folly of President Obama’s promotional blitz.

The public relations ploy will further decrease President Obama’s credibility.

How can we trust the government with our healthcare decisions when it is having so much difficulty constructing a web site?

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.

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It Is Just The Beginning Of The Problems

December 1, 2013

inHealthcare Insurance Industry, Medicare, Medicine: Healthcare System

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Stanley Feld M.D.,FACP,MACE

The recent problems with www.HealthCare.gov are just the beginning of President Obama’s problems with Obamacare.

CMS has tried every public relations trick in the book to restore public confidence in Obamacare. The web site is failing. The cost of healthcare insurance is rising above affordability for everyone except people who qualify for government subsidies.

The deficit is going to skyrocket because the young healthy people are not going to sign up unless they receive a subsidy. Even with a subsidy, the price of insurance through the health insurance exchanges is too high to afford.

President Obama has even tried to rebrand Obamacare. The new name is the Affordable Care Act. The ACA is the wrong name. Maybe it should be called the Unaffordable Care Act (UCA)?

The health insurance exchange policies are unaffordable because of government mandates for required care. This unaffordability will result in an increase in uninsured.

At the beginning of October, President Obama placed a November 30,2013 date for the web site being fully operational after the glitches were fixed.

It turns out that the problems are much worse than a few glitches.

“Despite recent progress at HealthCare.gov, a raft of problems will remain beyond the Obama administration's Saturday deadline to make the troubled federal insurance website work.”

The November 30^th deadline will be missed. President Obama has revised his declaration. Now the web site will be partially operational.

Once again President Obama’s original promise does not ring true. President Obama announced web site would be 80% operational. What does that mean?

Americans were warned by Henry Chao, the top IT official at the Centers for Medicare and Medicaid Services, who testified on Capitol Hill Tuesday on November 19^th2013 that more than 30% of the "back end" infrastructure still remains to be built in the federally-run marketplace.

The front end looks better according to recent users. The pages load faster. More people are getting through to sign up for health plans.

However the devil is in the details of the “back end.”

As of December 1,2013 healthcare.gov is missing the following,

The ability to verify users’ identities.
The ability to verify income for the purpose of subsidies.
The ability to transmit accurate enrollment data to insurers.
The tools for processing payments by insurers haven't been built.
The data centers ability to support the various site functions has been inconsistent causing the site to crash often.
The ability to supply adequate security for personal information.
Total disregard for HIPPA privacy.
Adequate security on every level.

http://youtu.be/uOk0vOup4yA

“Problems with the performance of the site's databases, storage and servers and their interaction with each other continue to slow the site or make it unavailable for short periods, as of December 1,2013, according to government officials and contractors working on the project.”

There are many problems. Forty-eight dollar an hour navigators, CMS spokespersons, and other government official are all rationalizing about the problems.

No one in the Obama administration comes out and tells the public the real problems. They just say it will be fixed.

The comment sections of online articles are many times more truthful than the media fed “facts” by the Obama administration.

One comment appearing in the article, “Health Site Is Improving But Likely to Miss Saturday Deadline.” Said the headline should have been written as “Health Site Is Improving But CERTAINLY to Miss Saturday Deadline.”

Richard Sullivan wrote,

“Our father, whose art be in heaven, Hollywood be thy name…………”

John Rogitz wrote;“The web site will be fixed. Eventually. What won't be so easily fixed is a culture that has relinquished its medical care to government overseers.”

Teresa Rich replied; We haven't relinquished our "care," Mr. Rogitz. We have relinquished our "freedom" — all for the promise of "free" health insurance for "the COLLECTIVE."

Charles Whitlach wrote the most educational comment of all.

"We programmers are laughing at the incompetence of this administration. I write in the very same server code as this website developer.”

“I am a Microsoft Certified Solutions Developer [MCSD]. I have been certified by Microsoft as an expert in this language.

Although I haven't written in ASP.net 2.0 since 2005. We use 5.0 now.”

The primitive program is a result of giving a non-bid contract to Michelle Obama’s friend rather than going through a competitive bidding process.

“The Javascript & CSS files are uncompressed. Programming 101 says compress them before release. Why are there so many JavaScript files? I have never seen so many JavaScript files on a page, even with sites like Google.”

“What happened to Unit Testing Mr. President?

Didn't anyone test this web site for load capacity? That is why people can never get to the "Select State Page". No one tested for load capacity.

Didn't anyone put in redundancy and fall back servers? These are the basic questions/steps every good IT person checks off before release.”

“Every good programmer knows that ASP.net 2.0 is "Leak-o-Matic". Who uses 2.0 anymore? This goes beyond legacy issues. What possible justification could anyone have in creating a website today in 2.0? There are none.

Obama calling in the best and brightest to fix the problem? Why didn't he call us in, in the first place?”

Lastly, "YOU CANNOT FIX BAD CODE, YOU CAN ONLY REPLACE IT."

“The website written in 10 yr old code cannot be tweaked. There have been too many API changes since 2005. The code must be rewritten.

The client-side and server side code of this website must be redone. 5 million lines of code need to be rewritten? In my field that is an epic failure.”

“Who ever created this website should return the money. This was utter incompetence.

The $684 million was wasted."

President Obama has been modifying his statements about the web site being completely fixed by November 30^th for the last two weeks.

“It will work for 80% of the people who try to enroll.“

Officials mixed optimism with caution. "November 30th does not represent a relaunch of HealthCare.gov," said Julie Bataille, a spokeswoman for the government's Centers for Medicare and Medicaid Services, which operates the site.

"It (November 30,2013) is not a magical date. There will be times after November 30th when the site, like any website, does not perform optimally."

The administration said plans are in place to replace the Verizon unit with H-P this spring.

Someone should tell the administration they need to rewrite the program. Switching database vendors is not going to fix the program.

“HHS also didn't initially contract for a backup website or monitoring tools like those used by sophisticated consumer sites, according to people familiar with the matter.”

Patrick Reikofski might be right when he said. “Ladies and gentlemen, your Federal Government in action…”

I have not covered the problems Obamacare will have with physicians, insurance companies or hospitals. Obamacare’s implementation will be a nightmare.

If we wasted $684 billion dollars so far on broken web site, how much more will we waste until Obamacare fails completely?

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

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Stanley Feld M.D.,FACP,MACE

Insurance Customers Still Having Problems With MNsure

It’s official: Obamacare debuts with more canceled plans than enrollments Obamacare may have promised health insurance for the masses. But on its first day, it’s left more Americans without coverage than before the law was passed.

"Obamacare confusion reigns as frustrated patients walk out of hospitals without treatment."

It’s official: Obamacare debuts with more canceled plans than enrollments

Obamacare may have promised health insurance for the masses. But on its first day, it’s left more Americans without coverage than before the law was passed.