Republicans who set out to skewer Health and Human Services Secretary Kathleen Sebelius got off on the wrong foot. First off, some of the first speakers on the House Energy and Commerce Committee started with the Wizard of Oz theme. Sebelius is the former governor of Kansas. “We’re not in Kansas any more” was used on several occasions, to no avail. Their theme simply didn’t fit into the day or its events.
Sebelius disarmed her attackers by immediately opening up with the following statement:
“Access to HealthCare.gov has been a miserably frustrating experience for way too many Americans,” she said in her opening statement. “So let me say directly to these Americans: You deserve better. I apologize. I’m accountable to you for fixing these problems. And I’m committed to earning your confidence back by fixing the site.”
Sebelius had not included that statement in her advance testimony so some lawmakers were caught unaware. Obviously Rep. Blackburn didn’t hear what she said because she went on the attack, accusing Sebelius of blaming others. From the Washington Post:
“You’re now blaming it on the contractors and saying it’s Verizon’s fault,” said Blackburn after Sebelius outlined some basic facts.
“Let me be clear. I’m not pointing fingers at Verizon,” Sebelius said. “We own the site.”
Blackburn pressed Sebelius to tell her who led the team overseeing the project, and when Sebelius provided it, Blackburn pounced. “Michelle Snyder is the one responsible for this debacle?”
“Michelle Snyder is not responsible for the debacle,” Sebelius said. “Hold me accountable for the debacle. I’m responsible.”
Basically, it appeared that Sebelius was treated rudely by some of the lawmakers and their staff. Some took pictures of her on their cell phones and some congressional staffers lined the walls and laughed and applauded when their bosses seemed to score gotcha points.
Sebelius overall appeared poised, knowledgeable, and in control. She gave every impression of leadership. According to the Washington Post:
She bluntly refused their requests to fire one of her deputies (“I will not, sir”), to make enrollment voluntary for the first year (“No, sir”) and to hand over enrollment numbers (“No, sir”). She answered mildly even as a red-faced Rep. Billy Long (Mo.) and a furious Rep. Cory Gardner (Colo.) demanded that she drop her health-care coverage and join an Obamacare exchange (she pointed out that the law wouldn’t allow it). She did not respond to Blackburn’s contention that Obamacare had deprived people of having a health plan that is “a Ford, not a Ferrari” or a “red Solo cup and not a crystal stem.”
What was the point of it all? Apparently the House Republicans wanted to play a good game of gottcha. Some of her accusers were probably somewhat thrown off after her opening statement and her cool demeanor. Sebelius didn’t shy away from taking the blame nor did she throw others under the bus. It will take more than a tornado to dislodge this modern-day Dorothy.
“I’ll get you, my pretty, and your little dog, too.”
There was no getting yesterday. Kathleen Sebelius walked out with her head held high, Toto in hand. She might have even splashed a witch or two with a bucket of water. She was definitely in a monkey court.
I just love the part from Sebelius when she stated that she was talking to the WH daily as they work on fixing the website yet apparently she didn’t speak to the WH at all BEFORE the site was launched. My what people will say to protect their loved ones!
@Pat.Herve
The plans are grandfathered in only if they don’t change. Then ACA said that they have to change.
Guess you don’t get to keep it.
Cargo, they don’t have to change that policy. If they want to compete they have to have the policies that are compliant.
@Steve Thomas
Heh…I read a comment somewhere else….
Complaining about the website instead of the program is like the nobles of France complaining that the guillotine is broken.
@BSinVA
I actually agree with you. Sebellius should stay. And report to Congress every month until this is fixed.
@Cargosquid
The plans are grandfathered unless they change. ACA did not say that they had to change – just if they changed that they were no longer grandfathered. The insurance company did not have to change the plans to be grandfathered ot to meet new standards.
and I will be a box of donuts that there is a constant DoS (Denial of Service) attack against healthcare.gov, which is probably what brought down the Verizon data center. I would think that it was also underway during the Sebelius hearing to insure that the site was not accessible.
@Pat.Herve
DOS attacks are detectable. If this was happening, it would have been front page news for DAYS.
Its crashing because the builders and supervisors are incompetent.
http://www.gpo.gov/fdsys/pkg/FR-2010-06-17/pdf/FR-2010-06-17.pdf
Pages 34552-34553
They estimate that 69% of all employer plans will lose grandfather status.
The regulations have been tailored so narrowly that only a few are grandfathered.
http://www.breitbart.com/Big-Government/2013/10/31/ObamaCare-wipes-out-insurance-plans-in-three-states
Virginia, Kentucky and Idaho have told insurance companies that they must scrap insurance plans that don’t meet the minimum coverage requirements laid out in the Affordable Care Act.
Some states allow insurers to amend their current plans to include the new benefits, such as maternity care and prescription drug coverage, required under Obamacare.
http://hotair.com/archives/2013/10/31/did-hhs-estimate-that-93-million-americans-will-lose-their-insurance/comment-page-1/#comments
Section 1251 of the Affordable Care Act contains what’s called a “grandfather” provision that, in theory, allows people to keep their existing plans if they like them. But subsequent regulations from the Obama administration interpreted that provision so narrowly as to prevent most plans from gaining this protection.
“The Departments’ mid-range estimate is that 66 percent of small employer plans and 45 percent of large employer plans will relinquish their grandfather status by the end of 2013,” wrote the administration on page 34552. All in all, more than half of employer-sponsored plans will lose their “grandfather status” and get canceled. According to the Congressional Budget Office, 156 million Americans—more than half the population—was covered by employer-sponsored insurance in 2013.
Another 25 million people, according to the CBO, have “nongroup and other” forms of insurance; that is to say, they participate in the market for individually-purchased insurance. In this market, the administration projected that “40 to 67 percent” of individually-purchased plans would lose their Obamacare-sanctioned “grandfather status” and get canceled, solely due to the fact that there is a high turnover of participants and insurance arrangements in this market. (Plans purchased after March 23, 2010 do not benefit from the “grandfather” clause.) The real turnover rate would be higher, because plans can lose their grandfather status for a number of other reasons.
@Pat.Herve
http://pjmedia.com/blog/draining-the-swamp-top-40-troubling-listings-from-the-obamacare-navigatorassister-security-nightmare/
Being hidden in the glare of the website SNAFU, is the waiting disaster of the “navigator” vetting
Cato,
Sounds like another credible link….NOT. Medicare Part D used navigators, what was your reaction then?
@Elena
Its not the use of navigators. Its the vetting and the lies.
And because you think that this is a “right wing” site, its not credible? PJmedia actually has very good reporting.
As for Medicare D…that’s another program foisted upon us.
You want old folks to not take their medicine and to eat cat food? Medicare D is a life-saver to some of those people.
Cargo said
Sez who? Virginia isn’t handling their own ACA. So why are they dictating the terms of policies?
If they did say that, which I doubt, and if the insurance companies complied, then why on earth is anyone blaming the ACA?
Totally makes no sense.
At the end of the day, people can either come together and ensure that Americans have access to decent healthcare or they will not. Here is what is clear, the old way wasn’t working. That the republicans couldn’t come up with their own comprehensive plan is not the Dems fault.
And, a debunked simplistic solution of just “open access between states” was not going to work. Who would think such a simple solution to a complicated problem was viable? complicated issues require complicated well thought out solutions.
@Elena
And why is it complicated? Because the government made it so.
Central planning for economic matters always fails.
Here is a really great exchange on NPR about the drawbacks of selling insurance via opening up state markets.
http://www.npr.org/templates/story/story.php?storyId=120276553
@Moon-howler
Virginia regulates insurance policies sold in the state. While Virginia did not set up its own exchange, it can regulate those “grandfathered” plans must change because those are plans sold by insurance companies licensed by the state, not plans sold by the Federal healthcare marketplace. So, at least three red states (Virginia, Kentucky, and Idaho) change their licensing requirements so that plans that would have been grandfathered have to change (and thus lose their grandfathered status), then Republican politicians say, “Look at all the people who lost their coverage you said they were supposed to be able to keep! Harumph! Harumph!” Well played. Had the states not required changes to these plans, they would still be eligible for the grandfather exemption.
First off, I am so glad to see you!!
Secondly, thanks for the information. so Virginia set them up for failure. Why am I surprised?
I am listening to Rep. Yarmuth of Kentucky right now saying how well his state is doing. They are running their own. He didn’t mention grandfather options.
Who would have controlled that in Virginia? The state legislature?
And we’d know these drawbacks are true, because we’ve tried it nationally so many times, correct?
Health Insurance sold in the State of Virginia is, and will continue to be regulated by the VA State Corporation Commission’s Bureau of Insurance, regardless of the fact that the Fed is operating Virginia’s exchange, which is why they told the insurance companies currently licensed to operate in Virginia that their policies had to comply with ACA. They are just following the law, as written, and as directed by HHS Secretary “Whatever”.
They didn’t need to change it. So who do we blame now????
This would all just be easier if Congress had repealed the EMTL Act http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act – then more people would make sure that they had some type of coverage. The fact that someone can free ride the system allows them to not participate.
And when that person gets a debilitating disease they will go on the medicaid band wagon. Why is that fair to me? Self responsibility – I thought that was a good thing.
I thought so too, Pat. What surprises me is a whole bunch of republicans defending people who don’t have health care. To me, it is simply irresponsible. Why would they encourage people to be irresponsible? Whose going to bail out the uninsured when they get sick or injured?
@Elena
“And, a debunked simplistic solution of just “open access between states” was not going to work. Who would think such a simple solution to a complicated problem was viable?”
Debunked? Debunked? Who “debunked” this “simplistic solution”, that has never been tried? What you call “simplistic”, I call a true “free market” solution, and there are plenty of examples of improving quality of service while driving down costs, through increased competition. Let’s see, there’s Airtravel, Telephone services, Mail & Shipping service, Freight Rail, Intermodal Transport… Perhaps you don’t remember the days when there were only 2 or 3 domestic air-carriers, Ma Bell was the only game in town for Telephone services, the US Postal Service was the only way to send a package door-to-door…I do. Flying was very expensive, long-distance was $0.25 per minute (and you had to rent your phone from Ma Bell), and stuff shipped through the USPS got-there-when-it-got-there, and cost a bundle to ship.
Flying a plane full of people and maintaining the planes and a schedule is pretty complicated. Transmitting someone’s voice from Virginia to California over a wire is pretty complicated. Getting a package from point-A to point-B overnight is pretty complicated. The free market’s solution was simple: Increase competition, and people will reward the companies with the best service at a price they are willing to pay with their business. How many times have the legacy Air Carriers been through bankruptcy? There’s a reason why Jet Blue and SouthWest are doing so well, even though you can fly to Orlando from DC for 99 bucks. How much are you paying for long-distance service now? How’s the USPS’ financial health compared to FedEx or UPS?
But I will agree with you on one point…the solution that the Democrats came up with, it IS complicated.
…and the free market/competition seems to be doing pretty well with all the other insurances we buy: Home, Auto, Life, property… but Health Insurance is so complicated that the Federal Government had to take it over.
See, here’s the issue; You confuse “Coverage” with “Care”. Having the former does nothing to decrease the true cost of the latter. As Pat so correctly pointed out, by law “care” had to be provided, regardless of “coverage”. Please explain to me how going from a $3,000 family deductible to a $7,500 deductible has made my health insurance “Affordable”?
I am trying to figure out why people even have deductibles. I sure didn’t have one.
Is your insurance through your company? Have they given you an explanation?
If it were a possibility to go backwards and undo “Obamacare”, then we would have two possibilities before us.
The one possibility would be 2013’s status quo where people can fall in the cracks and become uninsurable – where they are always one medical procedure away from bankruptcy.
The other is 2014’s status quo where everyone can get insurance, young people have to get it, self-employed people pay more for it, and most Americans pay roughly the same. With supposed potential for cost saving long-term.
You tell me which one most Americans want. This is reality now and it’s time to propose ways to make it better, not to sit around and complain about what’s done. There is no way we are ever going to back to “the way things were”, because they were worse then for the majority of people.
File “undoing Obamacare” away with other unworkable pipe dreams like a flat tax, privitizing Social Security, and doing away with the welfare system. They’re not realistic proposals; they’re unviable (and for good reasons).
@Moon-howler
“I am trying to figure out why people even have deductibles. I sure didn’t have one. ”
Insurance deductibles, whether they be Health, Auto, Property, Malpractice, are based on the “shared risk” principle, as “Insurance” is for the sole purpose of mitigating risk. If I am willing to take on more personal risk (ie. the deductible), the insurer’s financial risk is lower, and therefore the premium they charge is lower. If I want a “zero deductible” it means I am asking the insurance company to assume 100% of the risk, so they will charge me a higher premium.
Healthcare deductibles will go up, because of all the additional financial risk that must be assumed by the insurance carrier, because of all the additional services that must be included in their plans, by law. Their financial risk is expanded because they must now cover my free birthcontrol pills, mental health services, substance abuse services, etc. etc. and this applies to everyone in my “risk pool”. I am therefore expected to take on a greater portion of the risk (deductible), as well as pay a higher premium for the portion of risk the insurer will have.
I understand the concept of deductibles. I have them on my house, my car, my jewelry policies.
I didn’t have them on my county policy. I did have co-pays but no deductible. Now everyone is talking about deductibles, even before ACA. By the time you have a $3000 deductible, that is sounding more and more like a catastrophic policy.
If I had a $7,000 deductible, I would be getting another policy.
@Rick Bentley
“You tell me which one most Americans want.”
http://www.realclearpolitics.com/epolls/other/obama_and_democrats_health_care_plan-1130.html
It would appear that “most Americans” don’t want ACA. 2014 is going to be a very interesting election year.
“Their financial risk is expanded because they must now cover my free birthcontrol pills, mental health services, substance abuse services, etc. etc. and this applies to everyone in my “risk pool”. ”
You know those things aren’t really driving cost, right?
I would hope that all policies covered substance abuse and mental health…even before ACA.
Oh, I could have a “zero” deductible, if I was willing to go with an 80/20 plan, or pay a huge premium.
Up until fairly recently I way over $500 a month for one person–me. There was no deductible but there were co-pays. It was an employ policy but I was into the cobra end of it.
It’s expensive. It helped that my husband was on medicare because briefly I was paying out of pocket for him also. You do what you have to do. it’s a real eye opener when you have to pay the entire thing yourself without an company input.
Long-term, deductables are going to go up. It’s part of cost reduction. The old/existing paradigm of shielding people from cost – “your insurance covers this test, so let’s do it” – is going to be replaced by one where people feel ownership of their health care. And pay something in for anything other than routine exams or preventive care.
My company (100,000+ employees) implemented a system a couple of years ago where everything up to the first thousand dollars of health care costs comes out of my pocket. For better or worse, i’m aware of real cost and I resist tests and procedures that I don’t really need, which under a more “ordinary” policy my insurance company would have paid for. I think this is the wave of the future.
@Rick Bentley
“You know those things aren’t really driving cost, right?”
Rick, respectfully, you haven’t a clue as to how this all works, really. I guess in your world, there really is such a thing as a truely “free lunch” where someone doesn’t eventually get the bill, and in Vegas, the odds are not in the house’s favor.
The more things that “SHALL” be included in the plans, based on the rules issued by HHS, WILL have to be paid by the insurance company, is I decide to use them. The financial risk is higher to them, so they will raise my premiums to cover the risk. If I want to keep my premiums as low as possible, I must take on additional risk, in the form of a higher premium. This is how insurance works. All insurance.
@Rick Bentley
“My company (100,000+ employees) ”
Were all companies this big, the risk pool would be bigger, and the shared spread smaller.
Unfortunately, most people don’t work for big companies. They work for small/medium sized businesses, like I do. Under my company’s current plan, there is a $3,000 deductible (the company graciously contributes $2,000 to an FSA keep the employee’s net at $1,000). However, the FSA is gone, the deductible is going up, and the premium as well, just to keep the new plan affordable to my company. They used to pay 100% of the premium. It’s going to an 80/20 now….and this is being driven by the impacts of ACA.
Steve – can you tell me why the FSA is gone?
Because our current carrier doesn’t offer one.
Here’s the legalese behind why it went away;
Q11: Can an employer continue to sponsor a stand-alone health FSA for its employees?
A11. Yes, so long as the health FSA qualifies as HIPAA-excepted. A health FSA is considered to provide only excepted benefits if other group health plan coverage not limited to excepted benefits is made available for the year to employees by the employer, and the FSA is structured so that the maximum benefit payable to any participant cannot exceed two times the participant’s salary reduction election for the arrangement for the year (or, if greater, cannot exceed $500 plus the amount of the participant’s salary reduction election).
You’ve touched on the core of health care costs. Substance abuse and mental health are the most expensive health problems. If the government covered them we’d all have reasonably priced good health care.
Well, they shouldn’t be the highest priced. Whatever happened to the garden variety heart attack?
I have never had a policy where at least bare bones mental health coverage wasn’t provided.
It turns out that many EMPLOYER-BASED healthcare insurance plans may become non-compliant with Obamacare in 2014. The Administration estimated that 66% of small employer plans and 45% of large employer plans may lose their grandfather status. This statement is contained in a 2010 report in the Federal Register. This could cause more than 90 million people to lose their health insurance, according to the Forbes article.
http://www.forbes.com/sites/theapothecary/2013/10/31/obama-officials-in-2010-93-million-americans-will-be-unable-to-keep-their-health-plans-under-obamacare/
Well, who can prevent that? Congress. How about both sides come together, look at what their constituents are telling them, and fix the problem. That seems like a solution to me.
The other alternative is, if those who are uninsured get sick or injured, just let them lie there if they don’t have the money to pay their medical bills. If they die, they had their chance. No last minute heroics or changing their minds. A card laid is a card played. That way no one is forcing them to buy anything. I would expect a signed waiver saying that unless they can pay, no medical treatment.
They can’t have it both ways. I also don’t want to hear that young people never need medical treatment. They are always injuring themselves, getting pregnant or in fights. Who has the most car accidents?
I am just tired of hearing all this moaning, pissing, bitching and wailing over the young people who are being forced at gun point to have insurance. There is my solution. No bleeding heart liberal here. They are on their own. Screw them.
Kelly, that diatribe really wasn’t intended all for you. I am behind the scenes and need to hook on to a comment.
“Their financial risk is expanded because they must now cover my free birthcontrol pills, mental health services, substance abuse services, etc. etc. and this applies to everyone in my “risk pool”. ”
“Rick, respectfully, you haven’t a clue as to how this all works, really. I guess in your world, there really is such a thing as a truely “free lunch” where someone doesn’t eventually get the bill, and in Vegas, the odds are not in the house’s favor.”
In “my world”, birth control pills are so clearly a good investment from any perspective, for someone who doesn’t want a child, that it would be insane for an insurance company not to cover them. If only from the standpoint of preventing post-pregnancy complications and mental health. Do you really live in a world where your insurance premiums are going to go down if people in your pool have more unplanned children? (At any rate, birth control pills are as cheap as $9 a bottle so I don’t think that’s a cost driver here).
In “my world”, mental health services are a good investment for an insurance company because we would expect that someone in a disturbed state is likely to incur significant health care costs if they remain in it. I’ve seen this … I’ve seen depressed people drink or drug their way into the hospital. I’m sure that a large chunk of people in the hospital at any point in time are there because of underlying mental health issues.
And in “my world”, a similar argument exists for substance abuse programs. Insurance companies have undertaken them not because of any federal law, not because of underlying liberalism on their part, and not primarily out of a spirit of goodwill. They undertook them because they came to understand, over time, that these preventive measures will help their bottom line.
In “my world”, which I do perceive to be the one you’re actually living in, your particular examples don’t wash. They confuse utilitarian methods with some type of activism. You may or may not be happy to live in a society where people want sex without pregnancy, where the mentally ill are walking around free, and where drug use is a scourge of people and families, but that’s the world we live in. I submit to you that, at least in “my world”, you can’t reasonably think that insurance company policies have affected those things meaningfully.
Bravo!!! @Rick
As to your insurance going up, I’m sorry to hear that. I hope, long-term, that we move towards building a system where we all pay in less that we were doing circa 2013; I hope that we move towards cost reduction successfully. That’s why I don’t want to see ACA rolled back; I think there’s immense potential to build a better America where health care costs are contained, and I want us to move forward in that direction, not backwards towards an insane status quo where we pay 2-3 times more than other nations for equivalent care.
Bottom line health care in America, from the standpoint of cost, is a huge balled-up mess. Someone tried to start fixing it circa 1993 and the GOP beat them back on it, and at the Federal level nobody touched it again for 15+ years and the system got crazier and crazier. It is begging for an overhaul. We should be able to work together as Americans to do that overhaul. I see one group of people trying and another just sniping and pretending.