Trump administration won't answer questions about Obamacare enrollment
People waiting to enter an Affordable Care Act enrollment event sponsored by
SEIU-United Healthcare Workers West and Community Coalition in Los Angeles in November 2014.
AP Photo/SEIU, Michael Chavez
The Trump administration won't give any specifics about how it will handle the looming enrollment season in the Obamacare marketplaces, where 10 million-plus Americans are expected to seek health coverage for 2018. The six-week sign-up period will be the first handled exclusively by an administration that's hostile to the Affordable Care Act -- and one that hoped by now to see Congress pass legislation unraveling much of the law.
In each of the past four sign-up seasons, the Obama administration was a clear cheerleader for the marketplaces, engaging in widespread marketing efforts, supporting nonprofit "navigators" who helped with community-based enrollment and loudly proclaiming the availability of insurance plans -- and federal subsidies -- to just about anyone without employer-sponsored coverage, Medicare or Medicaid.
So is the new administration -- and specifically the Department of Health and Human Services, run by former GOP Rep. Tom Price -- a friend or foe of the marketplaces? On one hand, any problems with enrollment on Healthcare.gov are likely to be blamed on the agency, which is in charge of operating and promoting it. On the other hand, Price's boss, President Trump, has been loudly declaring his ongoing animosity to Obamacare and his hopes that its marketplaces will self-implode.
Health and Human Services Secretary Tom Price.
Photo by Jabin Botsford/The Washington Post
Here are just some of the questions on our mind:
§ Will the government contact current enrollees to alert them that sign-ups will last just 45 days, about half as long as in the past three years?
§ Will HHS run call centers for consumers who need help as they look for plans?
§ Will the HealthCare.gov computer system be adjusted to accommodate a possible crush of shoppers given the shorter sign-up period?
§ And how will automatic enrollment be handled? In previous years, notices have been sent out in mid-December, informing customers with coverage about price changes for their current health plan and urging them to shop around. This year, Dec. 15 is when enrollment will end.
Communications staff for HHS declined to answer questions from The Health 202 about a half-dozen specific facets of the enrollment season, which will run from Nov. 1 to Dec. 15. Instead, a spokeswoman for the agency's Centers for Medicare and Medicaid Services issued a generic statement: “As open enrollment approaches, we are evaluating how to best serve the American people who access coverage on HealthCare.gov.”
An hour later, the spokeswoman, Jane Norris, requested that the statement be withdrawn, saying that she did not have permission to release it. When I asked her again for detailed answers, neither she nor anyone else at HHS responded further.
The Healthcare.gov website
AP Photo/Andrew Harnik, File
So we decided instead to ask people who might know: State officials and health-care nonprofits around the country that have received so-called "navigator" grants to promote enrollment. (The three-year navigator grants were first awarded in 2015, and recipients say HHS has indicated they'll get the final annual payment in early September.)
Many of these folks attended a two-day conference in Baltimore in June, where HHS staff held sessions about the enrollment season. One of the attendees was Daniel Bouton, manager of a consortium that helps people enroll across North Texas, who said many attendees peppered officials with questions about their advertising intentions.
“Every time the question was brought up . . . the only answer we received is they were working on it, and they hadn’t made a final decision about whether they were going to have a marketing campaign this year,” Bouton told me.
Jessie Menkens, who works for another navigator group, the Alaska Primary Care Association, had a similar account of the Baltimore meeting. At one point she asked an official about whether the administration plans to do outreach around enrollment season.
"I said pretty much – is there a commitment at this time to proceed with this outreach?” Menkens said. “They very kindly said ‘We’re not able to provide a commitment to that.’”
Menkens and others say they believe the navigator groups are more important than in years past, given the lack of commitment from the Trump administration to promoting Healthcare.gov. “There is a lot of noise coming from Washington, and it is our job to try to cut through that and provide factual and relatable information,” Menkens said.
Staff at the liberal consumer-health lobby Families USA grew accustomed over the past four years to frequent meetings with HHS staff members to talk over eligibility and related issues for open enrollments. There have been no such meetings since Trump took office, and federal officials have sometimes replied to written questions by saying no decision has yet been made, Eliot Fishman, the group’s senior director of health policy, told my colleague Amy Goldstein.
Heather Korbulic, executive director of Nevada's marketplace, is feeling daunted by a similar lack of answers. She has tried to find out whether HHS intends to contact Nevadans with ACA health plans to remind them to enroll — a particularly pressing issue because the state exchange operates under a hybrid system and pays about $5 million to rely on HealthCare.gov. She also has tried to get federal officials to provide a list of currently enrolled residents so the state can notify them directly.
“I ask this question every week,” Korbulic said. “It’s verbal, written, and to different levels of management . . . We are desperately seeking answers.”
Julie McPeak, Tennessee’s insurance commissioner and the incoming president of the National Association of Insurance Commissioners, said that she and colleagues have contacted officials at HHS, the Justice Department, the White House’s Intergovernmental Affairs office, and its Office of Management and Budget, trying to learn which part of the government would make the decision about these cost-sharing payments and when.
“And we can’t get a clear picture,” McPeak said. As a result, she noted, Tennessee cannot plan its own outreach efforts because it is impossible to provide consumers accurate information about insurance prices and choices for the coming year.
“It’s entirely opaque to us,” McPeak said.
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Original article https://www.washingtonpost.com/news/powerpost/paloma/the-health-202/2017/08/08/the-health-202-trump-administration-won-t-answer-questions-about-obamacare-enrollment/5988b2ed30fb045fdaef1180/ by Paige Winfield Cunningham https://www.washingtonpost.com/people/paige-winfield-cunningham/?utm_term=.39f746f05a3f The Health 202 https://www.washingtonpost.com/news/powerpost/wp/category/the-health-202/
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I really do not understand the GOP. Polls make it clear that they will be held responsible for any collapse of health-care, by an overwhelming majority of Americans.
Deer in the headlights, maybe??
May I suggest that both apply? He doesn't understand, and he doesn't give a $hit.
I think that when the topic is profit, he understands much more than we give him credit for. The gears in his head spin wildly over how to maximize it by screwing over both the competition and the client. That's how all of his business ventures go.
Here is an excerpt from the article and a link
Nancy Pelosi, the House Democratic leader, wrote to her Republican counterparts extending “the hand of friendship” and offering “to work in a bipartisan fashion” to fix the flaws in Obamacare.
Let’s hope she really means it. Let’s hope Democrats won’t use the collapse of the Republican health care effort simply to score political points against an irresponsibly inept president and continue his record of legislative futility.
The temptation is great. Donald Trump is clearly unqualified to be president. His favorable ratings are dreadful. His new chief of staff, John F. Kelly, probably won’t change a 71-year-old man who refuses to adapt his impulsive and undisciplined style to the demands of governing.
In next year’s congressional elections, too, Democrats will be eager to exploit Trump’s dismal performance. And the poorer his record of accomplishment, the better their chances of defeating him in 2020 -- assuming he lasts that long and runs again.
But Democrats must face an inconvenient truth. They own Obamacare. They are responsible for it, with all its many benefits and failings. They made a huge mistake by passing it without a single Republican vote. Then they compounded that error by underestimating problems and overpromising results.
And now they owe it to the millions of people who rely on their program to improve it, to stabilize the marketplace, to focus on actual policy for a change and not just politics.
It won’t be easy. Hardline leftists in their own party will call any Democrat who works with the GOP a soft-headed traitor. And pragmatic Republicans will be pressed by ideological purists in their own ranks to reject Pelosi’s “hand of friendship.”
But Democrats must make a sincere effort here. And if they help produce a reform package that can pass the Congress and acquire Trump’s signature in some splashy Rose Garden ceremony, so be it.
Of course, Democrats relied on their own votes to pass Obamacare in the first place because Republicans refused to cooperate in crafting the bill. But now a few GOPers seem ready to defy Trump and the party’s hard-core crazies and enter negotiations.
I think that if you had to rely on Republicans to support the birth of a national healthcare program, to any degree at all, it would just plain never happen. There's a stubbornness to that aspect of conservative ideology that will never be overcome.
Hal
At this point I tend to agree if you are talking about a direct move to a single payer system - not going to happen but if we are going to achieve desperately needed support and improvements to the existing ACA then the Democrats are going to have to find a way to work with some of the Republicans to do so.
I certainly hope the Dems make every effort, very noisily, to help the GOP improve Obamacare. Their message, and their action, must be, "The American people have given the Republicans total control of the federal government. They are in charge. We Democrats have always worked for the well-being of the common man, so if our colleagues across the aisle wish to work on the improvement of the ACA, we shall participate diligently."
If all they do is "make noise" then what Cokie says will prove true and it will be "dueling messages" in 2018 and 2020 when the Democrats say "the Republicans broke the ACA" and the Republicans say "we tried to fix it and the Democrats would not let us fix the ACA"
Sadly many who supported Trump and many who opposed Trump with not be swayed from their positions regardless of what the two sides have failed to do ...
If all they do is "make noise"...
The fact is that the minority party can do nothing at all.
If the GOP wants to fix Obamacare, and if the GOP wants the Dems to participate... then something bipartisan may (probably will) happen. But the Dems can do nothing at all unless the Republicans wish it.
The Dems are the minority. Simple. Sad... but simple...
Bob what you are saying is that if the Republicans want to fix the ACA in the manner that the Democrats want it fixed than it can be done, but that a fix that gives both sides some of what they want cannot be accomplished.
That is hyper-partisanship on both sides.
Bob what you are saying is that if the Republicans want to fix the ACA in the manner that the Democrats want it fixed than it can be done, but that a fix that gives both sides some of what they want cannot be accomplished.
No, that's not what I said.
Obviously, if the GOP tries to just lower taxes on the rich, while calling the action "health-care reform", the Dems will not help them... but that's not what I'm talking about.
The Dems are the minority. They can do nothing. It is up to the GOP to take the lead. I've read several ideas for stabilizing the markets, that should be acceptable to everyone. But getting anything moving is clearly in the hands of the Republicans. Then the Dems must lend a hand.
It's tricky, because it means that the Republican leadership (which has not shown much desire to include Democratic ideas in its bills thus far) would have to garner enough Dem vote to overbalance the diehard far-right of their own party.
I can't be sure that the Dems will be smart enough to step up, boisterously, to help get needed reform of the ACA, but we won't know unless the Republicans at least try to get the ball moving.
But Democrats must face an inconvenient truth. They own Obamacare. They are responsible for it, with all its many benefits and failings.
Apparently, this is not true. Polls show that most Americans consider Congress and the Trump administration to be responsible for stewardship of the country's health-care system. The GOP has all the levers of power, and everyone knows it. Obamacare worked reasonably well until Trump became President, so it will obviously be incompetence or malice if it stops working now.
The topic is important, certainly.
Apparently Cokie Roberts, a well known and avid supporter of Democrats and liberal policies does not agree with you and feels that the Democrats have ownership responsibility for the ACA and also that voters will remember that in 2018 and 2020.
Polls can be deceptive (refer to 2016 election polling in October) and I think Cokie is on to something here
Dunno.
In any case, the Dems simply don't have the votes to actually do anything. The question is not "what should we be doing" but rather "what should we be talking about". Preparing the future.
There is way too much "talking about what we should be doing" instead of actually working with the other side (both sides are guilty of this by the way) to actually get things done.
Appreciate the back and forth
The problem, Robert, is, "Work on what?"
The Dems were completely shut out of the writing of the bills in both Houses. (Of course, most Republican Senators were also shut out, as the leadership worked entirely behind closed doors.)
The only way to get anything done is in public. Nobody trusts anyone, after the way the repeal (and replace??) bills were crammed through, so the onus is on the leadership to make the necessary gestures.
As I recall the ACA was passed without a single Republican vote because all the things they wanted were ignored while the bill was crafted "out in the open" - not all that different here.
I do agree that no one trusts anyone Republican or Democrat in Congress and that is sad for the country
As I recall the ACA was passed without a single Republican vote because all the things they wanted were ignored while the bill was crafted "out in the open" - not all that different here.
Kinda sorta true... although as I recall, there wasn't much (any?) serious Republican contribution to the ACA.
But you are correct that the ACA was a Democratic bill and law. They were then the majority. They are now the minority, so just as they had the lead back then, it's up to the GOP, now.
Let's keep in mind that Obamacare is a carbon-copy of Romneycare, which was a brainchild of the Heritage Foundation. It is a conservative form of health care, with a heavy (very heavy) private-sector role. Despite the ridiculous rhetoric of some of our conservative friends, Obama was always a center-right guy. His health-care package would not have been out of place in a Republican platform. It was rejected by the right for purely partisan reasons.
... which is another reason why, now, it's up to the right to go the extra mile...
Kinda sorta true... although as I recall, there wasn't much (any?) serious Republican contribution to the ACA.
A little more than "kinda sorta"
Because the democrats did not want to remove taxes on medical devices, or modify the individual or business mandates or anything else that came from the Republicans so the "open and cooperative" manner in which the ACA was created and passed was mostly show and little substance.
... which is another reason why, now, it's up to the right to go the extra mile...
Actually that is true only from a partisan point of view - it is actually time for elected representatives of all party affiliation (or none) to work together take responsibility for the failures of the ACA and take responsibility for the need to improve it for the people.
Again thanks for the feedback
Let me try a different approach.
What do you think would happen if the Dems tabled a bill to reform the ACA? (I'm not even sure that current House rules allow the opposition to table bills...)
I cannot imagine any action on such a bill...
Movement must start with the majority party. You are correct of course, that the majority party is often tempted to do without any input from the minority... which leads to serious trouble when (as now) the minority's aid is absolutely essential to get anything done.
Both parties are going to have to let bygones be bygones.
Totally get your point and nothing I know for sure would say you are wrong - but forget about the right and the left, the republicans and the democrats, the conservatives and the republicans - what we need is for one or two from the Republicans and one or two from the Democrats to meet for dinks and draw up a give and take list of items on a bar napkin which neither side likes in total but from which each side gets a couple of things it wants. And then each of them convinces a couple of their colleagues and so on and so until we actually see something get done on capitol hill.
For instance;
the democrats want no reduction in Medicaid spending and the republicans want am elimination of medical device taxes
the republicans want to eliminate the individual and business mandates for ACA and the democrats want negotiated lower prices for medicines (similar to Tricare and medicare) for all and continued funding for Planned Parenthood.
Are you getting what I am saying the left and the right are going to have to swallow some things that they do not want to get some things that they do want.
The problem is that both sides are letting their distorted views of "perfect" on this issue get in the way of beter.
the republicans want to eliminate the individual and business mandates
This is the kind of thing that makes life difficult. The mandates cannot be eliminated. They are essential to keeping the risk pool reasonably balanced.
When Republicans call for an end to mandates they either don't understand the mechanics of health-care, or they're being hypocritical, calling for something that pleases the Faithful, even though they know it can't be done.
Every health-care system in the world has some form of mandate. No "universal" system can do without.
bob
It is the starting point, perhaps rather than eliminated they are changed or if the mandates must stay (which many people millennials come to mind do not endorse) then the democrats would give on something else that the republicans want.
Negotiation that start from a point of things that cannot or will not be changed or started or stopped are likely doomed to failure (as we have seen) everything needs to be discussed and as I said the democrats and the republicans are going to need to give in and accept things that they do not like even a little bit.
It is the starting point, perhaps rather than eliminated they are changed or if the mandates must stay (which many people millennials come to mind do not endorse) then the democrats would give on something else that the republicans want.
What the millennials want is irrelevant. This isn't a question of what people like; it's mathematics.
If the other side in a negotiation wants to eliminate gravity, must I give up something to allow gravity to remain? That's what "eliminate the mandate" is: putting gravity on the bargaining table.
Your example of the medical device tax is better. I really do not know the whys and wherefores of that tax, but I have never heard that it is critical in the same way that the mandate is.
What any voter wants is relevant - that is what this country is built on the value of the individual.
Some things are optional, some are not. Having universal health-care is a choice... but once that choice is made, the mandate is not an option. It is as inevitable as gravity. Saying "we want to eliminate the mandate" is equivalent to saying "we want to eliminate health-care".
It's unreasonable to open a negotiation with a requirement to eliminate the object of the negotiation.
This is important. All three legs are necessary. Take any one of them away and the structure collapses. Unless the objective is to sabotage the system, their existence is not negotiable.
Their modalities are negotiable. In particular, the connection between the mandate and the subsidies...
The thing that must be accepted, though, is that there are limits on what can be done, regardless of how much someone wants it.
Reality is harsh...
You continue the absurd - the ACA in its current structure cannot exist without the mandate - I agree with that.
But contrary to what many think the ACA is not the only way to structure health care. What if there was a significant expansion of Medicaid to better serve the lower income urban and rural citizens and a lowering of the medicare age to 55 to better serve the more elderly and disabled citzens leaving the higher earning upper middle and upper class to choose the insurance they want or don't want on the open market.
An approach like that could lead to real reform and improvement in health care in the country
Or both sides can dig in and argue their own positions to absurd levels and nothing will change and the current ACA will get worse and worse and harder and harder to fix
Well... We'd best not flog this poor dead horse much further...
Personally, I'd be very happy with "Medicaid for all". By far the best solution. The problem is to pay for it. Again, I would be very happy with an across-the-board tax hike (preferably skewed toward the high end). But I can't see anything like that any time soon, with the "reduce taxes" GOP in power.
The ACA was the result of a great deal of negotiation. (Or sausage-making, if you prefer...
) Politics is the art of the possible.
Good conversation. Thanks.
If the other side in a negotiation wants to eliminate gravity, must I give up something to allow gravity to remain? That's what "eliminate the mandate" is: putting gravity on the bargaining table.
A perfect example of reductio ad absurdum and a contributing factor to little getting done in Washington and a great detriment to good discussion
obamacare is a scam that hurts many more than it helped--it ruined the health insurance of 30 million to help aprox 4 million-- that doesn't even make rational sense--hell no--obamacare was about power and taking control, the consequences be damned..dems have never given a shit about rising premiums beyond what people could afford NEVER..
why in the hell should the gov be responsible for sending out notices and reminders--hell the insurance co can do that--are the people that signed up for it so stupid they don't know when it starts or expires ?---why in the hell should we taxpayers be paying for "navigators" or marketing insurance co plans..BS..
i want nothing short of a full repeal--i don't want repubs to work with dems on this--they created this stinkin mess, they sure as hell can't be allowed to "fix it"..they will just throw good money after bad and premiums will continue to skyrocket..dems want the taxpayers to be the piggy bank of insurance co,...agian BS..
if any single piece of legislation made me hate dems and promise myself to never ever vote for one again, i don't care who he is, in my life it was obamacare...
cokie roberts is a friggin reporter, she isn't any kind of expert, just a mouth peice for obama and his policies.
Well that is obviously (in case you missed it) not going to happen but I do appreciate you sharing the rhetoric
I think it's pretty obvious that katlin hates democrats down to her DNA, Obamacare or not. Her bias makes her opinions on politics about as important as Dylan Roof's opinions on race.
I did seem to see a constant thread in her posts, but I hadn't yet figured out what it was...