Articles on the implementation of ObamaCare.

“Colorado’s 2.0 “Kentucky-style” system that is supposed to simplify the way people get health insurance won’t be ready until days before the Nov. 15 open enrollment starts.
And as Colorado’s health exchange enters its busy season, a third “chief” has announced she’s leaving Connect for Health Colorado. Chief Executive Patty Fontneau departed in August. Chief Financial Officer Cammie Blais left two weeks ago. And Chief Operating Officer Lindy Hinman announced her resignation and plans to leave next month after open enrollment begins.”

“On November 15, open enrollment in the Obamacare exchanges begins again. Before the second act of our national healthcare drama commences, let’s review what we’ve learned in Act I.
For starters, everyone now knows that federal officials are challenged when it comes to setting up a website. But they’ve demonstrated the ability to dole out a huge amount of taxpayers’ money for millions of people signing up for Medicaid, a welfare program. And they’ve proved they can send hundreds of millions of federal taxpayers’ dollars to their bureaucratic counterparts in states, like Maryland and Oregon, that can’t manage their own exchanges. But there are many other lessons to be gleaned from Year One of Obamacare.”

“HealthCare.gov, the website for health insurance under President Barack Obama’s health care law, has been revamped as its second enrollment season approaches. But things are still complicated, since other major provisions of the Affordable Care Act are taking effect for the first time. A look at some of the website and program changes ahead:
Old: 76 online screens to muddle through in insurance application.
New: 16 screens — for the basic application that most new customers will use. But about a third of those new customers are expected to have more complicated cases, and how they’ll fare remains to be seen.
Old: Prone to crashing, even with relatively few users.
New: Built to withstand last season’s peak loads and beyond, at least 125,000 simultaneous users. Actual performance still to be demonstrated.
Old: Six-month open enrollment season, extended to accommodate customers bogged down by website glitches or stuck in line at the last minute.
New: Shorter open enrollment season, just three months, from Nov. 15 to Feb. 15.”

“Deep down, Republicans who know health care know the truth: Obamacare isn’t about to be repealed.
But you won’t hear that in this election — and maybe not in 2016, either.
Republicans may be split on many issues, but they remain fiercely united in their loathing for the Affordable Care Act; they still see it as a terrible law, and they want it to go away. But GOP staffers and health care wonks also know that, even if they win the Senate, they’re not going to accomplish that in the next two years while President Barack Obama is still in office.
And after that? Well, think of the last time a major social program was repealed after three enrollment seasons, with millions of people getting benefits. That’s right — it hasn’t happened.”

“With the second Obamacare open-enrollment beginning on November 15th, the enrollment system’s testing begins with insurance companies this week.
Of course, last year the enrollment system testing was a real mess resulting in a humiliating Obamacare launch for the administration.
Up until now I wasn’t expecting any major problems with HealthCare.gov’s consumer enrollment system given all of the lessons learned and the new people running things.
But apparently, the administration is pretty worried about what could happen.”

“There are dozens of ways to escape Obamacare’s individual mandate tax — but good luck figuring that out come tax season.
Tens of millions of Americans can avoid the fee if they qualify for exemptions like hardship or living in poverty, but the convoluted process has some experts worried individuals will be tripped up by lost paperwork, the need to verify information with multiple sources and long delays that extend beyond tax season.
“It’s not going to be pretty,” said George Brandes, vice president of health care programs at Jackson Hewitt, a tax prep firm. “Just because you theoretically qualify for hardship, or another exemption, doesn’t mean you’re going to get it.””

“The Obama administration has already debuted its new, improved version of HealthCare.gov, but still won’t release premium rates on the website until after the Nov. 4 elections.
The Department of Health and Human Services unveiled the updated federal Obamacare exchange on Wednesday. The website is, by all accounts, in much better condition than last year.
HHS secretary Sylvia Burwell has said that the administration has put the new version of HealthCare.gov through its paces. And the administration has allowed insurers to test the site out themselves — although they made clear that insurance companies are not allowed to share their results with the media.”

“CMS says that states should reimburse Medicaid managed care plans for the Affordable Care Act’s health insurance provider fee, and says that the fee itself should be incorporated into plans’ capitation rates, however, as the firm JP Morgan notes, the agency leaves some “wiggle room” on whether states should also factor in other potential effects of the fee, such as its non-deductibility status. Medicaid Health Plans of America President Jeff Myers said CMS’ recently released frequently asked questions document provides certainty for plans, particularly in states that hadn’t yet agreed to cover those fees.
Myers said the plans are gratified CMS decided to move forward with the FAQ, and the release of the FAQ and the 2015 Managed Care Rate Setting Consultation guide suggest that CMS would like to play a more involved role in rate setting for managed care. Since plans have been asking for more transparency around rate setting, CMS’ involvement could be a net positive, Myers said. The Government Accountability Office has also said that CMS’ oversight of the rate-setting process needs improvement.”

“Healthcare information-sharing is largely stuck in neutral, according to the Office of the National Coordinator for Health Information Technology’s annual report on electronic health-record adoption, released Thursday.
While standards and services have been established to support information-sharing, “practice patterns have not changed to the point that healthcare providers share health information electronically across organization, vendor and geographic boundaries,” the report argued.
Information-sharing is seen as a key component in the move from a fee-for-service approach in U.S. healthcare to a quality of care approach, so signs that the sharing isn’t happening could spell trouble for progress toward that shift.”

“Faced with the rising costs of generic prescription drugs, health insurers increasingly are turning to tiers and preferred lists on their formularies to keep costs down. Those strategies previously were used only for brand-name and specialty drugs. Experts say those approaches will increase out-of-pocket costs for patients and could make them less likely to adhere to drug regimens.
For years, insurers have encouraged patients to choose generic drugs because they were less expensive than their brand-name counterparts, and most prescription drugs currently used are generics.
But over the past year the cost of generic drugs has skyrocketed, including for products that have been on the market for many years. A study by Pembroke Consulting comparing CMS data for average generic drug acquisition costs between July 2013 and July 2014 found that half of the generic drugs listed rose in cost, with the median increase nearly 12%. Some drug prices saw extreme increases. For instance, the per-unit price for a 500 mg capsule of tetracycline, a common antibiotic, increased from $0.05 cents to $8.59, a more than 17,000 % increase.”