Morning Jolt
. . . with Jim Geraghty December 18, 2013 A Bad Day, Even by the Standards of Obamacare's Bad Days President Obama probably can't wait to get away on that 17–day vacation. Because Obamacare just continues to careen from success to success: Some frustrated consumers are sending premium payments to insurers who have never heard of them. Others say they will pass up federal subsidies and pay full price through insurers, while still others have given up altogether on the promise of health insurance by Jan. 1. Consternation and confusion over applications sent through the federal HealthCare.gov website continue into the last seven days before the Dec. 23 enrollment deadline. Consumers with health issues are particularly nervous about the prospect of not having insurance at the start of the new year. Federal assurances last week about a "special enrollment period" for people whose applications have been hung up on the site are little comfort as neither insurers nor consumers have any idea how this will work and who will qualify. The Department of Health and Human Services recommends people call its help line with questions and concerns about applications on HealthCare.gov. But that suggestion is also proving less than helpful for many. … "Logic tells you I'm the target population for the law," said Nelson, a Lombard, Ill., resident and Affordable Care Act supporter. But when people seek help from the call center, "you're just being shuffled back and forth nobody owns the callers." Experts are divided on another possible solution for those hanging in the balance: sending premium payments before bills arrive from insurers. Sentara Health, which offers the Optima health insurance plans for Virginia on HealthCare,gov, is hanging onto payments it can't match with new customers yet. But Aetna warns that consumers should wait until they get a bill in the mail before writing any checks. That's a heck of a strategy for getting insurance: "Pay and pray." Oh, hey, more bad information on the sites, too: In the latest round of difficulties with Obamacare in Wisconsin, plans offered by at least three insurers temporarily disappeared from the online insurance marketplace last week. Before they came off the federal HealthCare.gov website for about a day, some of the plans from one company posted incorrect information about deductibles, according to the insurer. Oh, hey, more sudden resignations of state directors: MNsure's top official resigned Tuesday following a Watchdog Minnesota Bureau report that she took a two-week Costa Rica vacation in late November, during the rocky rollout of the state $150 million health insurance exchange. April Todd-Malmlov's abrupt resignation came during a closed emergency session of the agency's board of directors. Subsequent reports revealed that Todd-Malmlov was accompanied on her tropical getaway by Jim Golden, Minnesota's Medicaid director, raising possible conflict of interest and other concerns. Oh, hey, more broken promises of imminent fixes: Private health insurance exchanges still are not able to directly enroll consumers in subsidized health plans offered through Obamacare even though the government has said problems doing so should have been cleared up weeks ago. Executives from three online health exchanges that contract with both insurance companies and government agencies to enroll consumers eligible for federal subsidies in marketplace plans say the process still isn't ready to go and that more work remains. This despite several promises from government officials that technical fixes have been made to allow for business to be conducted on those sites, which are alternatives to the troubled HealthCare.gov website and health exchanges sites run by states. And Maryland may have to scrap its state exchange entirely: The pace of enrollments is still far too low. If the exchange is able to replicate its best weekday and weekend performance during every one of the 104 days between now and the end of the open enrollment period on March 31, Maryland will still only achieve about three-quarters of its goal of signing up 150,000 people with private coverage. The site may be better, but better isn't good enough. Under those circumstances, the question raised by Rep. John Delaney, a Montgomery County Democrat, about whether it would be better for Maryland to scrap its effort to build its own exchange and instead join the federal one has merit. Indeed, Gov. Martin O'Malley acknowledged on Monday that the option — and all others — remain on the table. That's a hard possibility for Governor O'Malley to acknowledge. Under his leadership, Maryland was one of the most aggressive states in the effort to build out its own exchange — a strategic decision that appears in retrospect to have involved no small amount of hubris and political ambition. Walking away now from all that effort and tens of millions in expenditures would be particularly embarrassing. But other than all that, Obamacare had an okay Tuesday. Nah, I'm just kidding. There's more bad news. Oregon Suddenly Realizes the Horse Comes before the Cart Crazy idea, fellas: build a product and distribution system that works, then start advertising. Oregon did it the other way around. You know those quirky, hipster ads with the "Live Long in Oregon" jingle you can't get out of your head? They're going away… for now. Bruce Goldberg, acting executive director of Cover Oregon, said during a Monday press conference that the ads will be on hold while the agency focuses on getting people enrolled. "We think it's appropriate to hold off on any further advertising," he said, noting the agency has pulled most of the ads while keeping some billboards. Critics of the quirky, vague and expensive ads will likely rejoice. The ad campaign was originally slated for about $10 million, but then officials doubled it to $21 million in October. Of course, this applies to almost all of the advertising and promotion for the Obamacare exchanges, doesn't it? Until the whole darn thing is working, end to end, the way it is supposed to, why is anyone spending a dime to promote this dysfunctional contraption? Because the plan is to spend a hell of a lot more than a dime: Now that the Obamacare website is working you can look forward to the next stage in President Obama's health-care overhaul: the media blitz. The trade group Television Bureau of Advertising, known as TVB, is saying that the money spent on local television ads by health insurers next year will jump to $500 million, more than double its 2012 total of $216 million. Speaking of advertising for the exchanges . . . Obamacare Finds the Poster Boy It Always Deserved 
Hmm. Nope, nope, and nope, pal. Where to begin? That appears to be a plaid adult onesie, and this is really testing my libertarian live-and-let-live limits. I suspect there's a reason grown men don't usually wear onesies. Probably something to do with zippers and midnight trips to the bathroom, and how you really don't want anything down there getting caught when you're half asleep and zipping up. By the way, if you're in the market for a plaid adult onesie, apparently they cost $69.95. What you wear to bed is your business, but that seems like a lot of money for something you sleep in. Of course, he's not sleeping in that; he's having hot chocolate and discussing health insurance. (Wonder if Michelle signed off on the hot chocolate.) It's probably fair trade Mexican hot chocolate. It's spicy, Ibarra. Hard to find but "he knows a guy." (This is the only point where my mockery is mixed with a bit of envy.) He appears to be raising his eyebrow and smirking a bit, as if there's someone directly to his left who he thinks should be quite impressed with him at the moment. Maybe this person just checked out the closet of his Brooklyn apartment and noticed all of the Urban Outfitters, Ambercrombie & Fitch, and American Apparel clothes -- this is after he's mentioned to his guest his disdain for "blind consumerism." Lots of "skinny jeans," of course. He undoubtedly has already mentioned that he has a lot of vinyl records of a bunch of bands you've never heard of, or the early work of your favorite bands "before they went mainstream." He doesn't actually need those glasses. He just wears them because he likes the way they "frame his face." Obviously, he's going to be discussing health insurance with someone. He's wearing his watch, which seems a little odd. Christmas lights -- er, wait, it's an Obamacare ad, probably "Holiday Lights" -- are up on the relatively bare walls. I'm definitely getting a "Pottery Barn Leather Sofa" vibe, which retails for about $2,999. If you're plunking down $70 for your pajamas, you're probably not going to be that horrified by the prices on Healthcare.gov. John Sexton notices: 
Oh, my money is on the guy from Big Bang Theory once they throw down in a slap fight. Get Taxed for Not Having Insurance? Two Colorado Lawmakers Want to Help This idea will probably not go anywhere, but give these two Colorado state lawmakers points for trying: Reps. Dan Nordberg of Colorado Springs and Jared Wright of Grand Junction announced that they will introduce a bill to give a tax credit to anyone who gets fined for not buying health insurance — at an amount equal to the federal penalty under the Affordable Care Act for not purchasing insurance. The pair of conservatives are calling it the "Healthcare Liberty Act." "Many Colorado families are relying on us as their elected representatives to try to mitigate the adverse effects of Obamacare," Wright said. "Our bill is an appropriate response to the tax penalty and will help people in Colorado who simply cannot afford this expensive new government health insurance mandate." ADDENDA: NBC News, yesterday: "Seventy-three percent of Iowa Republicans have a somewhat or very favorable impression of Ryan, the former GOP vice presidential nominee from neighboring Wisconsin. The reservoir of goodwill for the House Budget Committee chairman could translate to crucial support in Iowa come 2016, should Ryan decide to make his own bid for the presidency." Politico, today: "Paul Ryan will seek to become the next chairman of the Ways and Means Committee, a move that would bring instant star power to the cause of tax reform while complicating his presidential ambitions." Watch him endorse his friend from his home state, Scott Walker.
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