Now that the GOP hostage-taking is done, the media is ready to pay attention to the Obamacare rollout. It is been frought with problems — access to the website, errors on the website, transfers of data to the insurance companies and it just sounds like the failure of the century. Certainly something like this *should* roll out better, but I can’t think of a tech rollout that I’ve seen that has been glitchless. If you’ve used Faceboook long enough, you know that every time they change their interface, the place is glitch-city until they fix it. Facebook is not the same as Obamacare, of course, but Obamacare isn’t the only health care initiative that had a great many issues when it rolled out. So how about a reminder?
Medicare Part D.
This was a real mess when it rolled out — and this one I had first hand experience in, helping relatives get signed up. The signup was hugely confusing — lots of plans and a tough time matching up plans to your normal med needs and once you thought you were signed up, sometimes they couldn’t find you when you showed up at the pharmacy OR they charged you higher prices than you expected. Those things definitely got fixed, but once it rolled out, this looked like another serious botch too, at first:
Medicare’s new prescription drug benefit is off to a rocky start. Dozens of plans, overloaded computers and an entirely new system have left seniors nationwide scratching their heads. The problems are particularly serious for the 6.5 million low-income Americans who get both Medicare and Medicaid — and whose Medicaid drug coverage ended Dec. 31. [...]
It’s a problem that’s cropping up across the country. Computers are correctly recognizing low-income seniors as being enrolled in Medicare drug plans, but they’re not flagged as low-income — and are being charged the regular prices.
Stephanie Altman, staff attorney with Health and Disability Advocates in Chicago, says that effectively cuts them off from their drugs. “People are walking out of the drugstore in tears, maybe they don’t have a credit card or someone to borrow from, or the pharmacist won’t put it on credit,” she says.
It’s putting pharmacists in a difficult situation, says Tom Clark of the American Society of Consultant Pharmacists. “The pharmacy personnel are concerned that they may not get correctly reimbursed for the medication. And they may not be able to bill and get reimbursed later, after the medication is dispensed,” he says.
This article from Georgetown (comparing the ACA rollout with Medicare Part D) provides an excerpt from a Washington Post article that reported on the Medicare Part D launch:
The rollout of the new Medicare drug benefit has been anything but smooth. At a news briefing yesterday, Mark B. McClellan, head of the Centers for Medicare and Medicaid Services, provided a how-to demonstration of the much-awaited Medicare Prescription Drug Plan Finder, which he said would be available on www.medicare.gov by 3 p.m. It wasn’t. … Problem is, the Medicare folks have had some trouble getting the tool up and running. The original debut date was Oct. 13, but officials delayed it, citing the Jewish holiday Yom Kippur. Next it was promised on Oct. 17, but that day, too, came and went without personalized plan comparisons being available. Late in the month, McClellan told reporters that the feature definitely would be ready before Nov. 15, the date when seniors can begin signing up for the drug benefit. Yesterday [November 8], McClellan announced that the time had come. … But the tool itself appeared to be in need of fixing yesterday. Visitors to the site could not access it for most of the first two hours. When it finally did come up around 5 p.m., it operated awfully slowly.
What happened in Massachusetts is pretty much exactly what’s happening right now with Obamacare. After the law went into effect in Massachusetts, state offices were totally overwhelmed by the number of people clamoring to sign up for insurance, or what the state’s Medicaid director dubbed the “stress of success.” Lost paperwork, computer glitches, confusion over who was eligible for what, and not enough staff to handle the workload meant that in those early days, consumers could wait several months after submitting an application to finally get coverage. So many people were trying to enroll in the expanded Medicaid program that the Medicaid agency ended up with a months-long backlog of applications. In the first two months, only 18,000 of more than 200,000 potentially eligible people had successfully signed up through the connector, according to Jonathan Gruber, an MIT professor who helped design the Massachusetts system and served on the Connector board. And all of that happened in a state with only 300,000 or so eligible applicants and without a well-funded opposition trying to derail the law at every turn.
But guess what? Eventually the kinks got worked out and people got covered. Enrollment opened in October 2006, and by the deadline for getting mandatory coverage, July 1, 2007, the Boston Globe reported, 20,000 more people had signed up for insurance on the exchange than the state had expected—12,000 of them in just the two weeks before the deadline. Total enrollment went from 18,000 in December 2006 to 158,000 a year later, says Gruber. Today, Massachusetts has the lowest rate of uninsured residents in the entire country—less than 4 percent—and polls show that people are generally happy with how everything worked out. The conservative Massachusetts Taxpayers Foundation has called the state’s health care reform law “a well thought-out piece of legislation.”
Which isn’t to say that the current issues with the tech side of the Obamacare rollout aren’t serious, because they are. It is to say that the GOP jumping up and down about this implementation were not especially concerned about the difficulties in rolling our Medicare Part D or the Connector in MA. At least, they weren’t calling for either of these programs to go away, and in fact, they were mostly invested in making the kind of legislative changes that would help these programs be successful. They won’t be interested in making Obamacare successful, because making sure that poor working people have access to healthcare is against their religion.
But these problems aren’t unique to Obamacare, even though your media will work to convince you of that.