Sherrod’s Softball

Kathleen Sebelius, Secretary of the Department of Health and Human Services, was back on Capitol Hill today to testify about the Affordable Care Act and the troubled healthcare.gov website.  According to NBC News, was “grilled” by both Democrats and Republicans in the Senate Finance Committee.

Except, apparently, for Ohio Senator Sherrod Brown.  If the rest of the hearing was a grilling, Senator Brown must have been in charge of the backyard softball game.  NPR reports that Senator Brown asked Sebelius to talk about the law’s legacy:  “What are people going to say about the Affordable Care Act in five years and in 48 years?”

Huh?  The Secretary has presided over the most disastrous rollout of a federal program in living memory, the country is currently grappling with the fallout from that failure and other issues posed by the Act, and Senator Brown is channeling his inner Oprah and asking Secretary Sebelius to speculate about a legacy?

In fairness, these kinds of politicized questions aren’t unusual.  As the NPR story also reports, a Republican Senator used his entire allotment of time to make a critical speech, without asking Secretary Sebelius a single question.  What’s the point of having Cabinet officers testify if they aren’t asked questions?

These partisan antics are the kinds of things that drive me nuts about Congress.  There are dozens of entirely legitimate questions to ask Secretary Sebelius about how this landmark statute is working, why the website wasn’t better designed, and other topics of great interest to Americans who are trying to understand why the rollout of “Obamacare” could be so mishandled and what they must do to comply with a complicated statute.  Can’t members of Congress lay aside their party affiliations and their desires to make speeches, even once in a while, actually ask questions that should be answered, and get answers that will help them to decide how we can move forward?

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Public Sector Vs. Private Sector

You’ve got a new product that you want to roll out to the American public.  It’s hugely important, and hugely controversial.

You’re trying to appeal to young people.  You want them to sign up for your product.  You know that their participation is crucial if you want your product to be a success.

You also know that most of the people in your target demographic are tech-savvy folks.  If they are going to sign up, they are going to do so through a website.  After all, it’s how they buy music, and concert tickets, and other things that they want.  If your new venture is going to be successful, it’s essential that you have a website that is user-friendly.

So, who do you select to manage and supervise your roll out and website development?  A computer geek who has developed successful, accessible websites for google, Amazon, and other lucrative internet businesses?  A tech wizard who is intimately familiar with cutting-edge technology and user interface concepts?

Or, the ex-governor of Kansas?

Toto, I don’t think we’re in Kansas anymore!

Some Explaining To Do

The House Energy and Commerce Committee has scheduled a hearing on Thursday on the federal government’s health exchange website.  They’ve asked Kathleen Sebelius, the Secretary of the Department of Health and Human Services, the agency that is principally responsible for the website, to testify.  Sebelius has declined, saying she is not available to testify.

It’s not clear to me why Sebelius has declined the request.  The CNN story linked above doesn’t say Sebelius has a conflict on her schedule.  Instead, the HHS spokesperson said:  “Given that the government was shut down until today, we were given a very short timeline to respond to this request.”  Does that mean that the Secretary of HHS needs more than a week to be prepared to answer questions about how the website is working?  If so, perhaps the problems with the website are even more extensive than has been reported.

I hope Sebelius’ response to the request doesn’t mean that the Obama Administration is going to stonewall providing meaningful information about the operations of all of the health exchanges and the status of the enrollment process, and I hope that Sebelius reconsiders her decision and decides to appear.  The websites are a crucial component of the Affordable Care Act, and the federal government has already spent hundreds of millions of dollars on them.  Taxpayers and citizens have a right to know how the system is performing.

In my view, it’s also in the interest of Sebelius and other administration officials to explain what is happening.  If there are problems, identify precisely what they are and describe what is being done to fix them and when the fixes will be completed.  If the enrollment process has some successes to its credit describe what those are.  No doubt friendly members of the House Energy and Commerce Committee will be happy to ask some questions designed to fully elicit the good news, just as diehard opponents of “Obamacare” will be asking tough questions.

As a matter of good government, we should all support requiring administrative officials to promptly testify when Congress calls.  We would all be better off if Congress exercised more oversight over our vast administrative state — from its surveillance programs, to its spending habits, to its error-plagued websites, and beyond — and regularly subjected agency heads to tough questioning about federal programs.  I can’t believe there is anything on Secretary Sebelius’ schedule right now that is more important than appearing before Congress and providing a credible explanation of what is happening with Healthcare.gov and the other health exchange websites.

The “Glitches” Continue And The Concerns Grow

The continuing saga of the federal government’s Affordable Care Act website is worth following, because it is telling us a lot about how modern government works, and doesn’t work, and what we should believe.

Most people, including me, have focused on the access issues with the Healthcare.gov website — that is, the fact that there are ongoing reports that people simply cannot get on the website and use it as intended, and whether the design of the system in fact works against that.  But there are other issues, too.

For example, how complete and accurate is the information the website is collecting?  Anyone who has filled out a health-care application knows that a mass of information must be provided.  A recent article quoted industry sources who estimated that only one in 100 applications completed on the website contain enough information to actually enroll someone in a plan — which of course is the entire point.  As the article notes, much more serious problems could be coming if people believe they have successfully enrolled, only to be told later that the information they provided was insufficient or lost.

And speaking of information — how secure is the data those lucky people who have been able to use the website have provided?  Health care information and financial information is extraordinarily confidential.  Given the apparent design flaws with the website, why should anyone have great confidence that the designers at least got system security right?  Given the coverage of the problems with the website, are legions of hackers around the world targeting it as an easy potential source for personal information, like Social Security numbers and credit card data?

And finally, there is cost.  Some sources have tried to piece together government contracting data to determine how much the Affordable Care Act websites have cost the taxpayer.  The Washington Post says about $400 million has been committed to the health care exchanges.  The Digital Trends website estimates the cost so far is more than $500 million, with a total cost of more than $2 billion expected.

With costs like this, it’s fair to ask whether we are really getting our money’s worth.  On Thursday, Secretary of Health and Human Services Kathleen Sebelius visited Pittsburgh as part of a nationwide campaign to tout the exchanges.  She assured the audience that the “glitches” were being addressed and the system is getting better every day.  Event planners had brought more than 20 certified health care application counselors to meet with uninsured people, but even the certified counselors couldn’t access the Healthcare.gov website.  So, who do you believe — the bureaucrat who says the system is improving, or the fact that even computer geeks can’t get it to work?

Government By Waiver

One of the more troubling aspects of the “health care reform” legislation enacted into law last year has been the ability of companies and unions to get waivers that relieve them from having to comply with certain aspects of the law.  The waivers relate to provisions of the law that prevent plans from using high deductibles or low annual limits to control benefits.  Unfortunately, many plans need such provisions to manage costs; without those provisions, employers and unions would need to jettison their plans as unaffordable.

The Department of Health and Human Services may waive those provisions for certain employer and union plans.  The HHS website explains that, to be eligible for a waiver, the plan must certify “that a waiver is necessary to prevent either a large increase in premiums or a significant decrease in access to coverage” and must inform plan enrollees “that their plan does not meet the requirements of the Affordable Care Act.”  Whether to grant the requested waiver then seems to be entrusted to the discretion of the HHS and its Secretary, Kathleen Sebelius.  To date, 733 company and union plans, covering 2.1 million Americans, have received waivers.

This concept of “government by waiver” is troubling.  I’m skeptical of the claims of some conservatives, who believe that the waivers are being handed out as rewards for prior political support.  I do, however, question a process that allows unelected bureaucrats to grants waivers from a law that is supposed to apply to everyone.  The waiver process is symptomatic of the accumulation of power in the Department of Health and Human Services that seems to be the true hallmark of the “health care reform” legislation. If the law remains in force, Americans will need to get used to the idea that HHS will be making all kinds of decisions that have a direct impact on our health care.

In addition, what does it say about this hastily drafted, poorly considered law that more than 700 plans have certified that one of the law’s provisions will either vastly increase costs or cause coverage to be sharply curtailed?  Does anyone doubt that, if all American businesses had been aware of the possibility of obtaining waivers, that 700 number would have been multiplied by a significant factor?  It also is worth noting that the waivers aren’t limited to small, Mom and Pop plans.  To the contrary, some of the plans that have received waivers have hundreds of thousands of participants.  According to the HHS website, the plans that have received waivers include the United Federation of Teachers Welfare Fund (351,000 participants), CIGNA (265,000 participants), Aetna (209,000 participants), and BCS Insurance (115,000 participants).  Given these waivers, how can the proponents of the “health care reform” legislation continue to contend that the legislation will neither increase costs nor reduce coverage?  By granting the waivers, the bureaucrats at HHS are admitting that the exact opposite will occur if the law is enforced as written.

Phony Figures

Today Kathleen Sebelius, the Secretary of the Department of Health and Human Services, released a report that concludes that up to half of all Americans below age 65 — 129 million in all — have some kind of “pre-existing condition” that might otherwise cause them to be denied health insurance coverage.  The report, which was released on the day the House of Representatives began debate on a bill to repeal the “health care reform” legislation, notes that under that legislation those individuals with “pre-existing conditions” cannot otherwise be denied coverage, or be charged significantly higher premiums.

HHS Secretary Kathleen Sebelius

As is the case so often these days, this report seems to be motivated almost entirely by political concerns — in this case, trying to make a case for retaining the “health care reform” legislation.  Consider the study itself.  It concludes that “50 to 129 million (19 to 50 percent of) non-elderly Americans have some type of pre-existing health condition.”  Can’t we expect a bit more precision from our governmental studies than a margin for error of 79 million Americans?  No doubt the political manueverers at HHS realized that the news media would report the higher number — which is exactly what has happened.  The headline on the ABC News website report on the study, for example, is:  “Half of Americans Have Pre-Existing Health Conditions”.

And consider, too, the fact that the report itself notes that “as many as 82 million Americans with employer-based coverage have a pre-existing condition.”  In other words, those conditions — if they exist at all — have not stopped those 82 million Americans from getting and keeping insurance through their employers.  If the insurance companies were really as evil as Secretary Sebelius and the supporters of “health care reform” legislation argue, how could that have happened?  Why didn’t the greedy insurance companies immediately eliminate coverage for those 82 million Americans?  The fact that, according to the government, as many as 82 million Americans are maintaining health insurance notwithstanding their purported “pre-existing conditions” refutes one of the basic arguments for having “health care reform” legislation in the first place.

Finally, the report shows, I think, that our federal government really doesn’t have much respect for the common sense of Americans.  Does anyone honestly think that if half of all Americans under 65 really had pre-existing conditions that made it impossible for them to get private health insurance we would see the kind of vigorous opposition to the “health care reform” legislation that has continued, unabated, despite the best efforts of the news media and the federal government to quash it?