......I can’t excerpt all the parts that are noteworthy, although if you’ve been following news about the Healthcare.gov apocalypse you already know some of what Levin reports — the login fiasco is a result of HHS demanding that people create an account before seeing what plans cost, the system still can’t calculate subsidies correctly (which means some people are getting the wrong price when they buy coverage), the “back end” communications between the federal data hub and private insurers are a shambles, and the chaos will only increase if HHS solves the login problems without solving the back end problems. (Imagine insurers having to sift through 5,000 garbled enrollments per day instead of 50.) What about the timeline, though? Per Levin’s sources, D-Day will come sometime in mid-November.
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..........One key worry is based on the fact that what they’re facing is not a situation where it is impossible to buy coverage but one where it is possible but very difficult to buy coverage. That’s much worse from their point of view, because it means that only highly motivated consumers are getting coverage. People who are highly motivated to get coverage in a community-rated insurance system are very likely to be in bad health. The healthy young man who sees an ad for his state exchange during a baseball game and loads up the site to get coverage—the dream consumer so essential to the design of the exchange system—will not keep trying 25 times over a week if the site is not working. The person with high health costs and no insurance will. The exchange system is designed to enable that sick person to get coverage, of course, but it can only do that if the healthy person does too. The insurers don’t yet have a clear overall sense of the risk profile of the people who are signing up, but the circumstantial evidence they have is very distressing to them. The danger of a rapid adverse selection spiral is much more serious than they believed possible this summer. They would love it if the administration could shut down the exchange system, at least the federal one, until the interface problems can be addressed. But they know this is impossible.