Obamacare Goes Live Today: Here Is The Next Big Problem

Tyler Durden's picture

Obamacare officially went live at midnight. This means that 2.1 million Americans (the latest enrollment number provided by the administration) will be given a chance to exercise their new plans at hospitals and clinics across the country (it was unclear what the latest number of Americans kicked off their existing plans was most recently: the tally was 4.0 million as of mid-November and it is fair to assume it has risen since then). And then the real glitches will begin.

We reported two weeks ago that navigating the healthcare.gov labyrinth successfully and "signing up" for Obamacare is one thing; actually activating coverage by making a payment is something totally different. We added that "if people don’t pay by Dec. 31, insurers may end up stuck with a disproportionate number of sicker and costlier customers."

It is this "shock" realization that one's Obamacare plan is not active until after the healthcare service has been rendered, that may hit as many as 50% of all enrollees, which means that of the 2+ million Americans who believe they have coverage, up to 1 million is about to be served with a bill which they can't afford. This also happens to be the main story across various media outlets today.

First, The Hill:

Enrollment deadline delays and processing errors at HealthCare.gov have been an administrative nightmare for insurers, and may leave some consumers discovering that they don’t have the insurance they thought they purchased when they show up at the doctor’s office. 


It’s also likely that some people think they have insurance under ObamaCare but do not because they have yet to make their first premium payment. Until they do, they aren’t actually insured. 


In Washington and Nevada, only about 50 percent of enrollees have made their first premium payments. Those are the only states that provide the breakdown.


The biggest risk now is people thinking that by picking a plan, that they’re insured, when in fact final step is paying the premium,” Larry Levitt, a senior vice president with the Kaiser Family Foundation, told The Hill. “I haven’t seen good numbers on how many people are paying premiums, so that to me is the uncertainty.”

Next, it's Reuters' turn:

"It will be difficult for us to actually verify coverage - that's my concern," said Dr. William Wulf, CEO of Central Ohio Primary Care, which has 250 primary care physicians.


The task could be made more difficult by decisions by the U.S. government and many states to push back enrollment deadlines toward the end of the year, and to allow some patients well into January to pay for coverage that is retroactive to the start of the year.


The late deadlines mean that many enrollees who seek care initially may lack insurance cards or other proof of coverage. Wulf said his physician offices will assume that an existing patient is covered if they claim to be when they come in for appointments and their coverage cannot be verified immediately. But if they require expensive tests, such as MRIs or heart-stress tests that can cost up to $700, the Ohio practice will check with insurers first to make sure the patient has coverage.


Similarly, Dr. Andy Chiou, CEO of Peoria Surgical Group Ltd in Illinois, said that if the practice finds a "significant minority" of its patients do not have coverage when they believe they do, it might delay elective surgeries for patients until their insurance is confirmed.


"For the protection of patients and us, we'll have to say, 'Sorry, you don't have insurance,'" Chiou said.

That means 1 million Americans, some of whom are very ill, are about to get a big new year's disappointment from their doctor.

To be sure, some stop gap measures have been implemented: the Hill reports that some big insurers "will allow consumers to pay their first premium by Jan. 10 and still be insured on Jan. 1. In addition, Walgreens and CVS Pharmacies announced this week that they will provide up to a month of no-cost medications to consumers that haven’t received their ObamaCare IDs yet, but can prove they enrolled." However, for those who expected Obamacare to be a deus ex with zero payment at all, which appears to have been the case at nearly a majority level, no temporary measures will fix the situation that there is still a payment to be made: a payment which millions simply can not afford.

Needless to say, with 2014 an election year, the stakes for the administration are huge:

For the Obama administration, the political stakes are high in ensuring a smooth transition period for coverage, particularly after the website's problems damaged the popularity of the Democratic president and the healthcare overhaul, his top domestic achievement.


Republicans who have called Obamacare a costly program that will rob many Americans of insurance choices have said they will make Obamacare's problems their top issue in the November 2014 elections, when control of Congress will be at stake.


White House health policy adviser Phil Schiliro said on Tuesday that because of the intense focus on Obamacare, "problems that have never gotten attention before will get some attention now."

The Hill adds:

There’s little doubt the success of the healthcare law will be a big factor in Democratic efforts to retain the Senate, where Republicans need to gain six seats to win back a majority.


Doing so would be a huge blow to Obama’s remaining years in office, virtually assuring him lame-duck status through the rest of his term.


So there’s a lot at stake for the administration to ensure things go smoothly, starting on New Year’s Day.

At this point, some opt out to fall back to a naive belief that things will be well:

John Holahan, a fellow at the non-partisan Urban Institute, said the idea that people will be blindsided is foolish. “If they don’t pay they don’t have insurance, that’s part of the deal, you’re not really enrolled,” he said. “But I assume anyone who goes through the trouble of enrolling will go ahead and pay.”

Actually, most who have the free time to go through the trouble of enrolling likely don't have a source of disposable income.

A more realistic conclusion comes from Joe Antos of the conservative American Enterprise Institute, who predicted the flood of applications would be too much for the administration and the insurers to handle before the newly covered head out to exercise their plans. “There’s no way the insurance industry could hire enough people to process all that paperwork if the data was coming in correctly, and it’s not,” he said. “I think most people who think they have coverage will find some difficulty early in January."

We will find out in the coming days if the next big embarrassment for the administration will unfold and if Obama's ratings will tumble to fresh record lows as a result.

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Sudden Debt's picture

Well there's 2 options:

1. you quit your job and it becomes free

2. you get a second job to pay for it, noting that that will also trigger even higher fees.

Unpopular Truth's picture

Sudden Debt: Right on! Also, #2 means higher income taxes as well, making it a win-win for the administration ;)

Richard Chesler's picture

Free onesie pajamas with number 1

Deo vindice's picture

Probably the single greatest impetus to an enlarged underground economy and thriving black market ever devised.

How many people are going to want to work for 'cash under the table' and how many businesses are going to want to accomodate them?

NoDebt's picture

"Two enrollees enter, one enrollee leaves."

"Ladies and gentlemen, boys and girls..... it's DYING time."

In all seriousness and all of my typical ZH sarcasm aside, people are about to start DYING.  Real people.  Needlessly and at an extrordiary cost to everyone else who doesn't.  As with everything else this administration has touched, they'll relentlessly declare victory while reality is an obvious failure.


espirit's picture

Pay the toughest on the block "insurance", or pay a fine for not doing so.

Fucking Terrorists.

Boris Alatovkrap's picture

Dear USSA,

You are elect communist organizer from Hawai'i, er Kenya, er Indonesia, who is complete unknown and cannot is even write own autobiographical text (Bill Ayers is ghost author). What are you expect!? Then you are elect second time!? Sorry, when stupid why so surprise!? Now please stop to spy on every country, take back you pilotless avionic kill machine, and to stop flood world market with worthless petro dollar.


Rest of World

NoDebt's picture

The only rebuttal I can give to your comment (which I agree with) is this:

Obamacare NEVER enjoyed support of the American public.  Not when Obama first took office and proposed it, not when it was illegally jammed through Congress, not when it was upheld by the Supreme Court and certainly not now that the full horror is beginning to be realized.  It was never even close to 50% support on it's best day.  And we're pretty damned far from it's best day at this point, as you can imagine.

But yeah, people supporting the guy who supports the legislation they don't like and then complaining when that exact same legislation gets rammed down their throats by that exact same guy.... no, it doesn't get much more stupid than that.

Richard Chesler's picture

"most who have the free time to go through the trouble of enrolling likely don't have a source of disposable income."


markmotive's picture

Perhaps legal weed will make the need for many prescriptions obsolete?

Shops in Colorado stocking up on the sticky-icky!


Woodhippie's picture

+1 for a "sticky-icky" reference.  Goes by the name, "Devil's Lettuce" around these parts.

HardlyZero's picture

Here Is The Next Big Problem....HillaryCare ....the roots of Obamacare.    Remember your roots !   Looks like his mother...sickly pale...no makeup...wig ?



Spigot's picture

NONE of them have the mental capacity to associate who they voted for with the coming ass rape they will be getting ... pitty that.

philipat's picture

Business 1.01: A product or service is not sold until payment has been received. Of course, this does not apply to .Gov, where "Enrollment" simply means entering personal details into a (Less than secure) system. Experience in the online commerce space has shown that around 70% of items placed into the cart ("Enrollment") naver get converted into an actual sale by making payment.

Incidentally, to add to the list of options above:

3. Get sent to prison and it becomes free, together with "Board and lodging".

SonOfSoros's picture

Sorry NoDebt but the ACA did enjoy support of the American public.

Don't forget who bulk of Obama supporters are, the progressives and socialists who now form bulk of the American population. The only reason why the ACA has lost much support is as these progressives were slapped on their faces, by the harsh reality of the ACA.

Doesn't change the fact that majority of America are full of dumbasses though.

Praise the lords, I'm not there anymore. 

Popo's picture

Exactly right.   The thing is:  Americans actually thought they were voting for FREE healthcare.  They thought they were going to get a system like the UK has.   Most Americans have zero disposable income as it is.   When the reality of the ACA hit them with bills of $4000+ they suddenly realized what they had voted for.  Americans weren't thinking of CHEAPER healthcare, they wanted a freebie.   It turns out the ACA was a direct handout to the insurance and healthcare industry, and would ultimately reduce disposable income to ZERO (or less) for millions of Americans.  Now Americans are realizing how badly they've fucked up.  This will and must collapse the economy.  You can't take a family earning $50k per year and pull $4k out of their income and expect that family to consume anywhere NEAR what they were previously consuming. 

SF beatnik's picture


I eagerly await the Boris TV show on RT

nmewn's picture

"This is a big fucking deal man!" - Joe Biden

WASHINGTON (AP) — A Supreme Court justice has blocked implementation of portions of President Barack Obama's health care law that would have forced some religion-affiliated organizations to provide health insurance for employees that includes birth control.

Justice Sonia Sotomayor's decision came Tuesday night after a different effort by Catholic-affiliated groups from around the nation. Those groups rushed to the federal courts to stop Wednesday's start of portions of the Affordable Care Act, also known as Obamacare.

Sotomayor acted on a request from an order of Catholic nuns in Colorado, whose request for a stay had been denied by the lower courts.

Sotomayor is giving the government until Friday morning to respond to her decision.

This is not from the Onion ;-)

DaveyJones's picture

I'm noticing more and more stories sound like they're from the Onion


A Lunatic's picture

It is said that fact is oftentimes stranger than fiction, although the "facts" coming out of D.C. lately are mostly fiction anyhow.........

Pure Evil's picture

The Onion is the Matrix because their stories have become the New Normal.

WonderDawg's picture

You know shit is fucked up when it is so difficult to distinguish irony and sarcasm from reality.

BLOTTO's picture

Reality is their illusion


Their fiction is the reality

Blano's picture

I was actually shocked a TeleNegro appointee did that.

nmewn's picture

The feminists are gonna keep screwin around with the separation of church & state and find themselves in Sotomayor's box at some point.

Or sumpin ;-)

Zymurguy's picture

Don't believe it... Sonia is a fucking communist/statist/marxist/socialist and would never side with a religious organization.  The statists/socialists only "religion" is government and more of it.  They despise organized religion and see it as a threat to the "state".

Oldballplayer's picture

Yeah...the real power behind Barter Town was a freak and a retard.

Sounds about right.

RafterManFMJ's picture

...was a freak and HIS retard.


Hmmm...Jarret, Obama...

CuttingEdge's picture

Someone should put an Obama Death Clock (like the debtclock) online - every poor bastard casualty of the ACA fiasco and the Kenyan turd who created the situation published.

NoDebt's picture

Should we start off the count by including the civilian drone strike casualites overseas or just the domestic civilian casualties from Obamacare?

Nevermind.  I know the answer.  People getting killed overseas are never counted.  Neither is ambassador Stevens.  And, of course, US troop deaths should never be included in any count either.

JLee2027's picture

Why you could even have a tab for "Drone Strikes on Wedding Parties"

hoos bin pharteen's picture

If you think that's fun, wait till they get confirmed for benefits but the doctor refuses to accept their Obamacarepolicy.

Pure Evil's picture

The real horror begins when they find out the insurance doesn't kick in until the deductible has been met.

I hope nobody choose the Bronze plan to save money cause by the time you've met the deductible there's gonna be no change in anyone's pockets to spend on Christmas.

Woodhippie's picture

Absolutely agree ND. 

We have opted not to touch Obamacare or any other health insurance.  We go straight to the doctor on rare occasions and pay a discounted cash price.  No paperwork, no declines, no reimbersment wait, no co-pay, no deductable, no frickin' headache. 

Should say that we have no major health issues.  So I understand it doesn't work for everyone.


FredFlintstone's picture

That would undermine Social Security and Medicare thereby accelerating the death spiral.

mraptor's picture

That's how it worked in Eastern Europe when it was socialist .... it was "free" :)... but if you want healtcare you have to pay under the table... welcome to the Socialism .. in fact it was not only healthcare..but everything.. You couldn't own a bussness, but everybody was making favors and deals for cash ... behind the Iron curtain the black market could have been probably bigger than the official one


G-R-U-N-T's picture

Excuse me, as fees and taxes rise to pay for this massive unsustainable health insurance horror there will be less disposable income. Then you have Social Security, Pensions, etc.....It's obvious that this whole incompetent medling of Government as they try to control society and the economy will not end well. Expect civil unrest within the next couple of years.

Tom_333's picture

Welcome to Socialism! Forward!

Thing1Thing2's picture

3.  Obamacare is a failure.  Free loaders will demand coverage and get it from Uncle sam at no cost.

FMR Bankster's picture

Of course it's not a failure for Obama. The point was to give free health care to large numbers of people. (with the rest of us paying the freight)If you look at the original projections it was 22 million new people on Medicaid and 9 million uninsured covered by insurance they pay for. (In most cases subsidized)With half the states opting out of Medicaid they will be lucky to hit 10 million new welfare takers. (even though they work hard to force people on to Medicaid)The question I have is how many of these 2.1 million who may have signed up to pay are NEW insured and how many are just using the website and already had insurance? Looks to me like we screwed up the healthcare system for a strange attempt to increase the Democratic party voter roles. Strange thing about people is most of them would never wander next door and steal their neighbors lawn mower but if the government will pick their neighbors pocket for them that's alright.

ZeroPoint's picture

That's exactly right. All it does is directly cost shift the cost of the poor unto the remaining middle class. Rich people will pay the penalty, and go to private doctors, paying cash.


new game's picture

what if you dont sign up and don't give a shit?

what if you are healthy, live healthy and are intentionally uninsured?

what if you oppt out and laugh as you read this stupidity?

what if life is one big fucking ponzi ass joke of fools being gamed cause they are a greater fool thinking they are fucking someone else til they realize they are the mark?

Thing1Thing2's picture

"what if you oppt out and laugh as you read this stupidity?"

You be breaking the law and will be found guilty.  Obamacare has ways to terminate your life either by Lethal Injection, Electrocution, Lethal Gas, Firing Squad or Hanging.  This is why is it called the affordable heath care act.

espirit's picture


Orlando is advertising it as the "Affordable Car Act".

(and I thought I was getting a new Hundai)

new game's picture

lol/sarc off to respond-affordable meaning a penalty that far outweighs the cost of the care provided:)

HardlyZero's picture

In between ACA and the people will be the FED Melon Yellin funding.

Expect the FED Yellin to pick up the healthcare bills on a temporary basis starting in mid-2014 ( to allow for the midterm election ).

To capture the upside it will be re-named Yellin'ACA.

Neo's picture

We are all criminals now.

A Lunatic's picture

'There's no way to rule innocent men. The only power any government has is the power to crack down on criminals. Well, when there aren't enough criminals, one makes them. One declares so many things to be a crime that it becomes impossible for men to live without breaking laws.'
-Ayn Rand-