Charles Gaba at ACA Signups looks at the lost insurance at work Special Enrollment Period (SEP) for Healthcare.gov.
I’ve estimated that even during the off-season (that is, outside of the official annual ACA Open Enrollment Period window), around 7,000 – 9,000 Americans typically enroll in ACA exchange coverage each and every day via Special Enrollment Periods (SEPs)…. around 2/3 do so because they lost their current coverage…and the vast majority of those cases involve employer-sponsored insurance
SEPs are typically a 60-day enrollment window during which you’re eligible to #GetCovered via your state’s ACA exchange if you have a Qualifying Life Experience (QLE), such as losing your existing healthcare coverage;…
Starting in 2017, however, under the Trump Administration, CMS started requiring everyone who wanted to enroll via a SEP to upload documentation of their QLE…and then it had to go through the verification process, in which someone at CMS would give it the OK…That’s six million people who are going to be desperately scrambling to jump through all of the hoops which CMS is placing in front of them for no legitimate reason whatsoever.
That’s one hundred times the number of people who would typically enroll in “lost my coverage” SEPs via HealthCare.Gov in a typical two-week period.
The current SEP rules and organization of Healthcare.gov is set up to handle a small fraction of the expected number of people eligible.
Chris Briem at the University of Pittsburgh has been tracking Pennsylvania unemployment claims filings:
OK, low (only in that relatively sense) Pennsylvania UI claims for Saturday do not appear to be part of a trend. Big jump up to +65K initial UI claims statewide on Sunday (https://t.co/MwVKNLHauo). 5th biggest daily # thus far and cumulative since March 15 now over 1.1 million. pic.twitter.com/xHP9GIdCmh
— chris briem (@chrisbriem) April 6, 2020
No.. Pennsylvania is not leading the way in unemployment compensation claims because things are worse here as is the common presumption in the media, but because the state has made investments in IT that means the system is no longer dependent on decades old COBOL code!! https://t.co/7mvCf29ya2
— chris briem (@chrisbriem) April 4, 2020
Down in Florida, Politico reports on the failures of the unemployment processing system as a function of design:
Privately, Republicans admit that the $77.9 million system that is now failing Florida workers is doing exactly what Scott designed it to do — lower the state’s reported number of jobless claims after the great recession.
“It’s a sh– sandwich, and it was designed that way by Scott,” said one DeSantis advisor. “It wasn’t about saving money. It was about making it harder for people to get benefits or keep benefits so that the unemployment numbers were low to give the governor something to brag about…”
The new online system was part of a series of changes designed to limit benefits. The ultimate goal — which it delivered on — was to lower unemployment taxes paid by Florida businesses. A 2011 analysis done by the Florida Legislature estimated that the changes pushed by Scott would save businesses more than $2.3 billion between 2011 and 2020.
The legal availability of benefits is merely the first step of people actually being able to use needed benefits. The decisions and systems that allow for the determination of benefit eligiblity can either be readily made accessible or an incredible hurdle designed to kneecap as many people as possible before a positive determination. The 2nd COVID law that was mostly negoatiated between Speaker Pelosi and Sectretary Mnunchin had strong language that prevented many administrative barriers from being raised or maintained if they are designed to keep people off of Medicaid. A general SEP for the ACA on Healthcare.gov has far fewer paper work validation requirements than the lost insurance SEP. Trying to force a 100,000 people through a 6,000 daily work flow won’t end well. Pennsylvania is managing its unemployment filing surge because its IT system has been recently updated while plenty of other states either have updated systems that are designed to deny claims either directly or indirectly or are operating off of legacy code bases that can’t handle the surge.
Administrative friction will create social burns.
WereBear
I made it through the filing process in NY. Now I might try before the Crack of Dawn to do the “haven’t worked” Thing.
glory b
I work for PA unemployment. People apply on Sunday more often than any other day of the week.
Fun fact, the department has been in the process of testing a system upgrade when this happened.
TS (the original)
I was a COBOL programmer back in the day, didn’t realise it was still a usable skill. Started in the mid 1960s. I am old.
Brachiator
A great point.
It may not be as simple as dealing with COBOL, but California, for example, needs to upgrade its unemployment system and its DMV. It will become even more important as we emerge from this lockdown.
ThresherK
I am going to work from home when the setup is complete. My job is, now that our office is not occupied, going to be supporting other people who are working from home.
Tangent: I’m tired of leftier-than-thous thinking they’re dunking on Hillary by retweeting her tweet suggesting Trump re-open up the Exchanges. After all the evidence about why, where, and under whom (governors who are D and not-stupid-R) this works, Trump is having none of it. The response from some people show they really don’t have their eye on the ball.
(And this is also recognizing that becoming unemployed is a “eligibility event” which allows the affected to go to the Exchange, and ups the subsidy in it.)
Kent
I think we are going to see a distinct divergence between red and blue states in administering UI and other COVID relief programs. In effect, I think a lot more Federal dollars will flow to blue states rather than red states due to the deliberately crippled social insurance programs in red states.
I applied for UI here in WA two weeks ago and it was easy and seamless. Took about 20 minutes on the web site. By contrast, my daughter lives in Arkansas and has tried 4 times to get through their online application. I’ve tried to help via FaceTime and it is ridiculous Every time she gets through the initial digital interview the system locks up at the final stage and she never gets the claim submitted.
What I EXPECT to happen is that Federal dollars are going to flow much more freely to blue states that have robust systems in place to administer this sort of thing online. Red states that have crippled their ability to provide social programs in good times are going to find it difficult/impossible to do so in times of crisis.
What this will mean is not only much more misery and pain in red states as individuals are unable to access Federal benefits. But it will also harm the overall economies in red states to a greater degree than blue states. After all, what happens to UI benefits that are provided to individuals and families? They immediately get spent in the local economy to buy food, clothing, rent, and other essentials. It is, in effect, a local stimulus.
We know that Florida DELIBERATELY crippled its UI system under Governor Scott to artificially depress their unemployment rate and reduce business taxes. I expect the same sort of thing happened in other red states, either overtly, or simply through neglect and ideology.
Some social scientists should be studying how dollars flow to red and blue states under this crisis. I think we would find some interesting trends. In effect, it will be a repeat of the medicaid expansion scenario where red states gave up Federal dollars out of ideology. Although in this case it may be less deliberate.
Brachiator
@Kent:
Great post.
Of course, people in red states should not be asking for help anyway, since they get so high and mighty about never needing a gummint hand-out.
I can see Trump trying to shovel funds at red states, although I think that his efforts will be inefficient and untrustworthy.
Duane
Examples #10001-2 of workers being denied access to benefits they’ve earned. If you do gain access to UI, food assistance, SSDI etc. they’re not nearly enough. It’s a purposely cruel system that this pandemic has exposed. Wall Street’s not worth anything without the workers that make the product. Time to demand fair treatment and an equitable share of the riches. The cruel and unjust system we have has to end.
Ruckus
@TS (the original):
I worked for a company that had an IBM midframe main computer and used COBAL, in this century. Would upgrade the hardware every so often. They wouldn’t change software because the person responsible for purchasing had no concept of computers or what they could and couldn’t do, what was reasonable and what was stupid. They had to find COBAL programers to hire to keep the shitty stuff going. They had desktops, which most used as terminals for the COBAL programs. They bought Lotus software for the desktop software because of the name and as it was crap which meant it was impossible to make it work reasonable and productivity went farther down. Also they wouldn’t pay for training which helped immensely. I once had to order a half dozen computers for one of my departments and as it took about 9 months from PO to approval by the board the computers were different and I wasn’t allowed to purchase the newer stuff, even as they were better, faster and cheaper. I blame that company for making me bald by causing me to pull out every last hair. Best day was when I gave the CEO notice.
Duane
@Brachiator: The one thing Trumpov was supposed to be good at was spending money. Turns out he can’t even do that right.
Ruckus
@Duane:
The decades long accession of the MBA mentality in business needs to come to an end. The concept that the people that make a business successful can be replaced like a box of kleenex, that they are brainless chunks of nothing has to end. I say that as a person who used to be an employer, who spent lots of money on machines. The people that run the machines are still the most important part of the equation. The machines do things that humans can not do. Move metal, weave cloth at high speed, whatever, whatever. But it takes people to make them do that, trained smart people. Take a business that machines can assist the computers that run at 98.6 deg and it’s still those bodies and minds that make it work. I’ve met CEOs of extremely large companies, I’ve known companies of few employees and the thing that makes all of them work is the people with paychecks, not the dipshits with stock options in the big office. Yes they need guidance, any large group does. Take the military. The officers make decisions, but it’s the grunts that take the risks and do the work. The officers knew what to do, the enlisted know how to do it. The enlisted could do the officers work, the officers could not do the enlisted work.
Ruckus
@Duane:
My expectations of trump was that the country would be far more fucked up with him blundering around. I had far less than zero expectations. He has succeeded in massively surpassing my wildest expectations of his shittyness.
Betty
@Duane: You mean like big, structural change? Too bad none of the candidates for the Dem nomination didn’t run on that idea.
Kent
The problem is that it is the wealthy and mainly white racist MAGA class that share that ideology and they are actually a minority in most red states, especially southern states with large minority populations. They just happen to control all the levers of power for a lot of reasons from voter suppression to disengagement.
So a lot of quite innocent minority folks, and ordinary poor white folks are going to be completely screwed due to the systems set up by the GOP in their states. Is that THEIR fault? Maybe a little bit, but not entirely.
That is actually why I personally favor national programs like Medicare for All over state-run programs like Medicaid. Because it gives obstructionist red states much less chance to fuck the poor
Duane
@Ruckus: People said he’d get people killed, and his racist immigration policies does that. An irresponsible war would not be surprising, but the number of deaths from his failure in this pandemic, this national disaster, will be a tragedy of Civil War proportions.
Brachiator
@Kent:
There are a lot of white people of all social and economic strata who believed the MAGA bullshit. Some are even on the record as saying that they assumed that Trump was going to help them, but fuck over people who they believed to be non-deserving.
Many of these people believe the crap peddled by the GOP that some “undeserving hoard” gets all the benefits that belong to good, hard working white folks.
And of course, in Southern red states there is a long tradition of white people accepting getting kicked in the ass, so long as nonwhite people get kicked harder.
Yeh, I can understand your point here. But there are good state programs that are models for what the federal government should adopt.
WhatsMyNym
Nothing wrong with COBOL, it’s a compiled language that’s easy to port to newer hardware.
The problem is bad/inflexible code, that should never had been used in the first place. Like a lot of websites.
Duane
“Administrative friction will create social burns. The people thought about this and after they thought about it long enough, they declared war.” (h/t The Outlaw Josie Wales)