A new report from Heritage’s Edmund Haislmaier claims that the healthcare exchanges won’t encourage competition:
For the vast majority of states, the exchanges will offer less insurer competition than the state’s current individual market. Most of the insurers whose principal business is employer-group coverage appear to expect significant erosion in that coverage segment due to Obamacare inducing employers to drop their current group plans. Given that the distribution of exchange enrollees will likely be skewed toward the lower end of the 100 percent to 400 percent of FPL income range (and thus, eligible for reduced cost sharing), participating insurers are offering exchange plans with limited provider networks and a significant number of Medicaid managed-care plans opted to join the exchanges.
The insurers who have elected to participate in the exchanges are mainly a mix of Blue Cross carriers seeking to extend their current market dominance, group-market carriers seeking to retain enrollees when employers drop coverage, and Medicaid managed-care insurers expanding into a market that they view as very similar to their current business.
In fact, Obamacare’s complicated, income-based design of premium and cost-sharing subsidies will result in the exchange market essentially offering something like Medicaid managed-care for the middle class.
Avik Roy is worried about Healthcare.gov’s security:
One of the most underappreciated, but important, problems with Obamacare’s troubled health insurance exchanges are their inadequate safeguards against identity theft and misuse of private information. We’ve now learned that an important government report detailing “high risks” to the security of the Obamacare website was concealed from a key official, Henry Chao. The concealment misled Chao to believe that there were no longer any high security risks to the launch of the federal exchange, prompting him to recommend the approval of healthcare.gov. “I’m not even copied on this,” exclaimed Chao in aNovember 1 interview with the House Oversight Committee, where he was presented with the security report for the first time. “It is disturbing…This is…a fairly non-standard way to document a decision.”
It’s not clear whether or not the concealment was intentional. “I don’t want to think the worst of people,” Chao told investigators. But he acknowledged that it was “kind of strange” that he wasn’t included on the email that contained this critical information, given that there were people that report directly to him that were included on it, along with his direct superiors. “Why I’m surprised is that [Teresa Fryer, the Chief Information Security Officer] had me do this, file this process, but [didn’t] copy me on the [Authorization to Operate] letter. I mean, wouldn’t you be surprised if you were me?”
And Peter Suderman takes the administration to task for inflating its enrollment numbers:
[T]he administration isn’t actually counting enrollments. Instead, it’s counting the number of people who have placed health plans in their online shopping carts—not necessarily people who have signed up and agreed to be billed, and certainly not people who have actually paid the premium for the first month of coverage. It’s the equivalent of Amazon counting a TV sold every time someone puts a TV in his or her online shopping cart, regardless of whether or not they actually go through the checkout process.
The Dish 