Exchange Enrollment Kicks Off Plagued By Government Shutdown, Other Challenges

Despite a showdown in Congress about health care reform’s future that threatens to bring funding of the U.S. government to a halt and a host of recent security and other concerns about the security and operational readiness of its enrollment platform and details of the implementation of the marketplaces in many states that will provide the offered coverage, the Obama Administration is touting today, October 1, 2013, as the first day that Americans can apply for enrollment in coverage offered through the health insurance exchanges that the Obama Administration prefers to refer to as “Marketplaces” slated to take effect under the Patient Protection & Affordable Care Act (ACA).

Obama Administration Touts October 1 Kickoff As New Age of Health Care

In a post shared across social media today,U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announces, ” is open for business. Share this and let your friends and family know they can #GetCovered today at!”   In yet another post, Ms. Sebelius proclaims:  See also

“For the first time ever, today all Americans can begin shopping for quality health coverage that is affordable, and not be denied or charged more because they have a pre-existing condition.

The Health Insurance Marketplace is a new, simpler way for uninsured Americans and their families to purchase health insurance in one place.  Coverage begins as early as January 1, 2014 for people enrolling by December 15, 2013.   Today also marks the kick-off of outreach and enrollment activities in communities nationwide.  Enrollment events will take place in a variety of local settings including public libraries, churches, festivals, sports events, and community meetings.” 

Shutdown, Other Issues Raise Concerns

Ironically, while HHS continues to cheer its actions to implement ACA, a host of concerns cloud its implementation, including a federal government shutdown that also took effect October 1, 2013 as a result of a Congressional battle over the future of ACA and its funding.  Over the weekend, the Senate refused to approve legislation passed by the House that would have provided for continued funding of U.S. government activities while denying funding and delaying provisions of ACA.  Leaders in the Republican controlled House have indicated the House will not pass a budget without the carve out of funding and delay of ACA implementation.  The dispute means that Congress has not approved continuing funding from the U.S. budget of the monies necessary for continued operations of many government functions, including HHS support for implementation of ACA and its enrollment.  As a result, while HHS continues to bombard the media and social media with announcements touting enrollment, the main page of its website posts the following announcement in bright red text:

“Due to the lapse in government funding, only web sites supporting excepted functions will be updated unless otherwise funded.  As a result, the information on this website may not be up to date, the transactions submitted via the website may not be processed, and the agency may not be able to respond to inquiries until appropriations are enacted. …


We are experiencing a high volume of media requests about the Affordable Care Act and the Health Insurance Marketplaces. If you are a reporter, we have assembled these tools to help you:

  1. First try, which has comprehensive information about the Health Insurance Marketplace here.
  2. At the start of Open Enrollment, watch for media advisories for the Centers for Medicare & Medicaid Services’ regular operational updates for reporters. The first update will be held as a conference call on the afternoon of Oct. 1. HHS will post transcripts of these briefings in the HHS Newsroom.
  3. Email our media team here. If you have already contacted CMS’ media relations team, then HHS already has your request, and there is no need to email both agencies. Please be as specific as possible about your request and deadline.”

Beyond the government shutdown, other issues remain.  Last month, HHS released a HHS Office of Inspector General Report that raises concerns about the adequacy of the electronic security of the portal that will be used to register and apply for enrollment through the site.  See Observations Noted During The OIG Review Of CMS’s Implementation Of The Health Insurance Exchange—Data Services Hub.  A host of other problems and concerns also have been reported.  See e.g., Obamacare’s Insurance Exchange “Glitches” – The Foundry; Document Management Problems in New Insurance Markets Feds ; ObamaCare ‘glitch‘ watch: Exchange site posts error messages; D.C.’s Obamacare fail: Prices won’t work until NovemberObamaCare’s scope, rocky intro signals problems for Tuesday’s start.

As the January 1, 2014 promised commencement of coverage and individual mandates loomed, the Obama Administration’s delay of employer mandates while leaving individual mandate penalties against individuals who fail to purchase coverage, reports of employers cutting jobs, employee health coverage, or both, highly debated concerns about the cost, quality of coverage and other issues are fueling a showdown again in Congress, as many Americans grow increasingly concerned about what lies ahead.Are you concerned about whether health care reform preparations are on track or have other health care policy concerns.  With the debate continuing to rage, many individuals and employers are watching carefully, as the debate holds funding of other key aspects of government operations hostage.

Join the discussion about health care reform and share your input by joining Project COPE: Coalition for Patient Empowerment here.

About Project COPE: The Coalition On Patient Empowerment & Its  Coalition on Responsible Health Policy

Sharing and promoting the use of practical practices, tools, information and ideas that patients and their families, health care providers, employers, health plans, communities and policymakers can share and offer to help patients, their families and others in their care communities to understand and work together to better help the patients, their family and their professional and private care community plan for and manage these  needs is the purpose of Project COPE, The Coalition on Patient Empowerment & It’s Affiliate, the Coalition on Responsible Health Policy.

The best opportunity to improve access to quality, affordable health care for all Americans is for every American, and every employer, insurer, and community organization to seize the opportunity to be good Samaritans.  The government, health care providers, insurers and community organizations can help by providing education and resources to make understanding and dealing with the realities of illness, disability or aging easier for a patient and their family, the affected employers and others. At the end of the day, however, caring for people requires the human touch.  Americans can best improve health care by not waiting for someone else to step up:  Step up and help bridge the gap when you or your organization can. Speak up to help communicate and facilitate when you can.  Building health care neighborhoods filled with good neighbors throughout the community is the key.

The outcome of this latest health care reform push is only a small part of a continuing process.  Whether or not the Affordable Care Act makes financing care better or worse, the same challenges exist.  The real meaning of the enacted reforms will be determined largely by the shaping and implementation of regulations and enforcement actions which generally are conducted outside the public eye.  Americans individually and collectively clearly should monitor and continue to provide input through this critical time to help shape constructive rather than obstructive policy. Regardless of how the policy ultimately evolves, however, Americans, American businesses, and American communities still will need to roll up their sleeves and work to deal with the realities of dealing with ill, aging and disabled people and their families.  While the reimbursement and coverage map will change and new government mandates will confine providers, payers and patients, the practical needs and challenges of patients and families will be the same and confusion about the new configuration will create new challenges as patients, providers and payers work through the changes.

We also encourage you and others to help develop real meaningful improvements by joining Project COPE: Coalition for Patient Empowerment here by sharing ideas, tools and other solutions and other resources. The Coalition For Responsible Health Care Policy provides a resource that concerned Americans can use to share, monitor and discuss the Health Care Reform law and other health care, insurance and related laws, regulations, policies and practices and options for promoting access to quality, affordable healthcare through the design, administration and enforcement of these regulations.

Other Helpful Resources & Other Information

We hope that this information is useful to you.   If you found these updates of interest, you also be interested in one or more of the following other recent articles published on the Coalition for Responsible Health Care Reform electronic publication available here, our electronic Solutions Law Press Health Care Update publication available here, or our HR & Benefits Update electronic publication available here .  You also can get access to information about how you can arrange for training on “Building Your Family’s Health Care Toolkit,”  using the “PlayForLife” resources to organize low-cost wellness programs in your workplace, school, church or other communities, and other process improvement, compliance and other training and other resources for health care providers, employers, health plans, community leaders and others here. If you or someone else you know would like to receive future updates about developments on these and other concerns, please be sure that we have your current contact information – including your preferred e-mail by creating or updating your profile here. You can reach other recent updates and other informative publications and resources.

Recent examples of these publications include:

For important information about this communication click here.

©2013 Cynthia Marcotte Stamer.  Nonexclusive right to republish granted to Solutions Law Press, Inc. All other rights reserved.

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