Only 6 people managed to enroll in an insurance plan on Day 1 of Healthcare.gov | Hacker News Reader

Only 6 people managed to enroll in an insurance plan on Day 1 of Healthcare.gov

washingtonpost.com

35 pointsdanso75 comments

> "The first month of the new health law’s rollout reveals an unexpected pattern in several states: a crush of people applying for an expansion of Medicaid and a trickle of sign-ups for private insurance. This early imbalance — in some places nine out of 10 enrollees are in Medicaid — has taken some experts by surprise. The Affordable Care Act, which expanded Medicaid to cover millions of the poorest Americans who couldn’t otherwise afford coverage, envisions a more even split with an expanded, robust private market..."

So you're telling me that more people who are getting free benefits showed up to the party than people who have to pay significant annual premiums? Shocking. I think they need new "experts".

I think what they are referring to is the impact of the individual mandate. Sure you'd expect people to rush into the free option, but everyone who is uninsured and doesn't qualify for Medicaid will have have to pay a penalty if they don't buy insurance.

Of course people will enroll eventually, but the first ones will be the ones with the most to gain. It isn't guaranteed that individuals won't eat the penalty and enroll when they need it, but you can guarantee that people who benefit with little or no cost to them will be want their benefits ASAP.

My point was mostly that if their "experts" can't think critically about the incentive system the program creates, what else will they be surprised about? Adverse selection? Insurer bankruptcy and industry consolidation?

Pay 1.0-2.5% tax penalty for not having Insurance

Pay 10-15% of your pre-tax income for a plan under Obamacare

I don't think it's going to work out that great.

It depends on your expected medical costs. If you're relatively young and healthy, saving that 9-12.5% of your income is worth it. If you're sick/old/etc., then it's absolutely worth buying coverage. Note that in this system the healthy don't join the risk pool.

This, my friend, is called adverse selection.

The goalposts have already been moved to March 31st, 2014 and could be delayed further. What's the rush?

Adverse selection death spiral (https://www.google.com/search?q=obamacare+Adverse+selection+...), and moving the goalposts too far forward means insurance companies, which have to submit 2015 plans in the January through March (as I recall; maybe April) period will have very poor data to do that with, very possibly resulting in higher than needed costs.

And while I don't think you were addressing this, millions will lose their now outlawed plans on January 1.

And while I don't think you were addressing this, millions will lose their now outlawed plans on January 1.

I see this as a huge impending disaster that could turn public sentiment against ACA to the point that it does get repealed. If people get their old plans cancelled and it is very difficult to use healthcare.gov to sign up for a new plan, a lot of people are going to be left in the lurch.

Unfortunately the horse is already out of the barn and into the next county. Maybe by a stroke of luck healthcare.gov will be functioning smoothly at the end of November like Obama and company have said it would. But I'd be willing to bet this will not be the case, given all the problems that project has to deal with.

Even if a massive effort were put underway to stand up call centers so people could navigate the healthcare exchanges over the phone, it would still need to be administered via a computer system, there's little chance a wide-scale paper process could be put in place quickly at this point.

Shock and awe, anyone?

On the one hand it's around 5% of the population, and unless you need subsidies, you can get policies directly from the insurers, and there are private comparison shopping sites.

On the other hand, most will have to pay more money, often a LOT more, often for worse coverage in ways they most care about, and this small fraction of the population includes some of the most influential. Maybe ... the rules of that seem to be changing, this could in fact be a good test of the recent Angelo Codevilla et. al. modern US ruling and country classes thesis.

Sure, but what's the hurry? If you don't really want to buy insurance but are doing it to avoid the penalty, you might as well wait until the deadline is closer.

Definitely. However the concern here is that people ignore the individual mandate's penalty. Precisely nobody wants that, and the hope was that the ease of signing up and looking for insurance via exchanges would provide a carrot or at least a smooth road to go along with the stick of the penalty. Whoopfail.

The carrot isn't really in play either, yet, since there's no advantage to signing up before December. Coverage starts at the same date either way, so why bother now?

Perhaps because of the sticker shock and because, if you can get them, pre ACA plans are cheaper and offer more value. For example if you go to ehealthinsurance.com and compare the lowest cost pre-ACA 2013 plans with ACA-compliant 2014 plans for a healthy individual in their late 20's early thirties you get the following very affordable options pre-ACA...

BlueCross BlueShield; Deductible: $5,000, Co-Insurance: 0%, Doctor Visit: 1-2 $30 co-pay deductible waved, Cost: $98 /month

BlueCross BlueShield; Deductible: $5,000, Co-Insurance: 0%, Doctor Visit: 1-2 $30 co-pay deductible waved, Cost: $66 /month,

The closest ACA compliant option to the above...

BlueCross BlueShield; Deductible: $6,000, Co-Insurance: 0%, Doctor Visit: no charge after deductible, Cost: $130 /month

So in summary you are looking at paying somewhere between 32% and 97% more money, and don't get the benefit of 1-2 low cost doctors visits per year.

Aren't you comparing conditionally-issued insurance with guaranteed-issue health insurance? The big problem I had with sites like ehealthinsurance.com is that a family using it to find insurance had a coinflip chance of actually getting one of those rates after completing an application.

> Aren't you comparing conditionally-issued insurance with guaranteed-issue health insurance?

In addition to guaranteed issue, the Obamacare plans have (1) an annual out-of-pocket limit (2) no annual or lifetime limit on benefits (3) an absolute right to renewal.

These features raise the cost substantially compared to previous plans on the individual market. The classic example is if you get cancer and need $2 million in treatment. If your plan had 20% coinsurance, or a $1 million lifetime limit, then you'd be in rough shape. And if the insurance company dropped you when you got sick, on the grounds that you forgot to disclose some trivial and unrelated illness on your application, then you'd be in really rough shape.

The things that make Obamacare expensive are the features that don't show up on the sticker -- because they are now required of all plans. Guaranteed issue is the major one, because they prevent sick people from being washed out of the actuarial pool. All of these features are things that you hope you will never need to "take advantage" of. If you waste your money buying them, that's actually not a bad outcome.

I've also found it's like viewing interest rates on Zillow, it will be the lowest possible number that almost no one could qualify for but, it looks nice when shopping and gets people thinking they can afford it so the small increases later are accepted.

Yes, but how many people is that actually an issue for? Most of the preexisting condition demagoguery you hear about seems to stem from people who were going w/o insurance until they found out they had a medical condition. There were already limits on preexisting condition exclusions in a number of states. You also have to wonder if that in and of itself is worth a doubling in costs?

http://en.wikipedia.org/wiki/Pre-existing_condition#Current_...

Horse. Shit. I have a perfectly healthy family, a family in which I am notably the least actuarially sound bet. When we started Matasano, we found my wife and (at the time) 7 year old daughter both uninsurable, full stop, at any price, due not to preexisting conditions but instead previous medical examinations that led insurers to believe that at some point in the future the two (coincidentally? female) members of my family might develop a condition.

I've talked to dozens of people since then and come to the conclusion that "functioning human female reproductive system" is, in essence, a coverage-denying preexisting condition in many US states.

You're in IL right? For some reason the insurance situation in IL seems to be really crappy. They allow(ed) for looking back further in people's medical history than a lot of other states according to wikipedia. That doesn't explain why the new plans are so much more expensive though even in states that previously had restrictions on preexisting conditions and medical history use in underwriting.

Let's again be clear about what I said. "They" (meaning every insurer in IL) did not "look at our medical history". They looked at visits to doctors and (in one case) the emergency room that did not result in diagnoses, and decided to hedge their bets by presuming a preexisting condition that was not indicated in the record.

Another thing that happens --- particularly in California, lest you think this is an IL problem --- is that comparatively minor medical conditions were used as proxies for rare but expensive conditions. For instance, if you were a woman with abnormal cramping, you might be default-denied based on a simple blacklist of uninsurable conditions because insurers were scared that might presage something expensive down the road.

The preexisting condition and recission policies of insurers prior to Obamacare were a national disgrace.

It sounds like the insurers decision had more to do with visits to the emergency room than anything else. Those are expensive.

Thanks for your insight.

The case the administration is making is that these old plans had invidious characteristics such as lifetime spending limits and missing "essential" no-deductible coverage for preventative services and birth control. Not sure whether that's an accurate claim for the pre-ACA plans you listed. Presumably ACA's no-deductible requirement applies to the new plan, so while you might pay for irregular doctor's visits, your scheduled preventative checkups should have no out of pocket costs.

But I think that's small potatoes (the number of patients likely to exceed any reasonable lifetime coverage limitations has got to be tiny, and cheaply re-insurable by BCBS if needed). The real cost is likely coming from BCBS' estimate of the change in the risk pool characteristics of this new plan. Namely, it doesn't matter how healthy you are to sign up for the new one, so presumably on average it will be made up of less healthy people. There's also the cost-shifting that has to happen: Plans for older people can only be a set multiple (3x?) more expensive than for younger people, so the younger person's plan must be made more expensive. This is called cost-sharing if you're being polite, and a redistribution scheme if not.

"The case the administration is making is that these old plans had invidious characteristics such as lifetime spending limits and missing "essential" no-deductible coverage for preventative services and birth control."

Coupled with the claim that plans based on the new floor for coverage would be at least affordable. Which many are finding invidious because they can't afford the replacement policies that are initially offered by their existing insurers. With all subsidy calculations tied to the Federal site, those who might get a subsidy aren't able to find out for sure without generally extreme levels of effort, although subsidy calculators are available, like the Kaiser Foundation's: http://kff.org/interactive/subsidy-calculator/

That Kaiser calculator is great. I get the sense that this would have all worked so much better if the law had been structured such that HHS approved plans, insurers sold those plans on their own sites (or through private clearinghouses), while the IRS provided a quick calculator like this and a longer process to get a certification of your last year's income you could present to an insurer to get a subsidized rate.

I thought the law was supposed to encourage preventative care. Not offering at least one low cost doctor visit seems to betray that goal.

Preventative visits are required to be no-deductible, so I assume you only get hit with the cost if it's an irregular visit for an illness of some kind.

Health insurance is supposed to keep you from going bankrupt when your appendix bursts.

Well, sure, but most Americans and policymakers haven't thought about "health insurance" in those terms for a long time. PPACA makes plans that only protect against that kind of thing illegal.

Health insurance "yes", health care "no".

So much of the public debate regarding these issues is terribly confusing and misleading simply due to the wanton disregard for the difference between "health insurance" and "health care". I realize that some of the erroneous usage is just sloppiness, but these two things really aren't interchangeable from a public policy standpoint.

Prime example: the "Affordable Care Act" isn't about health care, it is about health insurance.

According to the details of each plan they all offer free preventive doctor visits. the 1-2 low cost visits per year are for if you got a cold or something and went to the doctor.

$5,000 deductible?

My PPO had a $2,500 deductible and I thought that was insanity.

It's not that crazy. Most young people, most years will never spend $5,000 on health care, particularly when preventative services are free. So if you're responsible enough and financially capable to save for a rainy day, it makes sense to pay less out of pocket every month. Those savings may still be tax-deductible; I'm not sure how ACA changed HSA availability in that regard.

Assuming you have savings high deductible plans are the smartest financial decision. Insurance is to keep you from going broke in the unlikely event that something serious happens not to pay for every runny nose you might get.

For reference, only 123 managed to sign up for Romneycare in the first month. There are clearly large technical issues, but early on it seems that people also do a lot of "let's see how much it'd cost" and sign up later.

Here's a source[1] for the sibling commenter. But there's a key difference - AFAIK Romneycare didn't start having to dig itself out of a hole of millions of people losing coverage as well.

[1]http://www.washingtonpost.com/blogs/wonkblog/wp/2013/10/29/r...

Link? Would love to read up on that, if in fact it's true.

I agree that data is preferred, but we can also look at it another way. There is no incentive to sign up before December 15th. All plans signed up before then start Jan 1. With all of the talk about the technical limitations, I think people are right to wait a month until people aren't ranting about it being broken.

http://www.businessinsider.com/obama-obamacare-romneycare-bo...

Not a good comparison. Romneycare was implemented in one state, Obamacare is nation wide.

So your assertion is that Massachusetts has an unusual aversion to signing up in the first month that the rest of the nation lacks?

My assertion is that the comparison made is not a good comparison.

And my question is, based on what? What makes Massachusetts a bad comparison? Why do you believe people would flock to Obamacare enrollment on the first day when that didn't happen in the state plan that Obamacare is based on?

Google the following: "was obamacare based on romneycare". Obama says yes, Romney says no. In this case I believe Romney.

Romney wouldn't even talk about Romneycare during the campaign. Taking credit for what the far-right wing of the Republican party deems "socialism" wouldn't have played well for him.

Politifact has a ruling: http://www.politifact.com/truth-o-meter/article/2012/mar/20/...

Thanks for the link. And, I do remember Romney being on the defensive because his plan was being compared with Obama's plan.

A moderate sized state in population, 6.6 million as of 2012 or roughly 2% of the nation's population, with a high median home income and as I recall a way above average percentage of insured residents.

Completely separate issue from the technical issues - but how are people expected to find out that they need to do this. I have to assume there's a non-trivial percentage of the population that's not only uninsured but also completely disconnected from news and the internet. Does somebody contact them somehow to get them enrolled?

Like taxes, this will likely be a largely individual endeavor. Maybe there will be PSAs, but their effectiveness is questionable. Many people (and the politicians who signed it!) don't know the enrollment requirements, subsequent responsibilities, and consequences for failure to comply.

Everyone is fighting over the validity and constitutionality of this law, instead of informing the public about what they need to do to avoid financial penalties. The debate will rage on no matter what, but whether or not you agree with this law (and I don't), the priority right now should be to help people make an informed decision about their compliance.

I think civil disobedience is appropriate, and that people should resist compliance and urge others to resist. I believe that the individual mandate is unconstitutional and that the law was passed in a party-line vote using shady Senate tactics. Further, we now know that President Obama flat-out knowingly lied when he told the public "if you like your plan you can keep it." The law needs to be delayed so that Congress can pass a bipartisan health care reform bill. This issue is too important to not have achieved a governing consensus.

Obamacare's individual mandate comes from the Heritage Foundation - that's right, the organization now run by the Tea Party.

http://americablog.com/2013/10/original-1989-document-herita...

It was essentially a bipartisan reform bill. Had Bush proposed the bill, Republicans would likely have voted en masse for it.

As for the Constitutionality of it, the Supreme Court disagrees.

This is the same organization that at the same time supported and prompted G. H. W. Bush's "assault rifle" import ban (which we are still living with, BTW). Whatever they might be today (I stopped paying attention to them back then), that has no bearing on what they were a quarter century ago.

This is as bi-partisan as you can get. The Democrats passed the Republicans' plan. The only reason it didn't get any Republican support was because the Republicans are completely nuts. There is no way to get their support for anything right now.

"As bi-partisan as you can get"? C'mon, that claim doesn't pass the laugh test. Plenty of legislation has passed both houses of Congress in the last five years with large bi-partisan majorities. Leahy-Smith[1] is just the first one I thought of.

As for it being "the Republicans' plan", you're hanging an awful lot on some Republicans' support for an individual mandate (conceived, remember, in opposition to Bill Clinton's nascent proposals for an employer mandate) twenty years ago. The guy who most Republicans actually voted for wanted to change the system to allow health care plans to be sold across state lines, and de-couple employment and health care via a universal individual tax credit [2]. Neither of those are in PPACA.

[1] http://en.wikipedia.org/wiki/Leahy-Smith_America_Invents_Act

[2] http://www.heritage.org/research/reports/2008/10/the-mccain-...

"As bi-partisan as you can get" is intended to be in the context of health care reform. Sure, you can get bi-partisan support for funding veteran death benefits or whatever, but that's not what I'm talking about.

The Republicans created the current plan. The most recent Republican candidate for President supported and passed this plan in his home state when he was governor. It's a Republican plan.

The Republicans have no serious alternative proposal. They pretend they do only to the extent needed to convince people who aren't paying attention that they really mean the "replace" part of "repeal and replace".

Sure, Obamacare isn't exactly the Republican plan in 100% of every detail. It's still the basic Republican plan overall, and the Republicans are not wrangling over details anyway.

Ross Douthat has a pretty good summary of at least the egghead Republican health care policy preference and its pros and cons. The whole thing is worth reading.

http://douthat.blogs.nytimes.com/2013/10/22/why-not-medicaid...

Short version: Subsidized catastrophic care for real "insurance", and tax-advantaged HSA's for your more predictable medical costs. The former probably still requires something like the existing individual mandate, so it's unfortunate that Republicans seized on that as one of their primary objections to PPACA (an objection that Candidate Obama shared in 2008!)

More practically, a Republican alternative would certainly not have made these catastrophic plans currently being cancelled illegal.

This stuff is not fiddling around the margins: PPACA will only work if it substantially shifts costs from the old and sick (who need comprehensive plans) to the young and healthy (who would typically be fine with catastrophic ones). I don't know why you would expect the GOP to be happy about a wealth transfer like that, particularly when they couldn't expect to extract any leverage from their participation with a Democratic super-majority able to pass whatever it could agree on. All for a bill whose popular support never seriously cracked 50%? I wish Democrats had engaged with President Bush in '05 when he came out of the reelect gate for Social Security reform, rather then declare the whole thing DOA. But I certainly am not shocked they behaved like an opposition.

If that article really is a pretty good summary of Republican thinking in this sphere, then I'd say it completely backs up what I've been saying. There's not much substance in that article. It very briefly mentions the subsidized catastrophic insurance you mention, but it doesn't go into much detail at all. Worse, it completely handwaves away the major problem with that model, namely, what happens to people with chronic conditions, by basically saying "oh well, too bad, so sad."

In any case, I don't see how that approach is ultimately very different. Sure, it means people cover a bit more stuff out of pocket, and places a higher burden on sick poor people, but overall it's pretty much the same.

The ultimate question that has to be answered is this: do we, as a society, find it acceptable to allow people to die of treatable illnesses when they can't afford to pay for the treatment? This question has been solidly answered as "no" in the US for some decades now, ever since hospitals were barred from turning away patients in the emergency room. The question now is simply how you accomplish it.

So, back to these subsidized catastrophic plans. You'll have to have a mandate on them! Without a mandate, people who aren't sick won't buy them unless you hold some other threat over their head, such as denying them the ability to obtain insurance if they're already sick.

Unless we're going to let people die, the wealth transfer you describe has to happen in some way. Pre-Obamacare, it works using a de-facto hidden employment tax whereby better-off people pay, in a really convoluted fashion, for the unpaid bills of poor people. With Obamacare, it works by forcing people to get insurance even if they don't want it. The Republican idea discussed in your link is some combination of the two, and exactly what the combination is depends on the exact details.

Obamacare is just about the most free-market solution for universal health coverage you can come up with. It's more free-market than the pre-Obamacare regime, it was proposed by Republicans, and it was passed by Republicans in Massachusetts just a few years prior to becoming law at the national level. And lest we think that those Massachusetts Republicans were some fringe group, they nominated the governor for President! Why should I expect Republicans to object to it for any reason other than being the political party of Crazy?

"If that article really is a pretty good summary of Republican thinking in this sphere...."

Ross Douthat is one of the New York Times tame "conservatives"; I haven't read that particular piece by him, especially since I'm not familiar with all the proposals by various people on that side so I can't critique it, but I can say you can't denounce our side on the basis of anything he portrays.

"[Obamacare] was passed by Republicans in Massachusetts just a few years prior to becoming law at the national level."

This must be some new definition of the word passed I wasn't previously acquainted with. The quickest refutation is can find is that the lower house has been Democratic since 1955. In 2006, 35 out of the 40 upper house seats were held by Democrats. It has long been a one party state by the time I showed up in 1979, with the occasional RINOs for flavor.

Anyway, you keep claiming things can be "bi-partisan" without Republican votes, a result that can only be achieved by twisting the word beyond recognition.

Mitt Romney signed and endorsed the law. He was later nominated to run for President. If that doesn't count, then I do not know what would. Or is Romney one of those "RINOs"?

YES! Romney called himself "severely conservative" at CPAC ... a phrase you'll only find non-conservatives using in that context (e.g. https://www.google.com/search?q=%22severely+conservative%22&... )

You're confounding the current eGOP, as in Establishment GOP, which controls the nominating process, with many of its "completely nuts" elected officials and its base, who've many times in the last few decades declined to (re)elect RINOs, i.e. G. H. W. Bush in 1992, Bob "Tax Collector for the Welfare State" Dole in 1996, McCain, who had a hereditary vicious tempter which he turned on the base after not getting the 2000 nomination.

And Romney, the sort of NE liberal/progressive Republican (granted, an old wing of the party, see e.g. Rockefeller vs. Goldwater in 1964, or Teddy Roosevelt after the previous turn of the century) who could win in overwhelmingly liberal and Democratic Massachusetts. It was the only state in the entire freaking nation to vote for McGovern in 1972 (along with D.C.) after all, "acid, amnesty and abortion", baby!

(Amnesty for Vietnam era draft dodgers, delivered by Carter.)

The Republican nominee for President in 2012 is a RINO and doesn't actually count for the purposes of bipartisanship, got it.

Seriously, what? What sane definition of "Republican" could possibly exclude Mitt Romney? How the hell am I supposed to know who you do and do not include in "Republican" if that's how you're going to be?

Not in such an indirect fashion. He obviously endorsed "Romneycare" long before the election, he didn't endorse Obamacare during the election.

Again, you claim "bipartisanship" for Obamacare without evidence of votes or the signing of legislation.

As for "sane" definitions, with the end of various systems of party discipline, anyone who calls themselves a Republican or Democrat is one. But that doesn't mean you can't distinguish between different types. Again, go back to after the turn of the century, the feud and eventual party split between progressive Theodore Roosevelt and conservative William Howard Taft, which gave us Woodrow Wilson.

Romneycare is Obamacare, at the level of detail you're talking about. Endorsing one is endorsing the other.

I also said it's "as bi-partisan as you can get". That's not a very high bar to clear, I hope you realize. My point is not that there's some imaginary outpouring of Republican support for the idea, but simply that Republican opposition to it is not rooted in any alternative. Obamacare is as bi-partisan as you can get. There is nothing that would be more bi-partisan than that, unless you count "nothing" as something.

Based on history, based on candidates, based on policy, Republicans should support Obamacare. It's their plan! But they don't, because they've become a mindless opposition. Their policy is whatever the Democrats are against. They no longer define themselves, but merely are the negative of their opponents.

That's all I'm saying. There's no alternative health care form that both parties could get behind. Obamacare is the closest you can get in the current climate. The idea that we should delay Obamacare in order to figure out a true bi-partisan reform bill is fantasy, because there is none.

It's their plan! But they don't, because they've become a mindless opposition.

There are obviously people here who both simultaneously think ACA might not be a positive public policy and are not mindless. Some of them might even be registered Republicans. Your constant repetition of the claim that voting for Mitt Romney was somehow an endorsement of a national version of Romneycare when the candidate himself explicitly campaigned on the opposite is, not to put too fine a point on it, silly. It is 100% consistent with federalist principles to believe that Romneycare might be great for the voters of MA, single payer might be great for the voters of VT, but that Obamacare is bad for the voters of the USA. It's also not inconsistent to believe that Romneycare was a horrible idea, but that Romney was still preferable to the alternative Republican candidates and/or preferable to President Obama.

"There are obviously people here who both simultaneously think ACA might not be a positive public policy and are not mindless.... Your constant repetition of the claim that voting for Mitt Romney was somehow an endorsement of a national version of Romneycare when the candidate himself explicitly campaigned on the opposite is, not to put too fine a point on it, silly."

Not so much silly, but an example of revolutionary truth.

We "mindless" opponents of ACA are wedded to bourgeois truth.

[Much omitted.]

This will not end well.

Describing comprehensive health care coverage and catastrophic insurance as "pretty much the same" is factually inaccurate and misses the point of Douthat's piece.

Consumers right now have essentially no motivation to choose a $30,000 maternity bed over a $50,000 one. Third party payment disrupts price signals and encourages overspending. Sure, there are a variety of ways to try to contain costs through centralized oversight or "per capita" reimbursement schemes, but the GOP, at least, believes that nothing works like a competitive market. Laser eye surgery is perhaps the canonical example: It's not covered by most insurance, so providers have had to compete on cost, and the result has been a rapid increase in availability and affordability. That's a free market, and it's nothing like how the vast majority of health care will be paid for post-ACA.

No, you're not going to pick which emergency room is cheaper when you're having a heart attack. Catastrophes are different, that's why you insure against them. But someone who's getting frequent treatment for a chronic disease should absolutely be allowed to consider visiting a less expensive clinic over a research hospital and pocket some of the resulting savings.

Why should I expect Republicans to object to it for any reason other than being the political party of Crazy?

That you think a plan passed by a ridiculously Democratic legislature in Massachusetts and signed by a fairly moderate Republican governor represents the will of the national Republican party is maybe not capital-C "Crazy", but it does call into question how focused you are on the realities of U.S. politics. Did you not notice what a huge stone that was around Romney's neck during the primaries, to the point that he had to make one of his key campaign pledges repealing ACA on "Day 1"?

Remember when Bill Clinton got NAFTA passed and created the WTO? How could Democrats object to comparable free trade agreements after that without being the political party of Crazy, right? GWB saw how that turned out, and even Obama had trouble in his own party getting his USTR confirmed. It turns out that political parties represent shifting interests and diverse demographic and geographic coalitions, and what a GOP governor of Massachusetts thinks is the best political deal he can get for his (deep blue) state may not be reflective of what the party would like as a national policy, especially when that party is skeptical of all one-size-fits-all solutions, and generally prefers state-by-state experimentation.

There is a $67 million on-the-ground mobilization program, largely the government paying President Obama's political allies to go out and enroll people.

http://www.foxnews.com/politics/2013/10/15/ex-acorn-operativ...

> In July, HHS inked a $33 million contract with PR giant Weber Shandwick. Centers for Medicare and Medicaid had already signed a $3 million and $8 million contracts. Porter Novelli also has a $20 million contract with the agency

There are contracts with traditional marketing agencies to market through traditional channels (presumably TV and print), although they're waiting until the site is fixed to actually turn the machine to full throttle.

So, SNL had it right when they said the site could only handle 6 users at a time http://www.realclearpolitics.com/video/2013/10/27/saturday_n...

I bet the data is still being processed by some of those 500 million lines of code

Look I am the first to be upset at how much healthcare.gov management and dev sucked.

But I don't give a darn how many signed up on the first day.

I care how many sign up by December 31st.

Then we can discuss enrollment problems.

No, the date is Dec. 15th. If your one of the apparently millions whose plan didn't meet the new guidelines then you must sign up by Dec. 15th.

The Dec 15th date is for open enrollment and coverage starting January 1. The mandate deadline is March 15. I think you have them confused.

Ah thanks for the correction.

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