...on this possibility just this afternoon. I wouldn't put it past the other side.

I got all the way to the end. I'm eligible for Medicaid expansion but when I get to the part to enroll in the Arizona portion I get dead links on healthcare.gov.

They are not "sabotaging" anything. They are exercising an option that was included in the legislation.

the Federal government running all the exchanges already makes it a lot easier.

My wife worked for BCBS for 29 years. The problem they had was that they had so many health care policies with so many different riders and coverages the computer could not handle them all. So they were patching constantly.

Here is an example from being a golfer. It used to be when you built a golf club you had 3 different shafts you could built a club with. And you have maybe a dozen club heads. Now you have maybe 100 different kinds of shafts and 100 different kinds of club heads. Now you have maybe even a billion combinations.

As you add parameters to anything the combinations are exponential. Just keep doubling from the number one. 1=1=2. 2+2=4. 4+4=8. By the time you do that 10 X it really expands.

Lord knows how many health care plan choices there are from state to state.

The federal site has to enter all the data and parameters for that individual state. So it complicates the core site. Had each state done its own exchange the federal site could refer to the proper state.

The states like Colorado who has their own exchange are doing a lot better and it is working. It is the ones who are not doing their own exchange. Take Florida for instance the GOP there is stopping navigators from helping people. That is like you house being on fire and there is someone at the end of your street blocking the fire department. And in the red states the helpers are being obstructed from giving information.

as possible wouldn't you run your own exchange and have it fail completely?

Even now states not expanding Medicaid are starting to get heat.

On the home page of the federal site you have a drop down box with a question "What state are you in?".

When the user selects a state, you simply link the user to the federally built web site for that state.

It would be madness to put all the states rules, business logic, and insurance company connection options into a single site (although that may indeed be what they attempted).

But having N state sites built by the Federal government would be simpler than having the states do it because all the contracting overhead is only done once.

The federal site wasn't supposed to offer any plans at all.

From telecrunch:

Healthcare.gov was supposed to be an information hub for the needs of millions of uninsured citizens who are now legally required to have a healthcare plan. The federal website ended up offering insurance directly, after 24 states (mostly Republican) refused to design their own e-commerce websites for their residents. Unfortunately, at launch, the federal and state sites crashed.

http://techcrunch.com/2013/10/20/how-healthcare-gov-doomed-itself-by-screwing-startups/

anticipate running them for a few, otherwise the PPACA wouldn't have provided for this.

The original language said you would have to pay an individual mandate penalty if your **state** had set up an exchange which would qualify for the subsidy. This is why the Republican states thought they had found a loophole and refused to set them up. So the IRS had to fiddle around and do their own interpretation that a federal exchange could also get the subsidy and that would suffice for the individual mandate penalty.

http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2106789

or the states ran the exchanges. The issue you specify has to do with whether you can get a subsidy
if you buy a policy on the the federal run exchanges. It was simply an error made in drafting the law
(we've discussed it on DU before). The PPACA always provided the options for a state to let the
federal government run the exchange for them.

Note that the issue does involve the employer mandate since they have penalties that depend on whether
their employees are receiving exchange subsidies.

They obviously didn't plan it that way technology wise. At least I hope so because that would be a better excuse.

If they truly did think that the federal government would be running even a single exchange for a state then that is beyond sloppy to write it that way.

And doesn't your exchange need to be eligible for a subsidy in order for the mandate to be applicable?

but who would have standing to challenge it at this point (the employer mandate has been delayed for
a year) ?

I repeat, it was always known since the PPACA was passed that the federal government would be
running some of the exchanges for the states (although not as many as it turned out).

Frankly if what you are saying is true I find it even more appalling.

Everyone knew in the beginning that MA, for example, would run this program themselves. They have practice. But for the rest of the states, it was a new thing and many figured that the federal government option would be better.

"And that's the catch — the law specifically refers to subsidies flowing through exchanges "established by the state." The law's critics say subsidies should therefore only be available in state-run exchanges — not in the federal version."

Read more: http://thehill.com/blogs/healthwatch/legal-challenges/297443-lawsuit-claims-irs-illegally-implementing-key-part-of-obamacare#ixzz2iPzIyGbQ
Follow us: @thehill on Twitter | TheHill on Facebook

They really did not intend for the federal government to run any of the exchanges.

some exchanges otherwise the law wouldn't have specifically provided for them to do so.

That was always planned as a contingency, not as the way they anticipated it would happen.

This is what the language tells me. If you have something to the contrary that they definitely knew the federal site would be selling plans I wouldn't mind seeing it.

50 states the option for the federal government to do so should tell you that they knew they would
have to run it for a few.

HHS may have to get ‘creative’ on exchange

While sorting out the policy kinks in setting up a federal exchange, HHS must tackle another problem: There is no money to pay for it.

A quirk in the Affordable Care Act is that while it gives HHS the authority to create a federal exchange for states that don’t set up their own, it doesn’t actually provide any funding to do so. By contrast, the law appropriates essentially unlimited sums for helping states create their own exchanges.

The lack of funding for a federal exchange complicates what is already a difficult task. HHS will likely be operating exchanges in states like Louisiana and Florida that oppose the ACA on principle and have said they will not comply with the exchange provisions. But HHS also will likely be responsible for several other states that may want to set up exchanges, but will be unable to enact laws and set up the infrastructure under the short time frame specified by the law.

A federal exchange will have the same authority states do to impose fees on insurance sold through the exchange once it is open for business. But there is no money coming in until people start purchasing insurance, and there is a great deal of work to be done to prepare to open the doors of federal exchanges.

“It’s very clear that [the HHS] secretary should ‘use such sums as may be necessary’” for supporting states in creating their exchanges, but it’s “sort of silent” on the federal fallback exchange, said Jon Kingsdale, the founding director of the Massachusetts Connector, who is advising HHS on the creation of the federal exchange.

Read more: http://www.politico.com/news/stories/0811/61513.html#ixzz2iQ6XsFqp

Maybe they were hoping and praying they wouldn't need to.

Word of mouth about the cost savings. Period. They are trying real hard to spread their propaganda, but Americans are bargain shoppers and the store has just opened with all kinds of savings.

Now if they just wake up and realize they are not Republican, maybe they can vote them out and have the same marketplace that the country obviously wants.

That must scare the Republicans. Maybe even more than the cost of having the ACA itself, could be the cost to them of voters not turning out for them at the polls. Yep...people want this and what comes along with it is not looking good for the GOP.

As were her "nothing between the ears" guests.

Couldn't help hear her spew her crap as my tea bagger landlord was watching--as she always does.

" Oh its the Kelly Files On Cluster Faux" She has her own bimbo show now!!

If you'll look at this info, you'll see that there are only six states now running active purchasing state exchanges. Kentucky and New Mexico I don't know about - their status may change.
http://kff.org/health-reform/state-indicator/health-insurance-exchanges/

There are plenty of Dem states who decided not to do their own marketplace right now, and in theory, that made sense. A lot of the info needed to make the determinations comes from the Federal government.

In any case, the states had this option under the law as written, and it is not sabotage to use this route under the law.

There is a relatively poor correlation between Medicaid & exchanges:
http://www.advisory.com/Daily-Briefing/Resources/Primers/MedicaidMap#lightbox/2/

The poorer smaller states mostly seemed to have figured that the federal government would do a better job at the exchange function, and some states were considering their own exchanges and then dropped them due to the time frame. They may try in another year. The templates for exchange functionality were only released this spring. It wasn't a lot of time.

Only about half the states are currently participating in the Medicaid expansion, but that number will expand soon.

is federal law and the federal government basically determines the rules.

It was known a long time ago that a lot of states were opting out of running their own exchanges. There was a lot of time to get the federal exchange going.

And the reason the states who opted out did that wasn't just to crash the computer system, it was to take a political stand for the benefit of their constituents seeing them take that stand.

Is that it is a very complicated system that was improperly tested and is nowhere near up to the task.

You might like Obamacare and love Obama, and you might believe that every Republican is an evil bastard hell bent on doing anything to destroy the things you love. But the reality is that this kind of thinking, this blind love and hate, is simplistic and silly. Leave that kind of bubble thinking to idiots like Hannity and analyze this stuff objectively.

(this is why people are having a hard time logging on and getting pages to show),
second it didn't undergo real beta testing (evidence by some insurance providers getting
bad data), which is what October is turning out to be.

They should have contacted some of the guys who run these major MMORPGs. Perhaps gotten the team from Blizzard or CCP to help them out putting together a server setup to handle it. It's pretty sad really. I have major issues with Obamacare myself, I think it's a bad law that will screw over a lot of people and seriously damage us as a party -- but I hate to see it screwed up like this.

They'll get it fixed though. Running the servers is comparatively easy. Explaining to broke American's that they now have a mandated bill and still no health care is gonna be a whole lot tougher to explain.

Hopefully red states will need to follow in the footsteps of Ohio.

They refused to create an exchange, they refused to provide oversight of insurance premiums in the exchange, and worst of all... they refused the federal Medicaid expansion funds leaving the very poorest Floridians still without coverage. So we Floridians are on our own down here.

I hope this stunt ends up being our nasty-ass governor's undoing.... along with our R-dominated legislature.

someone should have read the f'ing law. I live in az and I still cant get into the exchange so I can buy my overpriced new policy.

we can complain all we want about red states not setting up an exchange; but we voted the law in, the law allows it and they are just using the playbook we wanted them to use.

...sabotage, it's also the fact that each state's 'exchange' is both different and complex. In Georgia alone there are five different insurance companies, offering an array of options and in different areas of the state. Georgia has over 150 counties with only one company serving all the counties, so depending on where you live your options are different requiring you to navigate yourself through the maze...now multiply this by thirty-something times (the number of states that have opted out, and/or are contemplating doing so. The other issue of potential sabotage, and one I've been convinced of here, is hacking of the system (they did it to us during the '02 election) along with paid trolls - probably backed by the Koch Brothers - to overload the system with bogus inquiries all designed to crash the servers...and you're right, the MSM doesn't have a clue, and wouldn't ask about it even if they did.

even though they knew months before it opened that many states weren't going to have their own exchanges? That's not sabotage, that's failure to plan on the part of the implementers.

I really doubt the "red states" played any part in how the healthcare.gov website was constructed (wasn't the contract given to a Canadian firm?). It was poorly designed and executed, plain and simple. Fortunately it seems to be working better - for me at least - then again it took about a dozen accounts to get there.