The governor of the state with the most dysfunctional health insurance exchange in the country remains a strong favorite for reelection.

In Oregon, the state exchange still couldn’t enroll anyone online at the end of December. The state is relying entirely on paper applications and had to hire an additional 400 workers to process them. Some patients scheduled to go on dialysis next month are still waiting for answers from the exchange about what plans are available. The advertising campaign, directing people to the dysfunctional web site, was pulled down after spending $21 million. The exchange’s board extended a deadline by a week, announcing the decision one hour before the deadline. The $178,992-per-year chief information officer, who helped design the $160 million site, resigned for “personal reasons” earlier this month . . . citing the death of her mother-in-law. This CIO lived in Sacramento, California. Rocky King, the state exchange’s director, resigned for “health reasons.” (Hopefully he won’t have to rely on the exchange to get insurance in whatever new job he starts.)

The term “fiasco” and “disaster” are thrown around without dispute. Clearly, this would be a serious problem for the reelection prospects of Governor John Kitzhaber, seeking his fourth (non-consecutive) term, right?

Nope.

Elizabeth Hovde, columnist for The Oregonian, wrote Sunday that Kitzhaber

is strongly favored to win re-election for good reason: Credible candidates from his own party won’t get in the way, and the last time Kitzhaber ran, he beat former Trail Blazer Chris Dudley — a good Republican option in a state that sees blue. . . . I’m guessing Kitzhaber will be at the helm through 2018, if for no other reason than there will be a “D” next to his name.

Republicans do have two declared candidates, state representative Dennis Richardson and Jon L. Justesen.

If the worst-run, most expensive, most wasteful, over-promised, under-delivered program in the entire nation isn’t enough to get voters to reconsider whether you deserve another term . . . what possibly could?

From the Monday Morning Jolt . . . 

This Was an Awful Year, with Unmet Expectations! Fire the Coach!

Happy Black Monday! Yes, today’s the day that all across the country, institutions that promised their supporters and fans thrilling success, that have spent years of effort and millions upon millions of dollars, assess the performance of the past year, and conclude that the fumbles, the stumbles, the bad judgments, the over-optimistic assessments, the bad planning, and the overall incompetence can no longer be tolerated, and fire the guy who’s been calling the plays all year long.

Er, no, that’s not the person I meant . . . 

Um, no, not him either . . . 

No, not her either. Although it is rather striking that Sebelius has outlasted Mike Shanahan. Amanda Carpenter: “Seems like the only accountability in DC is in sports.”

Actually I meant NFL teams, but I can see why you might be thinking along those lines.

The good news for Obamacare: More than a million people have signed up for private plans! Maybe even 2 million once the state exchanges report their figures! (EnrollMaven.com puts it at 1.85 million.)

The bad news: That puts them at about 26 percent of their enrollment goal of 7 million, with half the enrollment period passed.

Another little snag:

4 million-plus: People whose individual plans were canceled because the plans didn’t measure up under the law. The government changed rules to allow substandard plans to exist for another year; it’s not known how many canceled policies will be revived. Another rules change allowed cancellation victims to sign up for bare-bones catastrophic coverage.” That’s from the AP; other estimates put the number of newly-uninsured at 5 million.

So . . . we’re still ending 2013 with more people having lost their insurance than gained it.

Jonathan Cohn, usually one of the law’s biggest cheerleaders, is refreshingly direct about the problems that may lie beyond those figures indicating an increased rate of applications:

It doesn’t tell us whether these people getting private (or public) coverage had insurance previously — or, if they had insurance, how much they were paying for it. It doesn’t tell us how many of these people have actually paid premiums, which is essential for coverage to take effect. It doesn’t tell us whether insurers have proper data on these people or what kind of access and protection the new coverage will give. It doesn’t tell us how many of the enrollees are in relatively good health or how many are in relatively poor health — or how that mix will affect insurance prices going forward.

In addition, the numbers do not appear to match the Administration’s own targets. According to internal projections, later reported by the Associated Press, officials expected more than 3.3 million enrollments by year’s end, with about 1.8 million of those coming through the federal website.

For all of those reasons, and a few others, it’s premature to say Obamacare is meeting expectations.

Say, will all of these new insurance-holders be able to see doctors?

Preventive care is one of the essential health benefits that all insurance plans must now provide, prompting some concern that new patient volume could overburden primary care offices similar to what happened in Massachusetts in 2006, when the state’s mandated health insurance law went into effect.

Wait times to get an appointment at primary care physicians’ offices grew significantly, and they have remained high, according to the Massachusetts Medical Society. Many offices have refused new patients.

Wait, just how bad are the wait times in Massachusetts now? Pretty darn awful:

The 2013 study shows wait times for new patient appointments with primary care physicians remain long in the Commonwealth, with the average time to see a family medicine physician at 39 days (down from 45 days in 2012) and the average wait time to see an internal medicine physician at 50 days (up from 44 days in 2012).

The study also showed that only about half or less of primary care practices — 51% of family physicians and 45% of internists — are accepting new patients in 2013.

For pediatrics — primary care for youngsters up to age 18 — the average wait time was 25 days, two days longer than last year, with 70% of pediatric practices accepting new patients, a decrease of 2% from 2012.

Perhaps most significantly:

The percentage of family physicians accepting new patients has dropped 19 percent over the last seven years; the percentage of internists accepting new patients has plunged 21 percent over the last nine years; and the percentage of pediatricians accepting new patients has fallen 10 percent over the last four years.

At what point does a shortage of practitioners accepting new patients amount to de facto rationing of care?

More bad news:

The Affordable Care Act requires insurers to cover mental health care just as they do physical care, but a new study shows only half of psychiatrists accept insurance. That means access to care for the millions of people with depression, post-traumatic stress disorder and other mental health issues may be limited to those who can pay for treatment out of their own pockets, despite the law.

From 2009 to 2010, 53% of psychiatrists accepted insurance, compared with 89% of all other physicians who did, said Tara Bishop, associate professor of public health and medicine at Cornell Medical College. She looked at data from the National Center for Health Statistics and released her team’s findings in The Journal of the American Medical Association . . . 

Nothing in the law requires psychiatrists to take insurance, and after years of low rates, administrative hassles, extra steps not required of other physicians and a plethora of patients willing to pay cash, many psychiatrists have simply opted out of insurance programs.

Next time some lefty tells you how uninformed Fox News viewers are, remind them of this uncomfortable statistic:

81: Percentage of young Democrats who approve of the Affordable Care Act, according to December poll by Harvard’s Institute of Politics.

58: Percentage of young Democrats who approve of “Obamacare.”

Ahem. “Obamacare” and “the Affordable Care Act” are the same thing.

From the Morning Jolt, back in February:

One thing we do need to establish going forward is that the right way to sort these divisions out is through primaries, and that this third-party spoiler crap has to end immediately. Here in Virginia, lieutenant governor Bill Bolling is the latest GOP lawmaker to flirt with the I’m-gonna-lose-the-party-nomination-so-I’ll-leave Club. If Bolling bolts, he’ll join Charlie Crist of Florida and Lisa Murkowski of Alaska; we can throw in Arlen Specter flipping parties, too.

Hey, guys, “if I stay in the party I’ll lose the nomination, and I don’t want to” is not a principled reason to leave the party.

Here we go again. In South Dakota, a state with a Cook Partisan Voting Index score of R+10, a self-described moderate Republican who endorsed Obama twice, at the ripe young age of 71, is making a comeback Senate bid:

Is South Dakota ready for a comeback from Larry Pressler?

Turned out of the Senate after three terms by Tim Johnson in 1996, Pressler will run for the same seat 18 years later.

“Today, I am announcing that I am running for the United States Senate, and I intend to win,” Pressler said.

But Pressler, 71, a lifelong Republican who was in the GOP for his entire time in Congress, won’t be in that party’s crowded primary. Instead, he’d run as an independent, giving voters next November a third choice between presumed Democratic nominee Rick Weiland and the Republicans’ top candidate.

In an R+10 state, a Republican has a strong advantage. In an R+10 state, with one Democratic candidate, one Republican candidate, and one independent candidate who spent three terms as a Republican, the Democrat has a shot.

Remember the volunteer firehouses that are still waiting to learn whether they’re legally obligated to provide insurance to their volunteers, or face federal fines under Obamacare?

The IRS declined to comment and referred the Tribune-Review to the Treasury Department, which is writing final regulations for the law’s employer mandate. In a written statement, the department said it is aware of the concerns of volunteer fire companies but declined to comment further.

Here’s another volunteer group suddenly finding themselves with a similar, significant problem for all of their volunteers:

The Obama administration has told Vista volunteers and other AmeriCorps workers that their government-provided health coverage does not measure up to the standards of the new health care law, and that they may be subject to financial penalties unless they obtain insurance elsewhere . . . 

Abby Grosslein, a Vista member in New Orleans, said she thought it was strange that the health benefits provided by a federal agency did not meet the standards of a law adopted more than three and a half years ago. “It would be nice if the government waived the penalty because we are a federally funded program,” said Ms. Grosslein, 24, who is completing her third year of service with AmeriCorps. “It’s as if the right hand does not know what the left hand is doing.”

Moreover, she said: “The Affordable Care Act has been on the books since 2010. Why are we hearing only now that our health plan is not compliant?”

. . . Rick Christman of Lexington, Ky., a former member of the board of AmeriCorps’ parent organization, the Corporation for National and Community Service, said no one expected that Vista workers would be subject to penalties because their health coverage was inadequate.

“It’s unfortunate,” Mr. Christman said.

Obamacare is establishing a giant disincentive to volunteer work and volunteer organizations, as every organization suddenly realizes it can’t accept more than 30 hours of volunteer work from more than 50 workers without being on the hook for health insurance for the volunteers, or paying $2,000 per “employee” even though workers are volunteers. The Kaiser Family Foundation reports that employers this year were paying $5,900 on average to provide health insurance for a single worker, and $16,000 for family coverage. Most volunteer and charitable organizations do not have that kind of cash lying around; providing coverage to the volunteers and covering those costs will mean diverting massive amounts of cash away from the charitable organization’s mission.

This is separate from the new regulations on charity and nonprofit hospitals.

Finally, Americans have a law cracking down on the menaces of AmeriCorps, volunteer firehouses, and charity hospitals.

Welcome back! Christmas was a welcome respite, but the news about Obamacare continues, and the new year is nearly here. Today’s Morning Jolt examines the new taxes and fees that kick in for 2014, as well as just what Obamacare’s new insurance purchasers will experience when they go to a doctor’s office or hospital this winter:

Some folks are going to head into an emergency room in 2014, thinking they have insurance, only to find their 834 packet didn’t transfer successfully from Healthcare.gov to the insurer.

Or perhaps they’ll find they do have insurance . . . but that the cost of that first visit to the emergency room hasn’t reached their deductible yet. Surprise! You’re on the hook for the entire $5,000 cost of the emergency room visit. No, I’m not kidding:

Sixty-four percent of bronze plans offered in Dallas, for example, require policyholders to meet the full deductible before insurance coverage kicks in, according to the eHealth/KHN analysis, which included all insurers except one, Molina Healthcare. The average deductible in those plans was $5,400, according to the data provided to eHealth by insurers.

How many of the newly insured will go to a doctor’s office this winter? Better hope it’s a mild flu season:

All new plans must cover some defined preventive services with no copayment by the consumer and without having to meet the deductible first. Those include some vaccinations, mammograms and other cancer screenings, contraception, including birth control pills, and periodic physicals. But prevention services do not include treatment for an illness, such as the flu. Charges could also apply if, during a preventive care visit, the patient is also treated for a medical condition or a minor injury.

How many of the newly insured think that insurance is covering most of the costs, for everything starting from day one? How many think their premium means their insurance company covers all of the costs? David Nather, writing in Politico:

The point of the Affordable Care Act is to cover people who haven’t had health insurance before, and it may have already reached some of those people. But because they’re new to health insurance, they may be in for a rude shock: It doesn’t cover everything.

There are deductibles, for example — the amount of money you have to spend out of pocket before coverage kicks in — which can be very high with “bronze” Obamacare plans, the cheapest kind. There are also co-payments for office visits, as well as co-insurance, the percentage of medical expenses you have to pay even if most are covered by your insurance.

There’s no way to know how big an issue this could be before January arrives — but if newly insured people think they’re getting free health care, or just think the deductibles are too high, they could be disappointed with their first experiences with Obamacare.

Back in June 2013, Megan McArdle shared a pastor/reader’s portrait of the decision-making of some Americans who, for all of their other wonderful qualities, aren’t so great at considering long-term consequences, deferred gratification, cost-benefit analysis, and other hard financial realities:

I work with what I’d call median Americans. Incomes right around the median. Family structure and dysfunction right around the median. You get the picture. And to work on spiritual issues often requires dealing with financial ones at the same time. (Often they are the same problem.)

Everything that I’ve seen about the ACA and its implementation seems completely divorced from how say 35%+ of these median Americans function on a daily basis. The ACA and every wonk assumes rational people who can make good financial decisions. Instead what you have is people with $100K of school debt because it compounded when they stopped paying it, who are leasing a new car, who have an interest only mortgage (or a HELOC to help them pay the original mortgage), who have at least 3 credit cards maxed, maintain a pay-day loan they got scammed into, and yet find cable with HBO and an iPhone 5 with all you can eat plan necessities. It is not that on a median salary it is not possible to live a good and prudent life; it just requires some restraint and a minimum amount of simple rules. (Rules like Dave Ramsey talks about, or Benjamin Franklin divorced from the Christian content). But this is what the ACA mandate and cost is going to mean to many of these people: do I keep HBO & Cable, my iPhone, or buy medical insurance? Which bill that I already have must be done without? They will refuse to even think about that. 

On top of that, if they recognize Obamacare at all what they think it means is “universal free health care” with emphasis on the free. When you try and say that it will cost them at least 4% of their income, they go directly into denial.



What I’m saying is that for a large minority of people opting out of the ACA probably won’t even be a conscious choice. It will just happen because of the complexity, the upfront sticker cost and the lack of ability to make good financial decisions. They will deal with it later when they file taxes which won’t be until September, because when their tax guy tells them they won’t get the refund they were expecting, they will file the automatic deferral to “put it off” for a little while.

May your Christmas, or nondenominational day off, be merry, and may your heart be filled with the spirit of the season . . . 

Ahem. I meant that other spirit of the season.

From 60 Minutes last night:

Lesley Stahl: But when you have so many phone records being held, emails, heads of state’s phone conversations being listened in to, has it been worth our allies being upset? Has it been worth all the tech companies being upset? Has it been worth Americans feeling that their privacy has been invaded?

Susan Rice: Lesley, it’s been worth what we’ve done to protect the United States. And the fact that we have not had a successful attack on our homeland since 9/11 should not be diminished. But that does not mean that everything we’re doing as of the present ought to be done the same way in the future.

Ahem. 

Above: Apparently not a successful attack on our homeland since 9/11.

That’s our National Security Adviser!

Today we pledge to never condone terrorism; never make excuses for it; never keep company with those who sow hatred; and never forget.

— Susan Rice (@AmbassadorRice) September 11, 2012

Valerie Jarrett just announced to the press that President Obama will “sign up for for Health Insurance on the marketplace by the end of today to lead by example.”

We can safely assume if the site is “down for maintenance” today, it is not planned.

This AP photo is actually of Obama doing an event with Twitter.

This is actually not necessary for the president, as:

the President, while in office, has access to treatment by military hospitals and doctors as the Commander-in-Chief of the Armed Forces. His family, as his dependents, also shares in this benefit. In the past, when Presidents have been sick or injured in office, they have almost always been treated at military hospital establishments. The cost of this treatment is borne by the taxpayers as part of the military budget appropriated by Congress.

As a federal employee, the president has a choice of about ten family plans, but it’s not clear how much, if any, President Obama pays out of pocket. TheLos Angeles Times:

The White House medical unit, with a staff of four doctors plus nurses and physicians’ assistants, is steps from his office. Treatment is free for Obama and his family (as well as for the vice president and his family).

The president’s coverage can change after he leaves office, though:

However, once the President leaves office, this may change. The President is afforded a set pension amount for his services, regardless of whether he served one or two terms. The amount of this pension, currently, is $199,700 per year, or a little less than 50% of an active President’s salary. The President receives this amount for life. The President is free at this point to choose privatized healthcare by paying health insurance premiums through the same carriers available to federal employees and will receive premium prices comparable to those employees. The President may also choose to purchase private health insurance from another company at his own expense. The one benefit the President and his family receive is the option to continue to receive treatment at military hospitals and healthcare provider locations, just as veterans are eligible for these services. This applies whether or not the President actually served in the armed forces, by right of being Commander-in-Chief for at least four years.

Still, it is good that the president will get to experience the joyfully simple and easy-to-understand, technically proficient web site that the rest of the country has enjoyed since day one.

From the last Morning Jolt until December 27:

Happy Obamacare Deadline Day! The News Is Still Bad.

Happy Obamacare Deadline Day! You’ve got to pick a plan by the end of today (and send in that payment!) to make sure you have health insurance coverage that starts on January 1.

Say, AP, how’s that going?

As a key enrollment deadline hits today, many people without health insurance have been sizing up policies on the new government health care marketplace and making what seems like a logical choice: They’re picking the cheapest one.

Increasingly, experts in health insurance are becoming concerned that many of these first-time buyers will be in for a shock when they get medical care next year and discover they’re on the hook for most of the initial cost.

The prospect of sticker shock after Jan. 1, when those who sign up for policies now can begin getting coverage, is seen as a looming problem for a new national system that has been plagued by trouble since the new marketplaces went online in the states in October . . . 

Hospitals are worried that those who rack up uncovered medical bills next year won’t be able to pay them, perpetuating one of the problems the new health care system is supposed to solve.

The Affordable Care Act doesn’t actually make care affordable.

To celebrate, SenatorJoe Manchin’s calling it a “meltdown”:

President Barack Obama’s healthcare law could have a “meltdown” and make it difficult for his Democratic Party to keep control of the U.S. Senate next year if ongoing problems with the program are not resolved, a Democratic senator said on Sunday.

Senator Joe Manchin of West Virginia, who has urged delaying a penalty for people who do not enroll for health insurance in 2014 under the law, told CNN that a transitional year was needed for the complex healthcare program, commonly known as Obamacare, to work.

“If it’s so much more expensive than what we anticipated and if the coverage is not as good as what we had, you’ve got a complete meltdown at that time,” Manchin told CNN’s “State of the Union” program.

“It falls of its own weight, if basically the cost becomes more than we can absorb, absolutely.”

And look at the poll result that Obama gets to unwrap this week!

Support for the country’s new health care law has dropped to a record low, according to a new national poll.

And a CNN/ORC International survey released Monday also indicates that most Americans predict that the Affordable Care Act will actually result in higher prices for their own medical care.


Only 35% of those questioned in the poll say they support the health care law, a 5-point drop in less than a month. Sixty-two percent say they oppose the law, up four points from November.

The uninsured remain persistently difficult to reach — almost as if they don’t care nearly as much about obtaining insurance as they say to pollsters:

Despite White House and state efforts to promote the Affordable Care Act, some people still don’t have health insurance or any idea how to sign up for it.

Take Corryn Young, a 32-year-old dental hygienist in Fort Collins, Colorado. She knows she needs to get health insurance but is a little vague on the details.

“What my income would qualify me for, when I need to be signed up, what type of deductibles they have to offer — that kind of stuff overwhelms me,” she says.

There are people available to help Young with all those questions. The White House has set aside more than a quarter of a billion dollars nationally to pay navigators to give people face-to-face help buying coverage and applying for new subsidies to make it more affordable.

But all the effort had netted about 23,000 customers for private insurance in the state’s marketplace as of Dec. 14 — only about 17 percent of the way to the state’s goal of enrolling 136,000 people by the end of March.

In Maryland, they’re having a blue-vs.-blue Christmas:

Maryland gubernatorial candidate Doug Gansler is incensed over the botched rollout of Affordable Care Act. He’s aghast at chronic problems with Maryland’s online enrollment platform and stunned that a state with “literally the smartest people in the country” would have hired a company from North Dakota, of all places, to help put its exchange in place. The whole spectacle, Gansler fumes, “is almost like a Saturday Night Live skit.”

The punch line: Gansler, Maryland’s current attorney general, is a Democrat.

The day’s headlines . . . 

1. The individual mandate, requiring the purchase of health insurance or paying a fine of 1 percent of annual income, is repealed for Americans who have had their plans canceled. The sudden change leaves some wondering whether the administration will enforce the individual mandate at all in 2014, including Chuck Todd this morning “If you put together all the different ways that they have delayed or grandfathered certain things in . . . I’m starting to wonder if anybody is ever going to pay the penalty in the first year. Is there going to be a single person that is going to be responsible for paying that $95? At this point it doesn’t look like it.” (Note that the fine is $95 or 1 percent of your income, whichever amount is higher.)
2. CBS News: “Teresa Fryer, the chief information security officer for the Centers for Medicare and Medicaid Services (CMS), told congressional interviewers that she explicitly recommended denial of the website’s Authority to Operate (ATO), but was overruled by her superiors. The website was rolled out amid warnings Fryer said she gave both verbally and in a briefing that disclosed ‘high risks’ and possible exposure to ‘attacks’.”
3. A growing consensus finds the Obama administration’s NSA policies indefensible: “From the moment the government’s massive database of citizens’ call records was exposed this year, U.S. officials have clung to two main lines of defense: The secret surveillance program was constitutional and critical to keeping the nation safe. But six months into the controversy triggered by former NSA contractor Edward Snowden, the viability of those claims is no longer clear.”
4. In the Iran negotiations, “A bipartisan group of 26 senators introduced legislation Thursday that threatened new sanctions against Iran, dismissing warnings from the White House that such a move could scuttle efforts to peacefully resolve the dispute over Iran’s nuclear program.
5. According to a forecasting model from the Washington Post’s John Sides, “Democrats currently have a 1 percent chance of retaking the House.”

Finally, today President Obama departs for his 17-day Christmas vacation in Hawaii. Must be tough to leave Washington when everything is going so well!

From the last Morning Jolt of the week:

Individual Mandate Repealed! . . . for Those with Canceled Plans

On the one hand, this is good news. Common sense, even.

The Obama administration gave another break to people losing their health insurance coverage late Thursday, offering a special hardship exemption to patients who want the extremely cheap, bare-bones plans known as catastrophic coverage.

It’s the latest in a series of last-minute concessions being made by federal officials harried by complaining consumers as the days tick down to Jan. 1, 2014 and the last deadline for getting health insurance for the new year.

Senior administration officials who declined to be named estimate that about 500,000 people may be affected.

Or, you know, maybe 5 million.

Ezra Klein declares, “This is the first crack in the individual mandate. But is it the last?”

Avik Roy, describing the result of this move as “utter chaos”:

This most recent announcement from the Obama administration is the first time it has publicly admitted that Obamacare is making health insurance less affordable, not more so, for millions of Americans.

. . . The catastrophic plans aren’t that much cheaper than the regular Obamacare plans. In California, for example, the median cost of a pre-Obamacare plan on eHealthInsurance.com, for a 25-year-old male non-smoker, was $92. The Obamacare bronze plans cost an average of $205 a month. The Obamacare catastrophic plans? $184. In some parts of the country, the catastrophic plans are actually more expensive than the bronze plans.

For this reason, I don’t expect that many Americans to sign up for the catastrophic plans. If you think that the Obamacare bronze plans are unaffordable, you’re likely to feel the same way about the catastrophic plans. Instead, you’re going to take advantage of the “hardship exemption” and go without insurance altogether.

“Panic mode” is how insurance executives are describing the administration’s moves — but the insurers themselves are going to have to wonder about the financial viability of their exchange-based plans.

I prefer “panic mode” to the naive, optimistic assurances that this will all work out in the near future once the mere “glitches” are fixed.

Ramesh asks if those folks are exempted from the fine for not buying insurance . . . why shouldn’t, say, the currently uninsured be exempted?

David Remus asks, “Given that the individual mandate was upheld as a tax, are there other examples of a president waiving taxes for certain groups?”

Doc Zero:

Bruce Webster writes in, “I would not be surprised — in the wake of this announcement — to see Healthcare.gov shut down ‘temporarily’ at some point during the holiday season and then a more general suspension of the individual mandate.”

And now, the Obamacare roundup . . . 

The Los Angeles Times editorial board member Jon Healey: “The Times’ editorial board has steadfastly supported the Patient Protection and Affordable Care Act, warts and all, because it makes a credible effort to make a more sustainable healthcare system. But it’s disingenuous to pretend that the changes mandated by the law cost nothing or that the benefits it delivers magically arrive for free.”

Oklahoma: “One Mayes County woman says she’s spent nearly 60 hours trying to sign up for Obamacare.

 She claims she sits in front of computer time and time again, only for the system to crash near the end of the sign-up process.”

Nebraska: “The family had run smack into the realities of the new market place. ‘The tax credit won’t mean much when you have such a high deductible,’ Marilyn said. ‘When people find out about the nuts and bolts, they are going to be pissed.’ She summed up her experience in one word, ‘disappointing.’”

And right after I hit “send” on today’s edition, I encounter this story:

Nearly three months after its launch and as millions of Americans log on to shop for health plans,HealthCare.gov still has serious security vulnerabilities, according to documents and testimony obtained exclusively by ABC News.

There have been “two high findings” of risk – the most serious level of concern – in testing over the past few weeks, the top Centers for Medicare and Medicaid Services (CMS) cybersecurity official told the House Oversight Committee on Tuesday in a private transcribed interview.

Hey, could an unsecure website count as a “hardship” worthy of an exemption?

A&E, the network that airs “Bates Motel,” the series “The Killer Speaks,” which interviews convicted felons, and “Psychic Tia,” and that has in the past aired “Growing Up Gotti,” “Criss Angel Mindfreak,” and “The Sopranos,” has deemed “Duck Dynasty” star Phil Robertson unsuitable for its broadcast because of an interview answer where he paraphrased Corinthians 6:9–11.

That’s where they draw the line!

National Journal’s Ron Fournier talks to Hillary Clinton’s friends and supporters and writes a “memo” of advice to her, based upon their thoughts. His conclusion:

Pope Francis has reminded us of the power of small gestures. Without changing the Vatican’s ideology one iota, he has transformed the way people think about the Catholic Church, one symbolic act at a time. And consider the parallels between your job and that of the pope — an old man running an ancient institution marred by scandal and incompetence. You can be just as transformative. Actually, if you run for president, you must be. That’s what a few of us think.

Stop. Just stop.

Hillary Clinton is more inside Washington than the District of Columbia Sewer and Water Authority. She’s lived and worked there since January 1993 — please, no more implausible spin that her heart is really in Chappaqua and that she’s always been a Yankee fan. As first lady, then senator, then secretary of state, Hillary Clinton has probably ranked among the five most influential figures in Washington every year for the past two decades. Even during the Bush years, there were few figures in D.C. or the world that she couldn’t get a meeting with and offer her views. She’s never been shut out of the policy-making process. During most of her Senate years, particularly post-9/11, most Republicans respected her. Since then, she and her husband have turned the Clinton Foundation into an unparalleled institution for hobnobbing with the world’s elites and the Davos set, with more than a few serious allegations of influence-peddling and favor-trading. “This Town” and its methods and culture have her fingerprints all over them. Since the moment her husband was sworn in, she has been at the top of Washington’s food chain, with everyone beneath her flattering her, sucking up, hoping to win her favor and have a future friend in the Oval Office. (“Clinton has racked up at least 15 awards in the nine months since she left the State Department.”)

Nothing in Hillary Clinton’s past suggests she’s ever been that dissatisfied with the way Washington and/or the country works. For pete’s sake, while secretary of state, she had Huma Abedin under a “special contract” that allowed her to be a consultant for private clients while keeping her $135,000-per-year State Department job.

The status quo has been very, very, very good for the Clintons. They have a net worth estimated at $55 million; Hillary Clinton’s speaking fee begins at $200,000, with Wall Street banks and private-equity firms most frequently picking up the tab: Goldman Sachs, KKR, the Caryle Group. Far from an impassioned reformer, eager to overhaul a system of crony capitalism and back-scratching, Hillary Clinton is our& political and economic status quo in human form.

Expecting Hillary Clinton to be a transformative reformer of Washington is like expecting Donald Trump to become a Bolshevik, Kim Jong Un to renounce power and become a monk, or the New York Yankees to push for the end of free agency in baseball. Powerful people rarely if ever decide to completely overhaul the system that made them powerful.

From the Thursday edition of the Morning Jolt:

Terrific: 58% of Uninsured Haven’t Even Looked at the Exchanges Yet

Before we begin this morning’s buffet table of bad news for Obamacare, a quick note on the typically bad-faith accusation from the Left that we’re somehow enjoying all the problems stemming from the implementation of this law.

From the beginning, Obamacare fans inside and outside of government insisted that they were right, that we were wrong, and that we were motivated by all sorts of malicious and callous motives. They insisted our skepticism was fueled by ignorance and outdated ideology. Our warnings and dire predictions were dismissed as sour-grapes negativity and pessimism.

Most of the ideas from the Right — medical-malpractice reform, interstate sales of insurance — were ignored or dismissed. We said you couldn’t require insurance companies to cover a lot of new expenses — i.e., pre-existing conditions — without driving up costs, and that higher costs inevitably would drive up premiums. Obama’s promise that his plan would lower premiums by $2,500 per year for families was always industrial-strength snake-oil, and yet somehow we were the bad guys for saying it couldn’t possibly happen, short of covering the costs from the discovery of the leprechaun’s pot of gold at the end of the rainbow.

Now it is exceedingly clear that one-sixth of the nation’s economy is being fouled up beyond recognition by a convoluted, complicated, poorly planned Rube Goldberg scheme of a law that has been implemented by hacks whose overestimation of their own abilities is on an astronomical level.

So we’re not enjoying any of the problems from Obamacare, but spare us the insistence that we not take any satisfaction in seeing our assessment of the world, the limits of policy, the capabilities of government, and the possibility of grandiose, utopian promises reaffirmed, verified, underlined, highlighted, and footnoted in high-definition, day after day.

Anyway, today’s roundup:

Most of the uninsured haven’t even looked at the exchanges yet:

Ten percent of uninsured Americans in the poll say they have applied for insurance under the exchanges. Thirty-two percent say they have looked up information about the exchanges but have not applied; 58 percent have not looked up information about health insurance exchanges.

Oh, and 59 percent of the uninsured think getting health insurance would “hurt them financially.”

Remember, all of this grief and aggravation is driven by the aim to get the uninsured to buy insurance.

Just how many Americans are losing insurance?

In the poll, 13 percent of insured Americans say they’ve received a notice that their health insurance plan is being cancelled or changed because it does not meet the minimum coverage requirements under the 2010 health care law.

Better hope the server change goes smoothly:

Some technical experts are perplexed at the U.S. government’s plan to switch web hosts for its new health insurance portal, HealthCare.gov, in the midst of an expected last-minute rush to beat a March 31 enrollment deadline for 2014 coverage. Switching hosts is not in and of itself a huge risk if it is done carefully and with lots of preparation, according to technical experts interviewed by Reuters. It is the timing of the highly complex maneuver that is risky. If there are problems, the website could become sluggish or even unusable for anyone trying to enroll. The government is tempting fate, they said.

Hey, come on. What are the odds of something going wrong with HealthCare.gov?

Back to square one:

Illinois officials are e-mailing and calling some 30,000 people, advising them to start over on their health insurance applications. They say it’s possible they were referred to Medicaid. Officials advise if the screener at the Get Covered Illinois website sends them back to healthcare.gov, they should create a new account with a different e-mail address and submit a new application.

And enrollment in some states remains abysmal:

As of Wednesday, the New Mexico Health Insurance Exchange had spent at least $2.5 million on marketing and outreach campaigns to get people to buy health insurance. And as of Wednesday, 291 people had enrolled for coverage beginning Jan. 1 on NMHIX’s small business exchange.

John Podesta, soon to become a White House adviser, recently called the Republican party “a cult worthy of Jonestown.” Today he apologized.

It’s an interesting metaphor, increasingly common — how often have you heard references to “drinking the Kool-Aid”? — but it’s worth recalling that Jim Jones was, before his horrific, sadistic end, an increasingly influential figure in California politics, particularly Democratic-party politics.

Jones’ “People’s Temple” religious group/organization/cult played a role in George Moscone’s election as mayor of San Francisco in 1975, and Moscone subsequently rewarded Jones by naming him chairman of the San Francisco Housing Authority Commission.

Salon:

Jones used his position to take possession of public housing units and install temple members in them, and he put other followers on the housing authority payroll. The preacher was building his own power base within city government. “He was using his power to recruit members and to put the hammer on people,” said David Reuben, an investigator for San Francisco District Attorney Joseph Freitas, another politician under Jones’s sway. “He had a lot of authority.”

“Jim Jones helped George Moscone run this city,” said Jim Jones Jr., a chillingly matter-of-fact assessment of the temple leader’s creeping encroachment in San Francisco.

Political leaders, aware of Jones’s ability to deliver — or manufacture — votes, lined up to pay tribute to the preacher. He worked his way into the good graces of officials high and low — most of them Democrats, since that was the party in power in California and San Francisco in the mid-1970s. But Jones was also happy to exchange mutually complimentary correspondence with the offices of Ronald Reagan and statesman Henry Kissinger.

During the 1976 presidential campaign, Jones wangled a private meeting with Jimmy Carter’s wife, Rosalynn, at the elegant Stanford Court Hotel on Nob Hill, arriving with a security contingent that was larger than her Secret Service squad. Later Jones accompanied Moscone and a group of Democratic dignitaries who climbed aboard vice presidential candidate Walter Mondale’s private jet when it touched down at San Francisco International Airport.

Governor Jerry Brown sang the preacher’s praises. Congressman John Burton, Phil’s brother, lobbied the governor to appoint Jones to the high-profile board of regents, which oversaw California’s sprawling public university system. San Francisco Supervisor — now U.S. Senator — Dianne Feinstein accepted an invitation to lunch with Jones and to tour Peoples Temple.

But no political figures were more gushing in their praise of Jones than Willie Brown and Harvey Milk, San Francisco’s rising tribune of gay freedom.

Jerry Brown and Jim Jones.

For a stark raving lunatic atop a cult of personality, Jones had amazing sway among the political leaders of his time. In 1977, facing increasing media scrutiny of allegations of abuse of his followers, Jones moved to Guyana, and renamed it after himself. The rest is gruesome, horrific history, culminating in the November 1978 cyanide poisoning of 909 members of the cult, including more than 300 children.

The comparison of today’s GOP to Jim Jones’s followers is deeply offensive and obnoxious, but also ironic, considering how some of the Democrats still on the scene today were all too eager to embrace Jones when he could provide political assistance.

He’s no Pajamahadeen.

Obamacare Finds the Poster Boy It Always Deserved

Hmm. Nope, nope, and nope, pal.

Where to begin? That appears to be a plaid adult onesie, and this is really testing my libertarian live-and-let-live limits. I suspect there’s a reason grown men don’t usually wear onesies. Probably something to do with zippers and midnight trips to the bathroom, and how you really don’t want anything down there getting caught when you’re half asleep and zipping up.

By the way, if you’re in the market for a plaid adult onesie, apparently they cost $69.95. What you wear to bed is your business, but that seems like a lot of money for something you sleep in.

Of course, he’s not sleeping in that; he’s having hot chocolate and discussing health insurance. (Wonder if Michelle signed off on the hot chocolate.) It’s probably fair trade Mexican hot chocolate. It’s spicy, Ibarra. Hard to find but “he knows a guy.” (This is the only point where my mockery is mixed with a bit of envy.)

He appears to be raising his eyebrow and smirking a bit, as if there’s someone directly to his left who he thinks should be quite impressed with him at the moment. Maybe this person just checked out the closet of his Brooklyn apartment and noticed all of the Urban Outfitters, Abercrombie & Fitch, and American Apparel clothes — this is after he’s mentioned to his guest his disdain for “blind consumerism.” Lots of “skinny jeans,” of course. He undoubtedly has already mentioned that he has a lot of vinyl records of a bunch of bands you’ve never heard of, or the early work of your favorite bands “before they went mainstream.” He doesn’t actually need those glasses. He just wears them because he likes the way they “frame his face.”

Obviously, he’s going to be discussing health insurance with someone. He’s wearing his watch, which seems a little odd. Christmas lights — er, wait, it’s an Obamacare ad, probably “Holiday Lights” — are up on the relatively bare walls.

I’m definitely getting a “Pottery Barn Leather Sofa” vibe, which retails for about $2,999. If you’re plunking down $70 for your pajamas, you’re probably not going to be that horrified by the prices on Healthcare.gov.

John Sexton notices:

Oh, my money is on the guy from Big Bang Theory once they throw down in a slap fight.

In yesterday’s Morning Jolt, we looked at the gift options from MyDemocraticStore.com. There’s a terrific new wrinkle to one gift . . . 

Merry Christmas Happy Generic Late-December Holidays from the DNC!

Getting down to the wire for Christmas shopping! Let’s check out the DNC’s store to see what they’re offering as last-minute gift ideas . . . 

A mug that says “Happy Holidays” and offers greetings in many languages, but not “Merry Christmas.” Perfect for that decorated veteran of the War on Christmas!

German-speaking Morning Jolt reader Dieter notes the Democratic merchandisers “couldn’t even spell ‘Frohe Feiertage’ in German correctly. Seriously? They misspelled it ‘Forhe’.” Clearly a continuation of the “judge us by our good intentions, not our bad results” philosophy that brought us Obamacare.

Other gifts available from the Democrats:

A “Speaker Pelosi” magnet pin. What, are these left over from 2010? $1.99. If you find one of these in your stockings, it is a sign Santa just didn’t give a damn this year.

“I heart Obamacare” sweatshirts. Can’t believe they didn’t sell out!

You love equality, but not capitalization.

For $49.95, you can buy a framed photo of President Obama and Nancy Pelosi at the signing ceremony for Obamacare:

You know, the National Republican Senatorial Committee might buy one; they’ll be using that image in their ads over and over again in the coming year . . . 

Today’s Morning Jolt is just a Dagwood sandwich of bad news for Obamacare, piled higher and higher:

A Bad Day, Even by the Standards of Obamacare’s Bad Days

President Obama probably can’t wait to get away on that 17–day vacation. Because Obamacare just continues to careen from “success” to “success”:

Some frustrated consumers are sending premium payments to insurers who have never heard of them. Others say they will pass up federal subsidies and pay full price through insurers, while still others have given up altogether on the promise of health insurance by Jan. 1.

Consternation and confusion over applications sent through the federal HealthCare.gov website continue into the last seven days before the Dec. 23 enrollment deadline. Consumers with health issues are particularly nervous about the prospect of not having insurance at the start of the new year. Federal assurances last week about a “special enrollment period” for people whose applications have been hung up on the site are little comfort as neither insurers nor consumers have any idea how this will work and who will qualify.

The Department of Health and Human Services recommends people call its help line with questions and concerns about applications on HealthCare.gov. But that suggestion is also proving less than helpful for many.

. . . “Logic tells you I’m the target population for the law,” said Nelson, a Lombard, Ill., resident and Affordable Care Act supporter. But when people seek help from the call center, “you’re just being shuffled back and forth nobody owns the callers.”

Experts are divided on another possible solution for those hanging in the balance: sending premium payments before bills arrive from insurers.

Sentara Health, which offers the Optima health insurance plans for Virginia on HealthCare,gov, is hanging onto payments it can’t match with new customers yet. But Aetna warns that consumers should wait until they get a bill in the mail before writing any checks.

That’s a heck of a strategy for getting insurance: “Pay and pray.”

Oh, hey, more bad information on the sites, too:

In the latest round of difficulties with Obamacare in Wisconsin, plans offered by at least three insurers temporarily disappeared from the online insurance marketplace last week.

Before they came off the federal HealthCare.gov website for about a day, some of the plans from one company posted incorrect information about deductibles, according to the insurer.

Oh, hey, more sudden resignations of state directors:

MNsure’s top official resigned Tuesday following a Watchdog Minnesota Bureau report that she took a two-week Costa Rica vacation in late November, during the rocky rollout of the state $150 million health insurance exchange.

April Todd-Malmlov‘s abrupt resignation came during a closed emergency session of the agency’s board of directors. Subsequent reports revealed that Todd-Malmlov was accompanied on her tropical getaway by Jim Golden, Minnesota’s Medicaid director, raising possible conflict of interest and other concerns.

Oh, hey, more broken promises of imminent fixes:

Private health insurance exchanges still are not able to directly enroll consumers in subsidized health plans offered through Obamacare even though the government has said problems doing so should have been cleared up weeks ago.

Executives from three online health exchanges that contract with both insurance companies and government agencies to enroll consumers eligible for federal subsidies in marketplace plans say the process still isn’t ready to go and that more work remains.

This despite several promises from government officials that technical fixes have been made to allow for business to be conducted on those sites, which are alternatives to the troubled HealthCare.gov website and health exchanges sites run by states.

And Maryland may have to scrap its state exchange entirely:

The pace of enrollments is still far too low. If the exchange is able to replicate its best weekday and weekend performance during every one of the 104 days between now and the end of the open enrollment period on March 31, Maryland will still only achieve about three-quarters of its goal of signing up 150,000 people with private coverage. The site may be better, but better isn’t good enough.

Under those circumstances, the question raised by Rep. John Delaney, a Montgomery County Democrat, about whether it would be better for Maryland to scrap its effort to build its own exchange and instead join the federal one has merit. Indeed, Gov. Martin O’Malley acknowledged on Monday that the option — and all others — remain on the table.

That’s a hard possibility for Governor O’Malley to acknowledge. Under his leadership, Maryland was one of the most aggressive states in the effort to build out its own exchange — a strategic decision that appears in retrospect to have involved no small amount of hubris and political ambition. Walking away now from all that effort and tens of millions in expenditures would be particularly embarrassing.

But other than all that, Obamacare had an okay Tuesday.

Nah, I’m just kidding. There’s more bad news.

Two big retirements in the House of Representatives today.

Frank Wolf, a Republican who represents Virginia’s tenth district and has served in Congress since 1981, is retiring. His district includes parts of Clarke, Fairfax, Fauquier, Frederick, Loudoun, Prince William, and Warren Counties — an R+2 suburban district with a high number of federal government employees that Democrats are likely to find friendly territory for a takeover.

Jim Matheson, a Democrat in Utah whom the NRCC found to be a frustratingly difficult lawmaker to defeat, is also retiring. Matheson’s fourth congressional district is a stunning R+14, so Democrats will have an extremely difficult time keeping the seat. While it’s likely that many Utah Republicans will explore a bid, Mia Love’s path to Congress just got a lot easier. 

Check out that runaway Obamacare enrollment over on EnrollMaven.com!

In Arkansas, its up to 1,404! Well along the way to the state’s goal of 51,000 paid enrollees by the end of March.

In Delaware, it’s up to 793! The state’s goal is 35,000.

In New Hampshire, they hit 1,569. Getting close to that goal of 19,000!

In West Virginia, it’s up to 775! They’ll hit their goal of 24,000 in no time!

In Hawaii, all the way up to 444! That goal of 9,000 is in sight!

In Colorado they’re up to 9,980 . . . with a goal of 92,000.

We can skip the scoffing over Oregon and Washington exchanges, as their ludicrously embarrassing failures have been extensively discussed. Oregon’s at 44, with a state goal of 237,000; Washington’s at 17,780 . . . with a goal of 340,000.

Illinois, the president’s home state! Surely they’re ahead of the curve in getting folks enrolled and paid, right? They’re at 7,043 . . . out of a goal of 143,000.

Even Kentucky, often cited as one of Obamacare’s shining success stories, is at 20,951 . . . about 10 percent of the way to their goal of 220,000 enrolled.

All of those “M” states with their own state exchanges, ambitious Democratic governors and deep-blue state legislatures — surely, they must be enrolling at a better pace, right?

Eh, not really. Maryland’s at 3,758, with the goal of 150,000 far from sight.

Massachusetts is at 1,700, even further from their state goal of 250,000 paid enrollees.

Minnesota has hit 4,478 . . . out of a goal of 67,000. Still trying to hit 10 percent.

Note that all of the above states have Democratic governors. The Obamacare fan’s usual dodge or whine that the rollout is impeded by uncooperative Republican governors does not apply in any of those states; the difficulties in these states indicate that the problems with the program do not stem from insufficient enthusiasm from GOP lawmakers.

The one state making serious progress is Connecticut; they’re up to 11,631 out of a goal of 33,000. Rhode Island has 2,669, but that state’s goal is only 12,000, one of the lowest in the country. (One health official in the state “predicts that 70,000 to 100,000 will enroll on the exchange by the end of next year.”)

Some states have hit more than five digits. In New York, they’re at 50,119; a pretty solid chunk of their goal of 218,000.

In California, they’re up to 159,004. That sounds pretty good, until you realize they were aiming for 1.3 million.

States with Republican governors are faring no better, of course.

In Iowa, they’re at 757! Nice number for a plane, but well short of the goal of 41,000 enrolled.

In Maine, they’re up to 1,747. Closing in on that goal of 23,000!

An overwhelming 398 in Alaska! Look out, enrollment goal of 20,000!

Let’s make this simpler. The only states that have reached 10 percent of their enrollment goals are California, Colorado, Connecticut, New York and Rhode Island; Kentucky is close.