# Obamacare Math

I’m no mathematician, but I’ve come to some interesting conclusions from “running the numbers” on the Obamacare debacle.

First, about 14 million people are covered under the individual health insurance market.

Of those, in 2013, 13% were covered by grandfathered plans; or plans that could be renewed for 2014.  So that’s 1.82 million who for sure can “keep their plans;” at least for 2014.

That means as many as 87% of individual health plans could be cancelled.

We know for sure that as of last week (this is a week by week changing number) 4.8 million people have already gotten cancellation notices.  These are people who were covered this year, and if they want to continue to be covered, need to choose and purchase new insurance plans by January 1st.

The CBO estimated that 7 million people would be covered in the health insurance exchanges in 2014, but that was an estimate based on a fully functional Obamacare website.  I’ve no doubt that that the Obamacare site will eventually be fixed, but how long will that take?  I’m pretty comfortable guessing that the problems will not be fixed by the end of November, as promised by the administration.

The administration estimates that 200,000 people have signed up for coverage with the exchanges by mid-November.  That means as of right now, of the people who had coverage under the individual health insurance market this year, 4.6 million of them still don’t have coverage for 2014.   Although I’m sure that the number of enrolled people will steadily increase over the next few weeks, does anyone think that the remaining people who lost their coverage because of the Obamacare requirements will have coverage by the start of the New Year?

Even the Obama administration isn’t that optimistic.

That means that thanks to Obamacare, more people will start off the year without health insurance coverage than had it this year.  Congratulations President Obama!  You’ve successfully wrecked the nation’s health insurance market!   I think the administration should have applied the lessons learned from the Hypocratic Oath: First, do no harm.  Instead, the administration burned down the house, only to learn that their plans for the new house were incomplete.

If the percentage of uninsured in this country is greater this time next year than it is now, it will be pretty clear who will be responsible for it.  I hope someone is smart enough to remind people of that for the elections.

# Arrogance of Trust

The news that Edward Snowden had somehow managed to persuade 20 to 25 of his fellow colleagues at the NSA to give up their passwords and login information has probably shocked IT professionals and corporate security types.  “What kind of slipshod IT security is the NSA running?”  Could the smartest guys in the room really be so dumb and trusting?  As Reuters reports:

Snowden may have persuaded between 20 and 25 fellow workers at the NSA regional operations center in Hawaii to give him their logins and passwords by telling them they were needed for him to do his job as a computer systems administrator, a second source said.

This may seem incredible to those involved in information assurance that a system administrator, who had only been at the job a few months, could talk that many people out of their passwords.  Don’t these people have any information security training?  Every company IT department  teaches its employees to never share their password information.  Didn’t these guys have any training?

Headquarters of the NSA at Fort Meade, Maryland. Español: Instalaciones generales de la NSA en Fort Meade, Maryland. Русский: Штаб-квартира АНБ, Форт-Мид, Мэриленд, США (Photo credit: Wikipedia)

It turns out they do.  The Department of Defense, which the National Security Agency falls under, has extensive computer security training.  But that only begs the question further.  Snowden was so new at his base in Hawaii that he probably didn’t have any long term personal relationships to play on in order to trick people out of their passwords.  But I don’t think he needed to trick anyone.  And I think I know why.

I should preface this by saying this is just my personal opinion, but I think the popular idea of intelligence agencies and organizations, at least American ones, as a font of constant paranoia, looking over your shoulder at all times, and a lack of trust between co-workers, as depicted in movies and popular culture (think the Bourne movies) is totally opposite of the real situation.  I think the security problem in US intelligence organizations, which Snowden exploited, is that everyone trusts each other too much.

Security Clearances for Top Secret and above levels cost thousands of dollars and can take months to complete.  Once you have a security clearance, it’s not only a marketable item, but it’s sort of a short hand as to what kind of character you have.  Although it actually means you’ve mostly stayed out of trouble and have not screwed up too much, it’s taken as a certificate of approval that this person is trustworthy and of good character.  So if you work in a classified facility, surrounded by cleared people, some of them may strike you as crazy, or unpleasant, but not thieves, not crooks, and not traitors.  Why?  It’s nothing they did, it’s simply from the fact that they are working there; they’ve been vetted.

Once you are on the inside, you are part of special limited clique, in which everyone on the inside of the vault door holds secret knowledge that those on the other side of the vault door don’t know, and can’t know.  It’s like being part of Skull and Bones, only instead of knowing secret arcane nonsense; you know real things about the world that matter.  That dividing line between those on the inside of the door and those on the outside is huge.

One of the first things they teach you in Basic Training and Boot Camp is to keep you locker and money locked up and secure at all times. Even the camaraderie of military service isn’t enough to be sure your buddy won’t grab your wallet in an act of desperation. But like Singapore, if you decide to leave your wallet on your desk at work in your secured facility, you can mostly be assured that it will still be there, undisturbed, when you come back from break.  Having many roommates in the past with security clearances, I never worried for a second about leaving money or valuables around out in the open. I may have worried if they would clean up the kitchen after fixing dinner, or vanishing for days on end, but I never worried that they would steal from me.  I granted them an automatic level of trust that most keep within close family members.

And maybe that’s the problem.  In spite of all the security, and in spite of all the rules and security procedures, it doesn’t mean a thing unless people can operate with even a normal level of caution.  In my corporate environment I would never turn over my password to anyone, system administrator or otherwise.  But if I was back in the classified world, inside that insular level of trust, I can’t be sure how I would react.  And the fact that I would even question that is the problem.

# Schadenfreude, and the Obamacare Timebomb

Considering the disaster of a rollout that Obamacare turned into, you would expect a lot more schadenfreude from the political right.  After all, it’s the President’s signature domestic policy.  For good or ill (and it’s mostly ill), this will be the domestic program that will be identified with President Obama.  And so far it’s a mess.  So why aren’t conservatives happy?  Part of it I think is that the right is still licking its wounds from the shutdown debacle.  They are still trying to heal a party that was pointless split for no good reason.  See?  I’m still trying to heal.  But the major part of this is that unlike a lot of wacky social programs that the left invents, screws up, and leaves to move on to the next big thing, healthcare is something that affects everyone.  The damage that Obamacare has done to the entire nation’s healthcare system, not just to the minority in the individual insurance market, is extensive, and much of it is permanent.  So there is no schadenfreude to be found in mocking the woman who said, “I was all for Obamacare until I found out I was paying for it.”

Fool, you’ve doomed us all.

If Obamacare had only ruined the healthcare system for those who supported it, then yes, the right would have the freedom to cackle with glee and point fingers, but eventually, this will affect everyone.

OK we’re still doing the finger pointing, but we’re not happy about it.

Right now the big Obamacare story is the website, which is a mess, but eventually the website will get fixed.  The problem goes far beyond the website.  The health insurance plans in the exchange depend on getting enough young health people to enroll to keep the cost of premiums down for the next year.  They need people paying but not using healthcare to afford the people who will enroll and will be sick and will be using healthcare; a lot.  That’s what insurance is all about after all.  If those young healthy people don’t show up and enroll, then you are left with more people taking out of the insurance pool than are putting into it.  That spells extremely high rates for premiums in 2015, or collapse of the exchange insurance groups.

And what could be pulling healthy young people from enrolling in an exchange insurance plan?  In a word; Medicaid.

So far (and admittedly this is a changing number) the majority of enrollees under the Obamacare exchanges are enrolling in Medicaid.  Under Obamacare the Medicaid expansion increased the Medicaid Eligibility to 138% of the Federal Poverty Line.  So all of those young healthy hipsters, particularly the ones who have extremely low incomes like students, are being enrolled, but they are being enrolled as Medicaid clients, not people in the actual private insurance groups.  So rather than contributing to the insurance pool, these healthy young people will basically be put on the dole, to drain the Treasury of funds to support healthcare that they could have otherwise been contributing to.

So if in the upcoming year we have insurance plans filled with the sick, while the healthy coast on Medicaid, than that’s a bomb that will blow Obamacare wide open.

Great plan geniuses.