Wonkbook: Can HealthCare.gov meet its November 30 deadline?

November 11, 2013

Welcome to Wonkbook, Ezra Klein and Evan Soltas's morning policy news primer. To subscribe by e-mail, click here. Send comments, criticism, or ideas to Wonkbook at Gmail dot com. To read more by Ezra and his team, go to Wonkblog.

(Photo by Andrew Harrer/Bloomberg)
(Photo by Andrew Harrer/Bloomberg)

Wonkbook's Number of the Day: 18 percent. That's the increase in the number of regulatory-compliance officers between 2009 and 2012, according to BLS data and an analysis by the American Action Forum. 

Wonkbook's Graph of the Day: Let's introduce Wonkbook readers to the "shadow" federal funds rate.

Wonkbook's Top 5 Stories: (1) Obamacare's next hurdle; (2) Yellen' about Benghazi; (3) gridlock watch; (4) security blanket, meet security tent; and (5) Haiyan on the policy radar.

1. Top story: Can Healthcare.gov meet its November 30 deadline?

White House relying more on insurance carriers to help fix Healthcare.gov. "The White House is increasing its reliance on insurers by accepting their technical help in efforts to repair the problem-ridden online health insurance marketplace and prioritizing consumers’ ability to buy plans directly from the carriers. The Obama administration’s broader cooperation with insurers is a tacit acknowledgment that the federal insurance exchange — fraught with software and hardware flaws that have frustrated many Americans trying to buy coverage — might not be working smoothly by the target date of Nov. 30, according to several health experts familiar with the administration’s thinking...The government has said for months that consumers would be able to go directly to insurance companies to buy the health plans offered on the exchange. But this was always imagined as a secondary route, along with call centers and in-person enrollment assistants." Juliet Eilperin and Amy Goldstein in The Washington Post.

Explainer: Obamacare by the numbersSarah Kliff in The Washington Post.

Technical problems are proving persistent and widespread. "Marilyn Tavenner, the head of the Centers for Medicare & Medicaid Services, the site’s manager, told a Senate panel earlier this week that the technology is improving daily, and now can register 17,000 customers per hour “with almost no errors.”...Where a month ago users weren’t even able to create an account, now most can register, submit an application and view plans, he said. The breakdown comes when users try to select a plan and make a purchase, he said. The entire process is still slow and “takes a lot of time on the computer,” McKinney said." Shannon Pettypiece and Alex Wayne in Bloomberg

@JimPethokoukis: Is ObamaCare causing part-time jobs surge? "So far, there are no data suggesting that this is true" - St. Louis Fed

Healthcare.gov is testing Jeff Zients, a tycoon and a tinkerer. "Zients is witnessing that ineptitude up close as the emergency fix-it man charged with righting HealthCare.gov, the bungled online marketplace for medical insurance...Administration officials say Mr. Zients has intensified the pace at the Centers for Medicare and Medicaid Services, the agency responsible for the website...Among other immediate changes, Mr. Zients recommended that the agency hire a general contractor to coordinate repairs, started daily telephone news briefings and instituted at the command center morning and evening “stand up meetings."...He said response times — how long users wait for a page to load — now average less than one second, down from eight seconds. The error rate — how often system failures prevent users from advancing to the next page — is 2 percent, down from 6 percent, Mr. Zients said." Sheryl Gay Stolberg in The New York Times.

The struggles of Healthcare.gov are weighing on the Obama administration. "Only 41% of Americans viewed Mr. Obama in a positive light in a late October Wall Street Journal/NBC News poll, with 45% holding a negative impression of him. That marked Mr. Obama's all-time low as president—and the first time more people saw him negatively than positively. A more fluid measure of Mr. Obama's standing—the public's assessment of his performance as president—is now also sliding. Only 42% in the late-October poll approved of the job he is doing, a low in Journal/NBC surveys, with 51% disapproving." Peter Nicholas and Colleen McCain Nelson in The Wall Street Journal.

@jimantle: Local tax preparer has ad in window offering to help people avoid Obamacare tax penalty.

How much does that X-ray cost? "Finding out how much an X-ray costs sounds like a simple question. But it is actually very difficult to get an answer. In Massachusetts, a new state law requires insurers to be able to tell members how much a test, treatment or surgery will cost...The point of this new requirement is to help patients make smarter choices so that they start behaving more like consumers of health care. Insurers aren't thinking that way. They all sound a little overwhelmed by trying to put a price tag on medical care." Martha Bebinger in Kaiser Health News.

Congress says five D.C. residents enrolled in Obamacare. There’s more to the story. "The District of Columbia's insurance marketplace has enrolled exactly five people in health plans, according to documents released by the Senate Finance Committee on Friday. That sounds like bad news for our hometown exchange. But, when you dig into the numbers a bit further it turns out -- as is true with most health policy issues -- the issue is a bit more complicated." Sarah Kliff in The Washington Post.

SUMMERS: Give the Obamacare bug the correct treatment. "Maximising the prospect of success requires providing for slack in the schedule and in the budget, structuring projects with very clear accountability and frequent checkpoints, and assigning responsibility for oversight not simply to general managers but to people with extensive IT experience...An additional requisite for success is steadiness and realism in the face of difficulty. Once a project gets off track there is an overwhelming temptation for everyone involved to circle the wagons and promise rapid repair so as to hold critics at bay. Yet the right response to such failures is to bring problems to the surface as rapidly as possible and to move deliberately and carefully rather than more quickly." Lawrence Summers in The Financial Times.

LASZEWSKI: It is unlikely that Healthcare.gov will meet its deadline. "It is now becoming clear that the Obama administration will not have Health.care.gov fixed by December 1 so hundreds of thousands, or perhaps millions, of people will be able to smoothly enroll by January 1...The administration needs a Plan B and they need it now. To get one, they can't be working on it themselves. They will need the help of the insurance industry, the state insurance regulators, and the many navigator organizations that have been sitting in a frustrating limbo since October 1." Robert Laszewski on his blog.

COHN: The huge Obamacare story you're not reading. "[T]he best available projections suggest that 13 million people will eventually sign up for Medicaid. That’s a much larger number of people [than those losing their insurance], most of whom had no insurance—none—before." Jonathan Cohn in The New Republic.

FREDDOSO: If you like more competition between insurers, you can't have it. "[M]ajor U.S. cities such as Atlanta, Chicago, Philadelphia, Pittsburgh, Raleigh, Louisville, Indianapolis, Columbus, Kansas City, Saint Louis ... well, let's just say a whole bunch of big and important cities have less than five insurers. In 78 percent of U.S. counties, customers have a choice between three ACA insurers or fewer. And in 17 percent of U.S. counties – including all counties in New Hampshire and West Virginia – just one insurer has a monopoly on the subsidized exchanges." David Freddoso in The Washington Enquirer.

GOTTLIEB: How the middle class thinks about Obamacare. "Ask them to donate several thousand dollars so that the less fortunate can have medical insurance — which is exactly what President Obama is asking me to do — and I’ll bet they’d change their tune about “ending inequality” and “creating fairness” and “doing what’s good for the country.”...Along with the smug insureds, President Obama doesn’t care much about the relatively small percentage of us with canceled coverage and no viable replacement. He keeps apologizing while maintaining that it’s for the good of the country, a vast improvement “over all.” And the “over all” might agree. But the self-employed middle class is being sacrificed at the altar of politically correct rhetoric, with nobody helping to ensure our health, fiscal or otherwise, because it’s trendy to cheer for the underdog." Lori Gottlieb in The New York Times.

DIONNE: What's the matter with motherhood? "If you’re a conservative strongly opposed to abortion, shouldn’t you want to give all the help you can to women who want to bring their children into the world? In particular, wouldn’t you hope they’d get the proper medical attention during and after their pregnancy? This would seem a safe assumption, which is why it ought to be astonishing that conservatives are positively obsessed with trashing the Affordable Care Act’s regulation requiring insurance policies to include maternity coverage...In the name of consistency, [members of the right-to-life movement] need to break with their conservative allies and insist that maternity coverage be included in all health-care plans. Shouldn’t those who want to prevent abortion be in the forefront of making the case that a woman will be far more likely to choose to have her baby if she knows that both she and her child will get regular medical attention?" E.J. Dionne in The Washington Post.

Music recommendations interlude: Allman Brothers Band, "Statesboro Blues," 1971.

Top opinion

MURRAY: Closing tax loopholes should be part of the budget conference. "Consider two examples of wasteful loopholes that could be ended immediately without risking overall tax reform. Right now, big corporations can skirt the limits on deductible executive compensation and claim massive tax breaks by paying their CEOs in stock options and bonuses instead of paychecks...Another loophole, known as “check the box,” allows major multinational corporations to hide foreign subsidiaries and profits from the Internal Revenue Service simply by marking a box on their tax forms. The ability to easily create these “disregarded entities” was intended to help U.S. companies reduce their tax filing paperwork. But big U.S. companies put their foreign subsidiaries in this category." Patty Murray in The Washington Post.

KLEIN: A game changer for campaign reporting. "Any time three staff members met in a room to badmouth a colleague or a candidate admitted to a moment of stress or self-doubt, authors John Heilemann and Mark Halperin appear to have been sitting in the corner, scribbling notes...[W]hen you buy “Game Change 2,” you should also buy its opposite -- “The Gamble,” by political scientists John Sides and Lynn Vavreck." Ezra Klein in The Washington Post.

CHAIT: What's at stake in the Senate's nuclear showdown... "[E]very single judicial appointment is intended to alter the ideological balance of that court. Grassley is, therefore, asserting a blanket right to blockade judicial nominees. His principle could be extended to prevent Obama, or any president, from filling any judicial vacancy at all...[T]he implications of the struggle extend well beyond even this court. The loose architecture of the constitution turns out to leave wide gaps where the relative power of the two branches is undefined. The debt-ceiling showdown was one such gap: Does this power to destroy the world economy grant Congress the right to force the president to accept unrequited concession?" Jonathan Chait in New York Magazine.

PONNURU: ...No, there's a meaningful difference in the D.C. nominees. "When Democrats mounted an unprecedented series of filibusters against Bush’s appeals-court nominees, that was just normal politics. They may have gone too easy on those nominees, since they were “extreme jurists” (Miguel Estrada? Peter Keisler?)...A few months ago, Sri Srinivasan was confirmed unanimously to the D.C. Circuit. So, in other words, the unprecedented “full-scale blockade” is not actually a full-scale blockade. The temptation to dress up a power grab as a matter of high principle is, evidently, hard to resist." Ramesh Ponnuru in National Review Online.

WALD: Fear of the dark. "Two years ago, the first time the government and the utility industry held an emergency drill to simulate a cyberattack on the nation’s power grid, 75 agencies and utilities showed up. For a second drill next week, organizers are expecting more than 200...The idea of a sustained blackout resonates in the public’s mind, agreed David Ropeik, an expert on risk perception, particularly because it could come from either cyberattack, physical attack by terrorists or even Mother Nature as a side effect of solar flares. “It is one of those low-probability, high-consequence events that every once in awhile scares the bejesus out of us,” he said." Matthew L. Wald in The New York Times.

KRUGMAN: Le complot contre la France. "[The plot against France] is one clear demonstration that in Europe, as in America, fiscal scolds don’t really care about deficits. Instead, they’re using debt fears to advance an ideological agenda. And France, which refuses to play along, has become the target of incessant negative propaganda...France has committed the unforgivable sin of being fiscally responsible without inflicting pain on the poor and unlucky. And it must be punished." Paul Krugman in The New York Times.

DOUTHAT: Dear Christie. "[Y]ou’ll need substance as well as regular-guy style: a tax plan that doesn’t play just as a giveaway to the 1 percent, a health care plan that isn’t just a defense of the pre-Obamacare status quo, an approach to spending that targets corporate welfare as well as food stamps...The bad news is that you’ll have a lot of big bundlers cornering you to explain that actually it’s much more important to cut capital-gains taxes or preserve the carried-interest loophole for hedge funds, and why can’t you move to the center on social issues and stick with upper-bracket tax cuts, because after all they worked in the Reagan era ... Which they did — in a completely different economic and political landscape. So if you want to have an era of your own, you’ll need to nod politely, crush your well-heeled advice-giver with a handshake, and then take a different path." Ross Douthat in The New York Times.

Hopefully this is not your life interlude: Dominoes falling.

2. Yellen' about Benghazi 

Sen. Graham unmoved on plan to block Yellen. "A Republican senator said Sunday that he won’t back down from blocking President Obama’s nominees for Federal Reserve chairman and homeland security secretary in a long-running dispute over the deadly attack on a U.S. diplomatic mission in Libya...Graham told CNN’s “State of the Union” that he hopes there’s a way to arrange interviews with five State Department employees so he can let the nominations move forward...The State Department has told Graham that it was concerned about congressional interviews with the survivors of the attack because of Justice Department advice that the survivors could be witnesses in a criminal trial and that any interviews outside the criminal justice process could jeopardize a case." The Associated Press.

Explainer: Economic data coming your way this weekAmrita Jayakumar in The Washington Post.

Trade deals now aren't about tariffs, but rather 'non-tariff barriers' to trade. "Negotiators seeking a new trade deal between the U.S. and Europe are aiming to chip away at regulations that limit trans-Atlantic trade. Standing in their way are fundamental differences between how the European Union and the U.S. approach regulation...In some sectors, such as automobiles, this could be relatively easy. EU auto safety regulations have caught up with U.S. standards over the past 15 years. And because of new rules passed by the Obama administration, U.S. rules on fuel efficiency and emissions have nearly caught up with European standards...The goal would be a system where a car made and tested in Europe would be ready for sale in the U.S., and vice versa...But in other sectors, such as chemicals, the U.S. and EU regulations feature some philosophical differences that threaten to deepen the trans-Atlantic divide in the coming years. At the heart of the European system is the "Precautionary Principle," which is enshrined in the EU treaty and gives European regulators more license than their counterparts in the U.S. to restrict or ban substances that are believed to be harmful." Matthew Dalton in The Wall Street Journal.

Businesses are hiring more regulation watchers. "A growing thicket of federal regulations under the Obama administration has contributed to an employment spike in at least one corner of the job market: the increasingly vital compliance industry. ObamaCare, the Dodd-Frank Act and other large federal undertakings have led to an outpouring of new agency rules derided by business groups and defended by advocates. But the regulations have also been a boon for professional compliance officers paid to help companies understand and adapt to the new requirements...Data kept by the Bureau of Labor Statistics (BLS) shows an 18-percent increase in the number of compliance officers in the United States between 2009 and 2012, according to an analysis conducted by the conservative American Action Forum (AAF)." Ben Goad and Julian Hattem in The Hill.

Bernanke: Why the 2008 crisis was a lot like the Panic of 1907. "'The recent crisis echoed many aspects of the 1907 panic.  Like most crises, the recent episode had an identifiable trigger--in this case, the growing realization by market participants that subprime mortgages and certain other credits were seriously deficient in their underwriting and disclosures.  As the economy slowed and housing prices declined, diverse financial institutions, including many of the largest and most internationally active firms, suffered credit losses that were clearly large but also hard for outsiders to assess.'" Neil Irwin in The Washington Post.

The U.S. labor force is still shrinking. Here’s why. "One big reason the participation rate dropped involves long-run demographic trends that have little to do with the current economy. Baby boomers are starting to retire en masse, which means that there are fewer eligible American workers." Brad Plumer in The Washington Post.

Obama's stock-market boom. "This year’s 24 percent jump in the Standard & Poor’s 500 Index is the third-biggest annual rally after a president was returned to office since the 1930s, trailing Bill Clinton and Ronald Reagan, according to data compiled by Bloomberg. The index has climbed 108 percent since Obama became president, adding more than $10 trillion in equity market value." Whitney Kisling in Bloomberg.

Writing interlude: Everything Jonathan Franzen hates.

3. Gridlock watch

Sen. Murray's new test. "Ms. Murray, the Senate Democrats' top budget-writer, has worked to keep her party in line behind her vision of robust health and safety-net programs. Now, the Senate Budget Committee chairwoman is again corralling Democrats in the latest round of budget negotiations...Ms. Murray, in an interview in her office, said that both parties must be prepared to give ground. "Our side has to say: 'Where can we cut responsibly?' Their side has to say: 'Where can we find some revenue?' "" Kristina Peterson in The Wall Street Journal.

Obama is trying to find a route to immigration reform, and it may run through Republicans. "President Barack Obama hasn’t given up on immigration reform, but he still needs a way to break through with House Republicans. The White House has reached out to former George W. Bush administration officials, conservative business leaders and selected House members, all in search of a way to hone a message that can move House leaders without scaring them off. In closed-door meetings, they have urged the White House to find a way to reach out to the GOP that doesn’t center on Obama banging the podium telling Speaker John Boehner to bring a bill to the floor." Reid J. Epstein in Politico.

D.C. circuit court nominees, welcome to gridlock. "Senate Majority Leader Harry Reid (D-Nev.) is raising the stakes of the ongoing confirmation wars by scheduling a Tuesday vote on Nina Pillard’s nomination to fill one of three vacancies on the D.C. Circuit. Republicans aren’t backing down and plan to reject Pillard and later block another Obama nominee for the court, Robert Wilkins — perhaps as soon as next week. Senate Republicans and Democrats agree on this: Obama wants to infuse the important court, whose duties include arbitrating conflicts between the federal government and private companies, with like-minded justices." Burgess Everett in Politico.

Wonkbook's past interlude: Out on Fort Hancock, the set of officer's homes I walked by every day may finally get new residents.

4. Some have security blankets. Obama has a security tent

Obama's portable zone of secrecy. "When President Obama travels abroad, his staff packs briefing books, gifts for foreign leaders and something more closely associated with camping than diplomacy: a tent...[A]ides quickly set up the security tent — which has opaque sides and noise-making devices inside — in a room near his hotel suite. When the president needs to read a classified document or have a sensitive conversation, he ducks into the tent to shield himself from secret video cameras and listening devices." Michael S. Schmidt and Eric Schmitt in The New York Times.

Congress may seek confirmation for NSA heads. "Frustration with the National Security Agency’s spying and the impending departure of its longtime director have fueled a congressional push to put its future leaders through the potentially grueling process of Senate confirmation — a scenario the White House has warned in the past could harm intelligence efforts. The idea — backed by California Democratic Sen. Dianne Feinstein, the leader of the Intelligence Committee and one of the NSA’s top allies in Congress — is among the more prominent agency reforms percolating on Capitol Hill. Some believe Senate confirmation for the director could bring sweeping change and more accountability to the ultrasecretive NSA. But it also threatens to subject the agency to public political showdowns and delays — which the Obama administration has said it wants to avoid." Tony Romm in Politico.

This is awesome interlude: There is a new programming language called "Pyret." Its file extention is .arr.

5. Haiyan on the policy radar

Philippines fears massive death toll as Typhoon Haiyan wreaks havoc. "The super-typhoon that tore through the Philippines and left a feared five-figure death toll touched down in central Vietnam early Monday, already ranking as one of Asia’s most destructive natural disasters in recent decades. As rescue workers struggled to reach some areas along a heavily damaged chain of Philippine islands, survivors described a toll that this impoverished country will be contending with for years." Chico Harlan and Carmela Cruz in The Washington Post.

Reading material interlude: The best sentences Wonkblog read today.

Wonkblog Roundup

The health effects of a nuclear test can last decadesHarold Pollack.

No-till farming is on the rise. That’s actually a big dealBrad Plumer.

Obamacare by the numbersSarah Kliff.

Et Cetera

Longreads: Elizabeth Warren is Hillary Clinton's worst nightmareNoam Scheiber in The New Republic.

FCC hires one of its best watchdogsEdward Wyatt in The New York Times.

As Washington keeps sinking, governors riseAdam Nagourney and Jonathan Martin in The New York Times.

Record number of foreign students flocking to U.S. Caroline Porter and Douglas Belkin in The Wall Street Journal.

Bills left in limbo are often just part of the choreography in Congress. Ed O'Keefe and David A. Fahrenthold in The Washington Post.

Got tips, additions, or comments? E-mail me.

Wonkbook is produced with help from Michelle Williams.

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