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tv   Inside Story  Al Jazeera  December 2, 2013 5:00pm-5:31pm EST

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>> this is al jazeera america live from new york city. i'm tony harris with a look at today's top stories. federal investigators want to know why the train that derailed was traveling 82 mph as it approached a 30 mph zone. four people were skilled and others injured. protesters and police clash in bangkok in an effort torpors the prime minister yingluck shinawatra to step down. 200 have been injured in the violence. it's as different as night as day, that's how officials
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describe . officials say it's working better, faster, but still they're cautiously managing expectations. vice president yesterday biden is in asia for a week long trip. biden arrived just a few hours ago. he'll speak with japanese and chinese leaders over islands claim by both countries. he'll also visit china and south korea. that's your look at our top stories. "inside story" is next. >> fixes appear to be working, but questions and challenges remain. i'm ray sa suarez and that's the "inside story."
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♪ >> president obama says the website is significantly improved. the administration said the site can now handle 50,000 people at once and 800,000 users a day. that's on the could called front end as people browse the site. but the back end is still a work in progress. that's where the real business is as insurance companies and the federal government share info and you finish your purchase. on this edition of inside story we're going give the affordable care act and online exchanges a checkup with the deadlines approaching fast. the obama administration says the ailing website is on the mend, and close to being cured of the bugs and glitches that had the
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president himself apologizing. >> what i'm going to do is make sure that we get it fixed. >> this weekend was president obama's sow-imposed deadline to make the site work. the department of health and human services announced a main online artery for americans to buy health insurance is working 90% of the time. more than 400 bugs in the system has been fixed since the launch, and as many as 800,000 users can access the system daily. >> you can never get a second chance for a first impression, and it was terrible. i think it will be an unfolding terror for the president. >> bottom line, on december 1st is night and day from where it was on octobe october 1st. >> reporter: and already users are seeing signs of improvements on .
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shawn of virginia signed up and got health insurance for himself and his kids. >> the experience was wonderful. i love it. there were no problems. we went through everything real smooth. >> reporter: with help from the non-profit neighbors' keeper people have been able to go to and get the health insurance they seek successfully. >> i was able to go all the way through and second a plan. >> reporter: but as another campaign season begins to ramp up, the botched roll out is political fodder. millions of dollars are being spent by conservative advocacy like generation opportunity to issue messages like this to discourage young people were using the health insurance marketplace. cautious of the website's updates, last week the white house urged friendly non-profits as well as state and local officials with concerns that
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online purchasers would flood the site, the administration curtailed the marketing campaign planned for this month. with all the focus on the problems on the front end problems with the back end remain to be fixed. the online system to deliver buyer's information to the insurers continues to have gaping holes. some insurance companies have no record of enrollment from customers to signed up on . and with a little less than three months come march 31ster the administration still hopes to see 7 million americans enrolled for healthcare by next spring. >> joining us now is kevin, ceo of access health connecticut, the state of connecticut's healthcare exchange. thank you for joining us. >> thank you. >> well, i would like to start by asking about how your state exchange interacted with the
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federal government site. what we're coming to call the back end. what exactly goes on there, and why does it have to work for connecticut's own effort to work? >> well, essentially what occurs after enrollment the application files are submitted to both sms treasury and the insurance companies. so that the insurance companies can begin to process eligibility and issue i.d. cards and welcome packets and make sure that the individuals are enrolled in their system so that coverage can be obtained. and also to the treasury department so that any appropriate tax credits can be submitted to the insurance company for appropriate information. >> so that interaction between the federal and your state had to work in order for people to make a successful purchase, is that right? >> that's correct. one of the things that connecticut has done, however,
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we reduced the number of service calls required by 50% up front because we've always wanted to be as self reliant as possible. >> now they're talking about the possibility of errors that go as far as people who think they've completed enrolled. are you worried of people showing up at the doctors after the first legal day after january 31st, and finding out they don't have healthcare insurance? >> we're actually not worried about that. we've been testing the 834 file transmissions with the health plans beginning last summer, and we're very confident that that will not happen or should not happen. >> do you also rely on the federal government to pay some of the credits towards full coverage that some of your connecticut citizens are eligible to receive? do you have to get those subsidies paid before someone's fully signed up and fully in the
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system? >> no, those are actually independent functions. and we've had some customers question whether if there are you issues on the federal side if that will impact their liability for premium payments and the answer is it does not. we're confident that the feds will have a transition and accurate payment of monies to the insurance companies, and we're equally confident that it will have the enrolllies by january 31st. >> we're sitting here in early december, that by march 1st this program will have made a dent in the number of uninsured citizens in connecticut? >> yes, as a matter of fact we think by january 1st that our uninsured level might be below 9%. and lower by the end of march. we're pretty confident this will make a difference. this is a multi year effort and
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it needs to be judged after three or four years and not after a couple of months or six months. it's hard when given the focus that this is a federal exchange has had, this really is a long-term effort. >> do you have a rough estimate of how many people have been signed up by your site. >> we've will over 20,000 people enroll so far. we believe that will add significantly by the end of december. and we expect roughly 100 million insured by the end of the march. >> thank you for joining us. we're going to take a short break and condition our program on the affordable care act and the fixes tha to healthcare.govn just a moment. this is "inside story."
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make it your own. >> watch the stream. >> and join the conversation online @ajamstream.
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>> welcome back. i'm ray suarez. we're giving the affordable care act and the online enrollment process a checkup. we go to the deputy secretary of u.s. department of health and
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human services anded a jumping fellow at the hudson institute and author of "what jefferson read, ike watched and obama tweeted: 200 years in the white house." and jodie ray, from the university of south florida, and igor, coauthor of "prescriptions for real healthcare reform." jodie ray, you're helping to guy navigate the insurance. how is it going down there now? >> we've been busy. we've been very busy. we have over 90 navigators on the ground, and we've got a lot of folks scheduling appointments and walking in to get assistance to apply.
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our navigators have been using all forms of applications to ensure that every consumer that comes in get assisted, but we're seeing more and more of those being done villa the web. in fact, for november, 71% of the applications submitted under our project were done by the web. >> jodie, does the problems with the website end up making the navigators more important? in florida you have a large population for whom english is a second and a lot of times third language. and you have a lot of seniors who may not understand what the law means for them? >> well, i think that's true regardless of the condition of the website. we're finding that our navigators are spending a lot of time explaining the idea of just what is insurance. what is the marketplace. what is insurance. how to use it, and then we're
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getting through the website, and you're on the other side, you're getting a lot of health coverage options for which you needing to through. the navigators need to go through the coverage options that consumers are being provided. so i think regardless of the website that is true no matter what. >> debby troy, the coo of one of the largest departments in the federal government. you know how a big beast an wita lot of moving parts can be a challenge. has the obama administration gotten over the hump at this point? has the marshal plan with the website with increaseds functionality and more volume available solve some of the bigger problems? >> i don't think so. everyone can agree the launch was terrible.
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this artificial report card, they're grading themselves on an artificial deadline of november 30th. well, we seem to be better. some vague standard they've established. it's probably better than it was in the beginning but we're a long ways out of the woods. >> they say just over 100,000. >> i don't think they said that, actually. the administration said they don't know the numbers yet, but bloomberg put out the 100,000 numbers. they were looking for 800,000 in the first two months. it's clear that they're not going to reach that number, it's a shame. >> is there time to recoupe by 2014? >> i agree, this is something that has to be graded on the long haul but on multiple levels. i fully expect this website will continue to improve over time. you have a lot of smart software people working on it, but there are other ways we'll have to
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grade this program in terms of coverage, how many people are going to be covered in 2019. costs, the costs seem to be continuing to go up and likely to go up. and then this promise that president obama laid out if you like your healthcare then you can keep it. he has established it's not a fully accurate promise. will it be established that it's not an accurate promise and in the market? >> it was said that the affordable care act is not a website. but if that is the front door to a big piece of policy doesn't it have to work for people to have confidence for the rest of it? >> they're saying now at least the user inter face for the most part has been fixed. they point to 80%. 80% of people who go through the website can go through the entire process and get coverage. you're right to ask what is success. point of view of success from
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the administration has changed. they said 7. million by the first year is success. now because of some of the problems you're seeing they're see something success is how well is the risk pool distributed? do you have enough young people to offset the others to make sure that premiums are balanced. bringing in enough young people in the program will really define whether or not the market is stable in 2015 and 2017. >> even if that is a new definition of success, do they have a shot of hitting that target? aren't there problems getting young people to come in? >> yes, absolutely. in the time when all the press is bad press they're hoping to do a big reach out campaign to young people next month and the months following that. but what we are seeing from the states that are running their own exchanges places like
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kentucky, maryland, they're reporting high interest in young people and the administration certainly hopes that they can replicate that in the national level. and you can achieve that delicate balance. >> you must be seeing people for whom this is a first time experience. they never had health insurance. are you getting young people in through the front door at least to browse? >> we're getting--right now we haven't really seen a consistent trend of what the applicant looks like, but except for the fact that we are seeing a lot of people who haven't had health insurance in quite some time. because we're an university, we're really trying to get the word out, utilizing those networks within the university to make sure that we are reaching those young adults for sure. and we're seeing very diverse populations coming through the door, both proactively
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scheduling appointments and walk-ins, and they're all over the map right now. i think it's a little early to tell any specific trend in what the applicants look like other than i can say that we're finding that we're really, really having to take our time explaining some of the concepts around health coverage, what the marketplace is, and you're right, i mean, in terms of people who have literacy and language barriers, we have to be able to address all of those issues at the same time. >> debby, when we come back from the break i want to hear from you on the risk pool question and marketing to young people. we want to take a break and continue our conversation in a moment. this is inside story.
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>> welcome back to "inside story." i'm ray suarez. the government says health can now handle 50,000 users at a time and the president calls the fixes significant progress. we're continuing our conversation now on the progress and the challenges ahead as the deadline for enrollment approaches. i think one of the essential questions is how good is good enough, and we heard jodie ray trying to get young buyers in there. can you get the risk pool that you need to make these numbers work? >> that's a great question, and i think there were really good questions long these lines. jodie said 70%, and i think that's low. and igor made an try point by
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changing the definition of success. 80% of people are going through the experience. the prior goal was 99%. if they're only having 80% success rate, they would not go to that. they're used to the amazon experience. they go, see the price, decide if they want it or not, and if they want t they get it delivered to their door. >> if you ask the young people how optimistic they are about the website, they tend to say by the greatest margins by age group they think the website can fixed. eight out of ten think that the website can be fixed. that's a swell that they'll do
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campaign. they say it's full of problems and they tell pollsters that they will return. >> they said that they were bewildered. they didn't you fully understand the law. they didn't fully understand what would happen when they got to the website. does having the navigators change experience, and are you less likely to have some of those back end problems if you work with someone who really knows the process inside and out? >> that makes a big difference. i've been doing outreach enrollment assistance for 15 years for the uninsured. one thing does experience show, but the research also shows that one-on-one application assistance is the key to getting somebody successfully enrolled. it has the best outcomes. and because that assistance
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tends to reduce the anxiety or stress if something runs into anything that they don't understand or if maybe they do have a challenge with the webb, maybe they don't know what it is they're being asked, and that navigator of that application, the assister, it really sorts to bring the mountain to them, and gets them through the process from beginning to end. people are getting lost along the ways. >> speed the process for thos those--for whom the affordable care act was meant to reach. the people who don't have a doctor. the people who don't go regularly. people who are using their emergency rooms for primary carry. for those who work low skilled, low paid jobs and don't get healthcare through their employer, and have not had the
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experience of comparing plans, and sitting and wondering the impact of this set of deductibles, and this set of copays versus what is offered on this other plan. are they going to come through the door? and are they going to be beckoned into the risk pool because they tend to be young as well. is this going to work as jodie said in southern florida, can that be replicated everywhere. she's in a pilot program. >> the navigators are an important piece of this and the other piece is medicaid. there has been a lot of success, much larger numbers are enrolling in medicaid. they're enrolling on the private exchanges partly because medicaid has been enrolling people since 1965. they know how to do it. they can go around the website, but you're right. you have to make sure that it
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works and the user interface has been fixed and reaching out to those people again asking them to come back and try again. restart their accounts, and making sure that they go through the process because if they're not in the private marketplaces there is no stability and the system doesn't hold up the following year. >> some of the res citizen tense has come from an honest policy disagreement. and they may come into the state run exchange programs down the road and will come in the state managed medicaid down the road and relief some of this federal burden. >> there is politics and policies and we've had many talks about our disagreements on policies. medicaid, the numbers in the early figures, four to one--four times as many people were enrolling in medicaid than exchanges, and by law its supposed to be a 50/50, an
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one-to-one ratio. that was another surprise. and it may be a good indicative that the aca wins is not good at signing people up yet. >> and is 2014 where we end up telling the story of whether this works for not? there are some things that remain to be known that even you who have been skeptic about the efficacy of this law have to wait and see? >> yes, i think a lot of my skepticism has been born out, but these are all questions that have to be answered in the long haul over the overall cost, if you like your healthcare, you can keep t and whether that applies in the employer market. that's something that we'll have to determine over many conversations. >> quickly before we go, what do we need to see in the coming months. >> we need to see a website function. the enrollment has to grow beyond 100,000 and really get
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out and enroll campaign to the groups to get that risk-pool balance. >> how are you feeling, optimistic? >> if the website holds up i think they can get the numbers they need. >> thanks, that bring us to the end of this edition of "inside story." thank you for joining us at home. the program is over but the conversation continues. we want to know what you think about this or any show, you can go to our facebook page or send us your thoughts on twitter. or you can reach me directly @ray suarez news. see you for the next "inside story." in washington, i'm ray suarez.
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>> no other sport can kick off mass emotion in indonesia like football, even if the national team languishes near the bottom of world rankings. >> indonesians, they're really crazy. we can see their ranking in fifa is going down, going down, going down. but every game in the stadium, 80,000 people, 90,000 people. >> even local competitions turn smaller stadiums into cauldrons of passion, with crowd turnouts matching the top leagues in the world. >> sriwijaya is my life. i'll do anything for sriwijaya.


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