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UPDATE: In June 2014, Ning Liang, one of the founders of HealthSherpa, wrote in about updates to the site. Ling said that they can now enroll people in ACA marketplace plans, including subsidies. According to Liang, “we are the only place besides Healthcare.gov where this is possible. We have signed an agreement with CMS as a web based entity to do this. We are directly integrated with the federal data hub, so going through us is identical to going through Healthcare.gov.”
Earlier tonight, Levick director of digital content Simon Owens discovered HealthSherpa.com, thought it was cool, and read a Daily Dot post about it that framed it as 3 20-something San Francisco Bay-area resident coding up an alternative to Healthcare.gov.
Could it be that easy, wondered Owens? Could these young coders have created a simpler, better way to shop for health insurance than the troubled Healthcare.gov?
Well, yes and no. As is so often the case, it’s not quite that simple, for several reasons.
1) As always, note the disclaimer at the bottom of HealthSherpa.com: “The information provided here is for research purposes. Make sure to verify premiums and subsidies on your state exchange or healthcare.gov, or directly with the insurance company or an agent.”
Why? The site is based upon the publicly available data published by the Department for Health and Human Services, individual state exchanges and Healthcare.gov for premium costs, like this dataset of premiums by county at data.healthcare.gov.
— The Health Sherpa (@healthsherpas) November 10, 2013
Unfortunately, there appear to be data quality issues, as CBS News reported, that may be an issue on both sites.
— The Health Sherpa (@healthsherpas) November 4, 2013
When I compared searches for the same zipcode in Florida for a 35 year old, single non-smoking male, I found the same 106 plans but was quoted different premiums: $128.85 on HC.gov vs $150.24 on HealthSherpa. Hmm.
That could be user error, but… it looks like Healthcare.gov continues to underestimate costs.
Healthsherpa may actually be doing better, here. Good job, guys.
2) Regardless, this is not a replacement for everything Healthcare.gov is supposed to do.
The federal and state exchanges aren’t just about browsing plans and comparing premiums for options in a given zipcode in the “marketplace.” After a user knows decides which plan he or she want, the software is supposed to:
1) Register them as a user (registration was up front initially, which was a controversial, important choice, relevant to the site crashing at launch)
2) Authenticate them against government data bases
3) Verify income against government data bases
4) Calculate relevant subsidies, based upon income
5) Guide them through the application process
6) Send that form data on to insurance companies for enrollment.
The tech that underpins the test and graphics website on the front end of those process continues to hold up well.
The rest of the software that is supposed to enable visitors to go through steps 1-6 software, not so much. 16 state exchanges and DC are having varying degrees of success, with HHS Secretary Kathleen Sebelius acknowledging issues with data quality in Step 6 in her testimony to Congress.
3) While it has a subsidy calculator, otherwise Healthsherpa doesn’t replace Healthcare.gov.
Healthsherpa enables you to find a relevant plan and then gives you contact info for the relevant insurer.
“Call Humana Medical Plan, Inc. at (800) 448-6262.
Use their menu or ask the operator to speak to someone about purchasing coverage.
Tell them you would like to purchase health exchange coverage, specifically the Humana Connect Basic 6350/6350 Plan for Hillsborough County, FL.
Follow their instructions to complete the application process.”
It does not place calls to the data hub to calculate steps 1-6.
That limited functionality, however, has been good enough for U.S. Senator Angus King to recommend HealthSherpa as a temporary alternative to Healthcare.gov.
“HealthSherpa offers a user-friendly platform to quickly browse through available health insurance plan options, including monthly premium costs, coverage plans, and possible premium subsidies,” Senator King said. “I recommend that Mainers who are having trouble with Healthcare.gov use HealthSherpa as a temporary alternative until the federal website functions properly.”
4) There are OTHER private healthcare insurance brokers that could be doing this.
Back in May 2013, the Center for Medicare and Medicaid Services issued official guidance for private sector brokers in online health insurance marketplaces. (PDF)
Former U.S. chief technology officer Aneesh Chopra said that these “Web-based entities” will be online this fall, operated by entities like eHealthInsurance.com and GetInsured.
For some reason, however, private sector insurance brokers have been stymied by the federal government from selling ACA insurance policies.
That’s unfortunate, given that the Obama administration could use a Plan B, just in case the progress on Healthcare.gov doesn’t lead to a functional federal health insurance exchange twenty days from now.
Update: Jonathan Cohn, writing for the New Republic, looked into Healthcare.gov’s backup plan and comes up with an interesting detail: issues with the so-called data hub could be holding back deployment of private online health insurance brokers.
…administration officials have been huddling with insurers about how to make more use of direct enrollment. Step one is to make sure that “side door” enrollment works smoothly. It doesn’t function well right now, because—you guessed it—it relies on the same information technology system that powers healthcare.gov. Fixing that portal, which techies tell me is called an “application programming interface,” is high on the administration’s to-do list. But it’s not clear (to me) whether improving the portal might require design modifications—or to what extent its success depends upon other, ongoing repairs to the federal website.
So, here’s some speculation: While it’s hard to know for sure, but it’s quite likely that that “portal” is the data hub that’s behind Healthcare.gov, and that it may not be up to additional volume from private sector demand.
The federal exchange and state exchanges both rely upon it, and, while federal officials have said that it’s working, a report by the New York Times yesterday that some state health insurance exchange are continuing to battle tech problems indicated that it’s not holding up under demand:
Even states whose websites are working well say they are hampered by a common problem: the federal website, particularly the data hub that checks every applicant’s identity and eligibility. That hub has stopped working on several occasions, preventing applications in the states from being completed.
If that’s happening now, concerns about the ability of the hub to hold up under the pressure of private sector online insurance brokers could well be justified. If I learn anything more definitive, I’ll share it.
Three years on, Republicans in Congress continue to follow through on promises to embrace innovation and transparency in the legislative process. Today, the United States House of Representatives has made the United States Code available in bulk Extensible Markup Language (XML).
“Providing free and open access to the U.S. Code in XML is another win for open government,” said Speaker John Boehner and Majority Leader Eric Cantor, in a statement posted to Speaker.gov. “And we want to thank the Office of Law Revision Counsel for all of their work to make this project a reality. Whether it’s our ‘read the bill’ reforms, streaming debates and committee hearings live online, or providing unprecedented access to legislative data, we’re keeping our pledge to make Congress more transparent and accountable to the people we serve.”
House Democratic leaders praised the House of Representatives Office of the Law Revision Counsel (OLRC) for the release of the U.S. Code in XML, demonstrating strong bipartisan support for such measures.
“OLRC has taken an important step towards making our federal laws more open and transparent,” said Whip Steny H. Hoyer, in a statement.
“Congress has a duty to publish our collective body of enacted federal laws in the most modern and accessible way possible, which today means publishing our laws online in a structured, digital format. I congratulate the OLRC for completing this significant accomplishment. This is another accomplishment of the Legislative Branch Bulk Data Task Force. The Task Force was created in a bipartisan effort during last year’s budget process. I want to thank Reps. Mike Honda and Mike Quigley for their leadership in this area, and Speaker Boehner and Leader Cantor for making this task force bipartisan. I also want to commend the dedicated civil servants who are leading the effort from the non-partisan legislative branch agencies, like OLRC, who work diligently behind the scenes – too often without recognition – to keep Congress working and moving forward.”
The reaction from open government advocates was strongly positive.
“Today’s announcement is another milestone in the House of Representatives efforts to modernize how legislative information is made available to the American people,” said Daniel Schuman, policy director at Citizens for Responsibility and Ethics in Washington (CREW). “The release of the US Code in Bulk XML is the culmination of several years of work, and complements the House’s efforts to publish House floor and committee data online, in real time, and in machine readable formats. Still awaiting resolution – and the focus of the transparency community’s continuing efforts — is the bulk release of legislative status information.” (More from Schuman at the CREW blog.)
“I think they did an outstanding job,” commented Eric Mill, a developer at the Sunlight Foundation. “Historically, the U.S. Code has been extremely difficult to reliably and accurately use as data. These new XML files are sensibly designed, thoroughly documented, and easy to use.”
The data has already been ingested into open government websites.
“Just this morning, Josh Tauberer updated our public domain U.S. Code parser to make use of the new XML version of the US Code,” said Mill. “The XML version’s consistent design meant we could fix bugs and inaccuracies that will contribute directly to improving the quality of GovTrack’s and Sunlight’s work, and enables more new features going forward that weren’t possible before. The public will definitely benefit from the vastly more reliable understanding of our nation’s laws that today’s XML release enables.” (More from Tom Lee at the Sunlight Labs blog.)
Jim Harper, Director of Information Policy Studies at the Cato Institute, similarly applauded the release.
“This is great progress toward better public oversight of government,” he said. “Having the U.S. Code in XML can allow websites, apps, and information services to weave together richer stories about how the law applies and how Congress is thinking about changing it.”
Harper also contrasted the open government efforts of the Obama administration, which has focused more upon the release of open government data relevant to services, with that of the House of Representatives. While the executive and legislative branches are by definition apples and oranges, the comparison has value.
“Last year, we reported that House Republicans had the transparency edge on Senate Democrats and the Obama administration,” he said. “(House Democrats support the Republican leadership’s efforts.) The release of the U.S. Code in XML joins projects like docs.house.gov and beta.congress.gov in producing actual forward motion on transparency in Congress’s deliberations, management, and results.
For over a year, I’ve been pointing out that there is no machine-readable federal government organization chart. Having one is elemental transparency, and there’s some chance that the Obama administration will materialize with the Federal Program Inventory. But we don’t know yet if agency and program identifiers will be published. The Obama administration could catch up or overtake House Republicans with a little effort in this area. Here’s hoping they do.”
This article has been updated with additional statements over time.
Writing at the White House blog, deputy US CTO Nick Sinai and Presidential Innovation Fellow Ryan Panchadsaram explain what’s new behind the next iteration of the federal open government data platform.
The first incarnation of Data.gov and subsequent iterations haven’t excited the imagination of the nation. The next version, which employs open source technology like WordPress and CKAN, uses adaptive Web design and features improved search.
It also, critically, highlights how open data is fueling a new economy. If you read Slate, you already knew about how the future is shaping up, but this will provide more people with a reference. Great “next” step.
If you have opinions, questions or suggestions regarding the newest iteration, the Data.gov team is looking for feedback and Project Open Data is encouraging people to collaborate in the design process by creating pull requests on Github or commenting on Quora or Twitter.
More signs that it’s 2013 and we’re all into the 21st century: Tomorrow at 2 PM ET, the United States Government Accountability Office will answer online questions about a decentralized electronic currency during a livestreamed event.
Yes, the USGAO is talking to the Internet about Bitcoin.
And yes, the agency tweeted about it.
— U.S. GAO (@usgao) June 17, 2013
Using social media to convene and amplify a discussion about a difficult, timely topic is a terrific use of the medium and the historic moment. Here’s hoping that USGAO officials get good questions and give frank, clear answers.
“One nation, undivided, with liberty and justice for all.”
I remember those words well from my days as a schoolboy, reciting the Pledge of Allegiance to the flag of the United States of America.
Decades later, after I’ve spent years living in the the District of Columbia and writing about governance and technology, those words are imbued with a special poignance and power for me.
We live in extraordinary times, yet access to opportunities, capital and the law is not equal.
We can hear the voices of people crying out for help and justice from around the world at an unprecedented scale and velocity, yet our leaders do not always listen.
We can separate fact from fiction and publish the data that underlies those arguments, yet our capacity to reason and compromise is not always augmented.
We, the People, can do better. Whenever I run down to see Mr. Lincoln and stare out at the Mall, imagining what he might think of our own historic moment, I can’t help but conclude that he would agree.
I intend to share the stories and voices of people who are doing better here, drawing from years of interviews, reporting and exploration. You’ll find analysis, original essays, pictures, videos and data, mixed together and presented in what I hope will be a compelling mix. I hope that you find it worthy of your time.
-Alexander B. Howard