As President Obama acknowledges the error-riddled roll out of HealthCare.gov during an address in the Rose Garden on Monday, administration officials insist that they are working overtime to fix the technical glitches associated with enrolling online. So what went wrong with the implementation of the president’s signature domestic accomplishment and how can the administration save it? Below is your guide to Obamacare’s bumpy rollout:
What’s the problem.
When HealthCare.gov first launched on Oct. 1, administration officials were surprised by the initial surge in public interest, as millions of Americans logged on to the site in search of coverage. Unfortunately, that’s as far as they got — for the overwhelming majority of users, the site crashed, ran too slowly, or simply froze. The federal website required users to create accounts before applying for coverage, creating a bottleneck of traffic and preventing visitors from browsing plans anonymously. Over the weekend, administration officials took the website down and added additional capacity. But the glitches didn’t end there. While more people were able to enroll, insurers complained about receiving duplicate enrollments, missing data fields, and other errors. The website also “gives inaccurate information” about the federal tax credits and sometimes “erroneously tells low-income people that they are not eligible for Medicaid.” The website is also “having trouble handling applications from people who are offered coverage through their jobs but could find better or less-expensive health plans through the new marketplace.”
What went wrong.
While it’s not clear why HealthCare.gov did not anticipate the surge of traffic, computer experts are attributing some of the problems to the use of outdated technology, last-minute testing of software, messy coding, and an inability to integrate different aspects of the site. Officials with knowledge of the implementation process have also questioned the Centers for Medicare and Medicaid Services’ ability to coordinate pieces of software from 55 contractors charged with writing code for different aspects of the project. “It is not common for a federal agency to assume that role, and numerous people involved in the project said the agency did not have the expertise to do the job and did not fully understand what it entailed,” the Washington Post reported.
The good news.
Uninsured individuals have until March 31 to sign-up for coverage. The administration says that it’s working around the clock to fix the problems and has hired “the best and brightest” tech experts to help fix the website. The homepage now allows individuals to window shop for plans, with a “see plans now” button that links to examples of pre-tax credit prices for all available plans by zip code. Users also have the option to “apply online” or “apply by phone.”
Almost half a million people have already begun applying for health insurance through federal and state exchanges, though the state-run marketplaces are more adapt at quickly fixing problems and making big changes. If state news reports are any indication, uninsured individuals appear to be encountering plans that offer more benefits and cost less than previous forms of coverage.
Also, the federal government has faced health care enrollment issues in the past. When President Bush sought to implement Medicare Part D, the program extending prescription drug coverage to the Medicare population, lower-income beneficiaries were unable to access needed drugs. The administration moved quickly to resolve the problems, allowing top officials to testify before Congressional committees. Eventually, seniors signed up for the program and now view it favorably.
The bad news.
Some contractors tell the New York Times they “worry that the system may be weeks away from operating smoothly” and could require a major overhaul to function properly. Administration officials “have been debating whether to designate one or more companies as the quarterback for information technology work on the federal exchange,” the paper notes, though CMS has begun “negotiating agreements with contractors on responsibility and deadlines for repairs” and hope to have a plan before Thursday.
Meanwhile, thousands of Americans who buy insurance on the individual marketplace are receiving cancellation notices. Insurance companies are claiming that the policies — some of which offer skimpy benefit packages — fall short of what the Affordable Care Act requires starting Jan. 1,” though some may be ending certain plans to shed risky (and expensive) beneficiaries. Under reform, most individuals should be able to find more comprehensive insurance at lower rates, though many are having trouble logging on and enrolling in coverage.
If the website is not fixed in a matter of weeks, administration officials will fail in enrolling the estimated 7 million uninsured Americans who are expected to enroll in coverage by 2014. The glitches and technical problems could also keep healthy people — who are critical to maintaining risk balance in the marketplaces — from signing up for coverage, significantly increasing premiums.
On Thursday, the House Energy and Commerce Committee will hold a hearing titled, “Implementation Failures: Didn’t Know or Didn’t Disclose?” reviewing some of the challenges in enacting the law. Conservative groups have also launched state-based campaigns to convince young people to avoid signing-up for coverage and prevent states from expanding their Medicaid programs. Meanwhile, the Associated Press reports that administration cabinet officials prepare to travel throughout the country encouraging people to sign-up for insurance.
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