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Administration Claims Success In Effort To Fix ObamaCare Website, But Victory Far From Clear

Healthhcaredotgov

Not surprisingly, the White House is claiming that it has largely succeeded in delivering on its promise to fix the issues that made the website serving the Federal Exchange nearly impossible for most people to use:

The White House announced Sunday it has met its goal to make its troubled Healthcare.gov website operate smoothly for most users, fueling hope among Democrats that attention can now turn to successes of the underlying health care law.

“The bottom line is health care.gov on December first is night and day from where it was October first,” said Jeffrey Zients, the president’s appointee to fix the website’s problems. “The site is now stable and operating at its intended capacity at greatly improved performance.”

When the site — which allows people to compare private plan benefits and costs before buying an insurance policy — launched Oct. 1, millions of people were disappointed by slow or frozen pages, an inability to log in, and incorrect or missing information. The White House tapped Zients to lead a team to fix the site.

At the beginning of November, Zients said the site had an “up time” of just 43%. As of Nov. 30, the site’s up time was 95%.

“We have a much more stable system that’s reliably open for business,” he said in a Sunday conference call with reporters.

The news was met optimistically by Democrats and with trepidation from Republicans Sunday.

Sen. Robert Menendez, D-N.J., said on CBS’s Face The Nation that the updates were good news, and compared the exchange’s previous performance to a store advertising a sale but forgetting to unlock the doors.

“It sounds like the front door has been opened successfully now,” Menendez said.

But Sen. Bob Corker, R-Tenn., said the health care law still puts “downward pressure on employment” and “upward pressure on the deficit.”

“I don’t know how you fix the many fundamental problems of this program,” he said.

The Republican governor of Wisconsin, Scott Walker, said the GOP needs an alternative, market-driven plan for health care.

“We just have to have the courage to stand up and do it, and we’re doing it in the states,” he said.

Rep. Adam Schiff, D-Calif., said the backlash is to be expected, but that he’s relieved to hear the website is now operating smoothly.

“Clearly by any metric, the website is much better than it was,” he said on MSNBC. “Let’s hope that this is now the end of the botched website — we can move into a new phase where people are enrolling, where people are seeing the benefits of expanded coverage.”

Whether these claims measure up as true, of course, will depend in no small part on experience that users face in the days and weeks ahead, and whether or not they are able to successfully able to create an account, browse for information regarding plans available to them in their state, select a plan and pay for it, and receive actual confirmation from an insurance company that they have indeed been enrolled in a plan. While we’re not hearing the same number of reports of complete inability to access the site that we did the first day it became available back on October 1st, it’s still fairly early in the process again so I suppose its worthwhile waiting to see how Rollout Part Two actually goes. In that regard, it’s worth noting that getting the website experience for customers working is only part of the equation, perhaps more important than that is what goes on out of view of the individual consumer, particularly the delivery of data to insurers that they need in order to properly set up coverage and ensure that it will be in place on January 1st. Even when most of the media attention was being paid to the front end problems that the web site was experiencing, there were several reports that insurance companies were receiving corrupted data files that made it impossible for them to process applications. At least according  to a report in today’s New York Times, those problems appear to be persisting:

Weeks of frantic technical work appear to have made the government’s health care website easier for consumers to use. But that does not mean everyone who signs up for insurance can enroll in a health plan.

The problem is that the systems that are supposed to deliver consumer information to insurers still have not been fixed. And with coverage for many people scheduled to begin in just 30 days, insurers are worried the repairs may not be completed in time.

“Until the enrollment process is working from end to end, many consumers will not be able to enroll in coverage,” said Karen M. Ignagni, president of America’s Health Insurance Plans, a trade group.

The issues are vexing and complex. Some insurers say they have been deluged with phone calls from people who believe they have signed up for a particular health plan, only to find that the company has no record of the enrollment. Others say information they received about new enrollees was inaccurate or incomplete, so they had to track down additional data — a laborious task that will not be feasible if data is missing for tens of thousands of consumers.

In still other cases, insurers said, they have not been told how much of a customer’s premium will be subsidized by the government, so they do not know how much to charge the policyholder.

In trying to fix HealthCare.gov, President Obama has given top priority to the needs of consumers, assuming that arrangements with insurers can be worked out later.

(…)

For insurers the process is maddeningly inconsistent. Some people clearly are being enrolled. But insurers say they are still getting duplicate files and, more worrisome, sometimes not receiving information on every enrollment taking place.

“Health plans can’t process enrollments they don’t receive,” said Robert Zirkelbach, a spokesman for America’s Health Insurance Plans.

Despite talk from time to time of finding some sort of workaround, experts say insurers have little choice but to wait for the government to fix these problems. The insurers are in “an unenviable position,” said Brett Graham, a managing director at Leavitt Partners, which has been advising states and others on the exchanges. “Although they don’t have the responsibility or the capability to fix the system, they’re reliant on it.”

Insurers said they were alarmed when Henry Chao, the chief digital architect for the federal website, estimated that 30 to 40 percent of the federal insurance marketplace was still being built. He told Congress on Nov. 19 that the government was still developing “the back-office systems, the accounting systems, the payment systems” needed to pay insurers in January.

While insurers will start covering people who pay their share of the premium, many insurers worry that the government will be late on the payments they were expecting in mid-January for the first people covered.

“We want to be paid,” said one executive, speaking frankly on the condition of anonymity. “If we want to pay claims, we need to get paid.”

Insurers said they had received calls from consumers requesting insurance cards because they thought they had enrolled in a health plan through the federal website, but the insurers said they had not been notified.

“Somehow people are getting lost in the process,” the insurance executive said. “If they go to a doctor or a hospital and we have no record of them, that will be very upsetting to consumers.”

Thomas W. Rubino, a spokesman for Horizon Blue Cross Blue Shield of New Jersey, which says it has about 70 percent of the individual insurance market in the state, said the company had received “some but not a lot” of enrollments from the federal exchange.

In no small doubt motivated by these problems, there is at least some talk among insurers about finding ways around the Federal Exchanges that would allow people to sign up for policies. Even if they are able to do that the insurance companies, and to some extent the consumers, are still going to be dependent on the Federal website to calculate any tax subsidies that the customer may be eligible for and to ensure that insurers receive those subsidies in a timely manner. As noted above, though, there are still indication that this back end of the website not only isn’t fully functional, but that important parts of it have not even been built yet. If that’s the case, then the fact that the website is functional is really just an illusion. Given that there are, as of today, just about three weeks left in the period in which people must sign up for coverage to kick in on January 1st, this is a pretty tall order and it seems clear that the President, his staff, and his supporters ought to brace themselves for a new round of functionality complaints that will make mere error messages seem like good news.

The final test of all of this, of course, is whether the supposed fixes to the website lead more people to log on and sign up. We learned today that November saw some 100,000 “signed up” for a plan through the Federal Exchange in November. While this is far better than the roughly 26,000 who had signed up in that manner during October, it is still far short of the projections that had been made before the enrollment process began. Indeed, two months into the enrollment period, enrollment is only at 2.8% of the goal that the Administration had set for the period ending March 31, 2014 even though more than 1/3 of that enrollment period has expired. Additionally, as with October’s figures, it’s unclear how the Administration is counting “enrollment” when it releases these figures. Today’s numbers, for example, include all people who had “selected a plan,” which suggests that yet again they are counting people who had picked a plan but had yet to actually sign up for it or pay a single premium. There doesn’t seem to be any word about how many of those people had actually taken those final necessary steps that would lead to coverage, but one presumes that it is lower than the 126,000 combined number for the Federal Exchange in October and November. Also unavailable is any demographic information about the people being counted as “enrolled” and whether there are sufficient numbers of the younger, healthier, potential insureds that most people agree are necessary to make the entire risk pool viable without massive premium increases further down the line.

So, notwithstanding the Administration’s claims, it’s far from clear that the Affordable Care Act implementation process is even on the road to recovery. That’s something that only time will tell.

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About Doug Mataconis
Doug holds a B.A. in Political Science from Rutgers University and J.D. from George Mason University School of Law. He joined the staff of OTB in May, 2010 and also writes at Below The Beltway. Follow Doug on Twitter | Facebook

Comments

  1. Bob @ Youngstown says:

    The website problems are not the principle concern of the conservatives.
    The real conservative nightmare is the number of poor and working poor who will be grateful to get insurance and vote democratic in the future. That’s what scares the bejesus out of the conservatives.

    Highly-rated. Helpful or Unhelpful: Thumb up 22 Thumb down 1

  2. stonetools says:

    It looks like the Obama Administration has found in Zients the website management version of Plouffe, his campaign manager-a fixer who can deliver the goods. He promised to hit certain milestones by December 1 and, by gum, he delivered-despite Doug and a zillion conservatives rooting for his failure. Now he didn’t deliver unicorns for everyone, but he did deliver a highly functional website consumer wise, and not all the naysaying that Doug can scrape up can deny him that .
    Now there’s a lot of work to be done on the back end, but he has restored trust and there is now good reason to believe that the back end stuff WILL Be fixed, and in timely fashion. Guess the website won’t be Obama’s Katrina after all.

    Like or Dislike: Thumb up 10 Thumb down 4

  3. JKB says:

    @Bob @ Youngstown:

    Well, it is the middle class suburban individuals who are taking Obamacare on the chin. And they turn out to vote in higher numbers than the urban poor. So we shall see.

    Those seeing higher premiums for less choice and lower quality won’t need the rabble rousers to GOTV. On the other hand, to get the subsidized out, the Dems will have to harp on Obamacare and how it might be taken away, day and night. Whom do you think will be motivated to vote the issue most?

    And it seems that once you’ve been slotted by the bureaucrat in website form, you can’t cancel your plan, even when it turns out they lied about your subsidy. Oh, I’m sorry miscalculated.

    Obamacare – Progressivism in all its infamous glory.

    Like or Dislike: Thumb up 4 Thumb down 9

  4. David M says:

    @JKB:

    Did you bother to read the article you linked to:

    Imler says she won’t be quitting healthcare.gov for good. This is a separation, not a divorce. Imler’s been uninsured for nearly a decade and wants that to change. She plans to log back into the website early next year and is hopeful that signing up for insurance will go a lot more smoothly then.

    Like or Dislike: Thumb up 9 Thumb down 0

  5. stonetools says:

    Just to give some historical context, the Social Security Act was passed in 1935, the first Social Security cards were issued in 1937 and the first benefits paid in 1940. Despite that terribly slow roll out, Social Security survived and has prospered to this date, although again, a zillion conservatives have rooted for (and still root) for its failure.
    I’ll also mention that the universal health insurance plan rolled out by good ol’ Otto von Bismarck in 1889 is still going strong 124 years later-and that somehow it didn’t bankrupt Germany. Funny that.

    Like or Dislike: Thumb up 11 Thumb down 1

  6. Mikey says:

    @stonetools: There are many aspects of the PPACA that have already been successfully implemented, with positive results. Unfortunately, the website and associated back-end systems are the true “meat” of how people will access the benefits, and progress on those is worryingly slow. Hopefully, Zients is the right man in the right job at the right time to get it done, but I’m not counting any chickens at this point.

    Like or Dislike: Thumb up 3 Thumb down 2

  7. C. Clavin says:

    “…The final test of all of this, of course, is whether the supposed fixes to the website lead more people to log on and sign up…”

    Actually the real test is the ratio of young and healthy to old and sickly. But as you are only interested in website design, and not policy, I wouldn’t expect you to know that.
    In Kentucky and California…where the law was embraced and is succeeding…the ratios are roughly tracking population distribution.
    What’s really telling in your ODS Post of the day…

    “…there is at least some talk among insurers about finding ways around the Federal Exchanges that would allow people to sign up for policies…”

    It seems that only Republicans are interested in preventing the sick and poor from receiving Health Care. I wish someone could explain that to me. No one seems able to…even those who would deny others…JKB, bill, edmondo, Jenos…
    An excellent insight (more about policy than website design) in an excellent piece by Sullivan:

    “…Now it seems to me that the Church is rightly neutral about the means of achieving the end of universal care. It is not a single-payer Church or an Obamacare Church. But it cannot and is not neutral in any way when it comes to the core moral imperative that each individual in our society, especially the most vulnerable, be able to get care in the wealthiest country on earth. In so far as the Republican party is absolutely indifferent to the millions of Americans without health insurance, in so far as they have relentlessly opposed one feasible plan for universal insurance without offering an alternative that could achieve the same thing, the Republican party simply cannot be supported by Catholics right now…”

    http://dish.andrewsullivan.com/2013/12/02/the-pope-and-the-american-right/

    Like or Dislike: Thumb up 7 Thumb down 1

  8. C. Clavin says:

    @JKB:
    Actually…and I don’t think you are close to smart enough to see this…but Obamacare has shown Republicanism in all it’s lack of glory.
    After all…you are rooting for the poor and sick to be denied access to Health care. Bravo for you. Well done sir. You should be proud.

    Like or Dislike: Thumb up 13 Thumb down 3

  9. Mikey says:

    @stonetools: Yeah, my grandpa said the Social Security website was a real bitch when he tried to enroll back in ’37.

    (Kidding, of course…although my grandpa, aged 94 and still plugging along, probably actually did apply for his SSN in 1937.)

    Like or Dislike: Thumb up 8 Thumb down 0

  10. Bob @ Youngstown says:

    @JKB:

    Well, it is the middle class suburban individuals who are taking Obamacare on the chin.

    The middle class suburbanites that we hear are taking it on the chin are the ones that won’t walk on the same side of the street as a democrat. So, no shifting of political allegiance there.

    Those that think that the poor and working poor are urbanites haven’t spent any time in rural America. I know for a certainty that Deep South Ohio and rural Kentucky are becoming more blue each day that obamacare is taking root.

    Like or Dislike: Thumb up 10 Thumb down 3

  11. JKB says:

    @Mikey:

    But it was saved when FDR gave a speech on TV which made it all better.

    Like or Dislike: Thumb up 3 Thumb down 4

  12. JKB says:

    @David M:

    All the more reason to get this debacle trashed and move on to something useful. The poor woman wants healthcare insurance, but was lied to about the subsidy and now wants to choose a plan more aligned with the current subsidy promise.

    Like or Dislike: Thumb up 3 Thumb down 8

  13. JKB says:

    @Bob @ Youngstown: I know for a certainty that Deep South Ohio and rural Kentucky are becoming more blue each day that obamacare is taking root.

    Well there you go. All good for the Dems. Well, at least until those people try to get into see the few doctors on the Obamacare plan. And then discover they have no choice since only one or two insurers offer in their rural catchment area.

    Oops.

    It’s all good when it is dripping off the lips of the Liar in Chief but then something has to be produced but it isn’t quite what was promised by the golden orator.

    Like or Dislike: Thumb up 2 Thumb down 9

  14. David M says:

    @JKB:

    Miscalculating a subsidy doesn’t really seem like the end of the world here. I’m not sure why she doesn’t create a completely new account and sign up for the other plan.

    Like or Dislike: Thumb up 5 Thumb down 2

  15. C. Clavin says:

    @JKB:
    Jesus-Gawd…you’ve got nothing but emotional rants based on hearsay.
    You are the definition of an ODS sufferer.
    Sad, really.

    Like or Dislike: Thumb up 10 Thumb down 4

  16. Tyrell says:

    Word has it that they finally pinned down the cause to a computer code problem. Seems that they were using Morse Code!

    Like or Dislike: Thumb up 2 Thumb down 5

  17. Bob @ Youngstown says:

    @JKB:

    Well there you go. All good for the Dems.

    It’s good for those who seeing any doctor at all was out of the question, it is good for all those who care about “the least of these”

    It is not good for the egocentric, self absorbed, isolationists, who don’t really want to be engaged in the whole of society. If that applies …..

    Like or Dislike: Thumb up 10 Thumb down 1

  18. Tyrell says:

    @Mikey: Those dern Tandy computers! Those things always did give trouble .

    Like or Dislike: Thumb up 1 Thumb down 2

  19. michael reynolds says:

    It was a lousy roll-out. Which has nothing to say either positive or negative about the underlying law.

    But as as pointed out above, in the states where it’s working, it’s working roughly as projected in terms of young/old enrollment. This suggests that once the technical issues are fixed, the larger national enrollment will track roughly as projected.

    None of this will stop the JKB types, of course. 30 years from now he’ll still be denying it can possibly work. We’ll just see a slow evolution of whining, from whining about the website, to regurgitating a series of Fox News made up horror stories, and eventually it’ll turn out to involve either Acorn or Benghazi.

    The real Teapublican Party objection is of course: white folks payin’ taxes fer black folks’ healthcare. The facts are irrelevant, that’s what it’s about from their point of view. That’s the emotional core. Subtract race from the picture and working poor whites would be jumping at the opportunity to sign up, because it’s a much better deal for working people.

    Bottom line for me, is this: the American people within the next year will have fully metabolized the anti-recission provisions, the pre-existing conditions fix, the adult children extension, the end of artificial limits, all the goodies, all the easy stuff. Which boxes Republicans in, by ending their fantasy of “repeal,” forcing them to confront reform, or a replacement that includes all of those provisions, which will bring them right back to Obamacare, since it is, after all, essentially a Republican program.

    Obamacare will figure in 2014, but I suspect strongly it will not be an issue of much potency in 2016.

    Like or Dislike: Thumb up 10 Thumb down 3

  20. michael reynolds says:

    @David M:

    Miscalculating a subsidy doesn’t really seem like the end of the world here.

    It’s worse than Hitler.

    Like or Dislike: Thumb up 10 Thumb down 4

  21. stonetools says:

    The Republican governor of Wisconsin, Scott Walker, said the GOP needs an alternative, market-driven plan for health care.

    Heh, the fact is that Obamacare IS the market -driven alternative universal health insurance plan. Doesn’t he realize that?

    “We just have to have the courage to stand up and do it, and we’re doing it in the states,” he said.

    I’m afraid the Republican plan at both the national and state level is still “Don’t get sick.” It’s why neither David M or I can get any answer out of Doug or any conservative commenter when we ask for the Republican alternative to Obamacare. They got nothing.
    I’m betting that once Obamacare signs up its first couple of million people, you’ll hear the Republicans start talking about ways to improve what they’ll call Heritagecare.

    Like or Dislike: Thumb up 8 Thumb down 1

  22. beth says:

    @michael reynolds: Please, in five years the Republicans will be introducing a bill in Congress to rename it “The Bob Dole Healthy Americans Act”.

    Like or Dislike: Thumb up 9 Thumb down 1

  23. michael reynolds says:

    @stonetools:

    If you had the identical plan but it had been created by Paul Ryan, Republicans would love it. As a matter of fact, they nominated for president the guy who had the plan earlier. They have got nothing. Empty little noggins with a hard little ball bearing of incoherent rage rattling around inside.

    Like or Dislike: Thumb up 10 Thumb down 3

  24. Grewgills says:

    Indeed, two months into the enrollment period, enrollment is only at 2.8% of the goal that the Administration had set for the period ending March 31, 2014 even though more than 1/3 of that enrollment period has expired.

    Even if everything had been up and running perfectly, I would have been shocked to see more than 10% signed up in the first 33% of the enrollment. People tend to procrastinate. What percentage of taxes are filed 3 months before they are due?

    Like or Dislike: Thumb up 5 Thumb down 0

  25. Kari Q says:

    @JKB:

    Well, it is the middle class suburban individuals who are taking Obamacare on the chin.

    Actually, middle class suburban individuals are almost all getting their health care through their employer or spouse’s employer and are virtually unaffected by Obamacare.

    Like or Dislike: Thumb up 8 Thumb down 0

  26. grumpy realist says:

    The latest issue of Technology Review has an analysis of what went wrong with the original project. Haven’t read it yet, but my guess is the standard: technical specifications not defined until too late, a bunch of over-optimistic programmers–or a bunch of realistic programmers and a middle-management layer that didn’t listen to them.

    Like or Dislike: Thumb up 4 Thumb down 0

  27. Jr says:

    @stonetools: Nah, even they are that obvious when it comes to hackery, they simply call it the ACA when it starts to work.

    Like or Dislike: Thumb up 1 Thumb down 0

  28. JKB says:

    More than 400 of the 600 fixes on the administration’s ‘punchcard’ of repairs have been made.

    It’s worse than we thought. According to Ezra Klein they are using punchcards for Obamacare. Or, at least, the repair project.

    Like or Dislike: Thumb up 1 Thumb down 3

  29. An Interested Party says:

    According to Ezra Klein they are using punchcards for Obamacare.

    Good gravy…hopefully you are being facetious…perhaps you don’t realize what the quotation marks indicate…I mean, one couldn’t really be that stupid…

    Like or Dislike: Thumb up 4 Thumb down 0

  30. C. Clavin says:

    @JKB:
    At first I thought you were joking because you couldn’t be that dumb.
    Then I realized…

    Like or Dislike: Thumb up 7 Thumb down 0

  31. JKB says:

    @An Interested Party: @C. Clavin:

    That says more about Klein than anything. One suspects he meant ‘punch list’

    But it is amusing given his advocacy for Obama.

    Like or Dislike: Thumb up 0 Thumb down 1

  32. bandit says:

    @Bob @ Youngstown: Good projection asshole. The reason they’re not walking on the same side of the street is they’re going to work to pay for the moochers insurance subsidy.

    Like or Dislike: Thumb up 0 Thumb down 2

  33. rudderpedals says:

    That sounds painful

    Like or Dislike: Thumb up 1 Thumb down 0

  34. Tillman says:

    I’m afraid the Republican plan at both the national and state level is still “Don’t get sick.” It’s why neither David M or I can get any answer out of Doug or any conservative commenter when we ask for the Republican alternative to Obamacare. They got nothing.

    As a matter of fact, they nominated for president the guy who had the plan earlier. They have got nothing.

    You know guys, the Republicans floated an alternative healthcare reform plan while Obamacare was being debated in Congress. It just sucked in comparison. Let’s try to be accurate: attacking strawmen like “the Republicans don’t have a healthcare plan” is not nearly as effective as saying “the Republican healthcare plan sucks.”

    Like or Dislike: Thumb up 1 Thumb down 0

  35. anjin-san says:

    @ bandit

    moochers

    How are things at Galt’s Gulch?

    PS, when are you going to start lobbying to ban red states from taking welfare from blue states?

    Like or Dislike: Thumb up 3 Thumb down 0

  36. Stonetools says:

    @Tillman:

    It’s not really an alternative plan if they don’t really advocate for it, bury it the moment the ACA passes, and don’t mention it at all in the next four years. I think they floated it just to say they had an alternative but even they didn’t believe in it. The current Republican line is that we need to tear up Obamacare and start over. Certainly the conservatives here don’t seem to think of that proposal as the Republican health care proposal, so yeah, they got nothing.

    Like or Dislike: Thumb up 0 Thumb down 0

  37. Stonetools says:

    @Tillman:

    It’s not really an alternative plan if they don’t really advocate for it, bury it the moment the ACA passes, and don’t mention it all in the next four years. I think they floated it just to say they had an alternative but even they didn’t believe in it. The current Republican line is that we need to tear up Obamacare and start over. Certainly the conservatives here don’t seem to think of that proposal as the Republican health care proposal, so yeah, they got nothing.

    Like or Dislike: Thumb up 0 Thumb down 0

  38. Snarky Bastard says:

    @JKB: Please explain how to get an improvement when 218 Republicans in the House won’t vote for anything that could possible help anyone who makes less than $250,000 a year

    Like or Dislike: Thumb up 3 Thumb down 0

  39. C. Clavin says:

    Meanwhile it turns out Obamacare is going to cost less than projected…so that’s another thing opponents have been wrong about. It’s getting to be a loooooong list.
    http://www.nytimes.com/2013/12/03/business/affordable-care-act-so-far-seems-likely-to-cost-less-than-expected.html?pagewanted=1&_r=0

    Like or Dislike: Thumb up 4 Thumb down 0

  40. grumpy realist says:

    @JKB: I actually trained on punchcards, I’ll have you know….

    Like or Dislike: Thumb up 1 Thumb down 0