Finally Fixed

12.01.13

Is the HealthCare.gov Fix Too Late to Save Obamacare?

So the troubled site apparently now works 90 percent of the time. That should be good news for Obama—but the question is whether Obamacare will get the mass enrollment it needs.

HealthCare.gov finally works. Now people just need to use it.

The error-plagued website, which was supposed to be the portal for Americans seeking to buy health insurance through the exchanges set up by the Affordable Care Act, is finally approaching basic functionality two months after it went online.

In a report released Sunday, the Department of Health and Human Services breathlessly announced that the website now functions more than 90 percent of the time, not including scheduled downtime for maintenance. That is twice the rate of the beginning of November, when the website was functional 42 percent of the time. Of course, for users logging on in an attempt to get health care for themselves and their family, HealthCare.gov still won’t work roughly 10 percent of the time. But it’s still an improvement.

The test of the website in the coming weeks isn’t just whether it will work but whether its failures have already fatally undermined consumer confidence in Obamacare as a whole.

The report and an accompanying blog post offer a blizzard of metrics, none of which has been independently verified, on how the website has improved since the fiasco of its launch. Those working to turn around HealthCare.gov, according to Julie Bataille of the Center for Medicare and Medicaid Services, “identified the root cause problems that needed to be addressed to fix the site. These root causes included hundreds of software bugs, inadequate hardware and infrastructure, and a general lack of system monitoring and incident response capabilities. The assessment also identified weaknesses in how the project was being managed, with slow decision-making and diffuse or unclear accountability. With these root causes identified, the conclusion was that HealthCare.gov was fixable, if significant changes were made to the management approach and if we executed against the lengthy punch list of software and hardware fixes with relentless focus and discipline.”

The question now is whether people will enroll even if the website is functioning. The best comparison to Obamacare is the Massachusetts Health Connector, better known as Romneycare, the universal health-care program in Massachusetts enacted when Mitt Romney was the state’s governor. Romneycare was fully rolled out in May 2007, but the requirement for all Massachusetts residents to have insurance didn’t take effect until December 31. The result was a late surge in enrollment in December.

Although the open enrollment period for the health-care exchanges has been extended until March 23, 2014, anyone who wants a policy that will be effective at the beginning of 2014 must enroll by December 23. The date is especially critical for those who had their existing health insurance policies canceled for being non-compliant with the Affordable Care Act, as well those who originally tried to enroll on the website in October but had little success in doing so.

For the reforms of Obamacare to work, the framework of the Affordable Care Act requires mass enrollment. The individual mandate was introduced precisely to reduce the uncertainty over enrollment numbers and use the premiums of otherwise healthy uninsured people to underwrite the cost of banning discrimination based on preexisting conditions. But the website shortcomings didn’t just slow the pace of enrollment, they undermined confidence in the entire program. After all, if the government can’t run simple HTML code, how can it be capable of handling the health-care industry? The test of the website in the coming weeks isn’t just whether it will work but whether its failures have already fatally undermined consumer confidence in Obamacare as a whole.