Remember, based on Compete.com’s best estimate from web traffic analysis, just 36,000 users were able to enroll successfully on Healthcare.gov during its first five days online despite 3.72 million attempts to register. That’s a success rate of less than one percent. Twelve days later, the site’s working slightly better, which means more enrollments; on the other hand, some people who tried repeatedly and failed during the first week are bound to have given up, and lord only knows how many of the successful enrollments that insurers are seeing are actually bona fide sign-ups rather than duplicates inexplicably generated by Glitch Central.
Let’s be very generous and assume that there’s somewhere in the ballpark of 95,000 enrollments right now, and let’s also assume against all evidence that every one of those enrollments is bona fide. HHS’s target for October was … nearly 500,000. And that number was only as “low” as it is because they figured not all of the uninsured would discover Healthcare.gov right away.
And now here we are.
In the memo, officials estimated that 494,620 people would sign up for health insurance under the program by Oct. 31. And that was portrayed as a slow start.
“We expect enrollment in the initial months to be low,” said the memo titled “Projected Monthly Enrollment Targets for Health Insurance Marketplaces in 2014.”
A big jump was expected after Thanksgiving, since Dec. 15 is the last day people can sign up so their coverage will take effect Jan. 1. Starting in the new year, the health care law requires virtually all Americans to have insurance or face fines. At the same time, insurance companies will be forbidden from turning away people in poor health.
See now why industry experts keep warning that the timeline for debugging the system is much shorter than what the White House and HHS would like you to believe? The fact that they’re so wildly off-target halfway through launch month means one of two things — or rather, both. One: There’s a huge crush of people who are patiently waiting for the wrinkles to be ironed out before they try enrolling again. That’s good news for the White House in the sense that they haven’t lost those enrollees for good (yet) but terrible news for Healthcare.gov’s IT team insofar as there’s another massive load of users ready to test the site’s infrastructure again. Those wrinkles had better be completely gone or else America might end up in 404 hell again after “re-launch” or whatever. Two: There’s another bunch of users who may have given up, if not permanently then for the foreseeable future until they stumble across a reminder about enrollment somewhere again. That’s the nightmare scenario for O because the lower the number of early enrollees, the greater the panic within the industry that they won’t make up the shortfall anytime soon and thus the greater the chance that they’ll have to hike premiums on people who already have insurance to avert a “death spiral.” Missing the target puts a lot of political pressure on O to make sure that doesn’t happen somehow, which raises the odds of delay. And right now they’re missing the target badly.
How bad is the site even now, after more than two weeks of frantic, round-the-clock triage attempts by HHS and its contractors? The Times asked users:
Mr. Wheeler, an independent sales representative with a neuromuscular disorder, had succeeded where many in other states had failed, getting through a thicket of log-in pages. But when he tried to find out whether two health plans he liked would pay for his medications or let him keep his current doctors, he could not.
He called one doctor on the spot, but the receptionist could not tell him whether the practice was in the new plan networks. Nor could Mr. Wheeler, 61, get quick answers from the insurers themselves. Exasperated, he put off completing his application…
Exchange officials say they plan to make it easier for customers to see which providers and drugs are covered as they continue to refine the new Web sites. But for now, a lack of quick and easy search tools is adding another layer of frustration in the opening weeks of a program that has been plagued by technological problems and political attacks.
The whole point of the site in theory is to make it easy for users to comparison shop between plans. As it is, while users can compare prices, they need to go to the individual websites of each insurer to read the fine print on what’s covered and what isn’t. So if you’re looking at plans from insurers W, X, Y, and Z and you’re considering the “gold,” “silver,” and “bronze” plans from each, that’s 12 different sets of fine print scattered across at least four and maybe as many as 12 different web pages you need to sift through to see if your current doctor and prescription are cpvered under each. See now why Mr. Wheeler gave up?
As icing on the cake, read Peter Suderman’s post on how confusion within the administration about O-Care goes well beyond HHS. Apparently, it came as news to the IRS — the agency tasked with enforcing the mandate and collecting the penalty associated with it — when industry experts announced recently that the deadline for buying insurance to avoid the penalty is mid-February, not March 31st. “So it took a private tax firm to realize—after three years of administration work on the law’s implementation—what the applicable tax law really is,” writes Suderman. We’re in good hands, my friends. Exit question: Granting that not quite everything is HHS’s fault, what’s the argument nonetheless for why Sebelius shouldn’t resign?
Update: A fascinating counter to my post about delaying ObamaCare from Philip Klein. If Obama declares that he has no choice but to delay the law due to technical problems, should conservatives accept that as a victory — or block it to try to force the law’s ultimate defeat?
The operating assumption would be that Republicans would jump at the chance to delay it. But after the past few weeks, can we really be sure that this would be the case?
It’s perfectly conceivable that if such a scenario played out, the position of the Tea Party activists and their allies in Congress would be that delaying the law for a year would be tantamount to a bailout of Obamacare.
If Obama doesn’t agree to full repeal, they could argue, the law should go into effect and destroy the private insurance market so that Americans can experience the full disaster of the law and increase the public pressure to repeal it entirely.
One can easily see the logic behind this argument. It’s much easier to blame Tea Party Republicans for shutting down the government and the potential consequences of not raising the debt ceiling than it would be to blame them if Obama’s pet project backfired and wreaked havoc with the insurance system.
Having offered delay as a solution to the fiscal standoff as recently as a week ago, though, would congressional Republicans turn on a dime and suddenly declare it out of the question because it’s too late now?