They’ve got a few weeks.
But if federal officials can’t get the new online insurance marketplace running smoothly by mid-November, the problems plaguing the 3-week-old website could become a far bigger threat to the success of the health law, hampering enrollment and fueling opponents’ calls to delay implementation, analysts say…
“If we’re not seeing a substantial improvement in the next two or three weeks, we’ll be in a bad place,” said , director of exchange technology at Leavitt Partners, a consulting firm. “We’re already behind the curve in getting to that 7 million mark.”
Public awareness of the new health insurance exchanges has risen substantially in the weeks since they opened, but only a small percentage of consumers have visited the sites. Most of those already have insurance and are simply trying to learn more about the program, according to a survey released on Monday by the Pew Research Center.
The survey found that only about 3 in 10 people thought the exchanges were working well. That appears to reflect widespread reports that many of the 34 states with exchanges run by the federal government have encountered technical problems, while state-run insurance exchanges appear to be functioning more smoothly…
Even among the uninsured who plan to visit the sites, many were not yet seriously thinking of the exchanges as a health insurance option. While 64 percent of uninsured Americans either have visited or plan to visit an exchange Web site, only 33 percent said they were looking at health insurance options for themselves and their families. Nearly as many (29 percent) said they had visited or planned to visit the sites but only to learn about the exchanges, not to look at options for themselves, the survey found.
President Obama said Monday he’s “frustrated” by the disastrous launch of an online computer marketplace for Obamacare. Here are five reasons why frustration isn’t enough. He should be frightened…
Nobody expects the chief executive to be reviewing computer code or hosting East Room “hackathons.” But this falls on him. The CEO of a corporation or country is uniquely responsible for making sure the team is on task, and he or she is ultimately responsible if it’s not. In Obama’s case, did he demand thorough updates on the progress of the site? If so, did he ask the right questions? Did he put the right people on the job in the first place? Given the horrid first days of Obamacare, the answer to at least one of those questions must be “no.”
The names on the team coming in to fix the site? The Obama administration isn’t saying.
“I don’t have a list of names, but they include people from within the federal government and from the private sector,” a Department Of Health And Human Services official told BuzzFeed. The official referred questions about team to a Sunday HHS blog post that described “a tech surge” on its way to fix the troubled site…
During the daily White House press briefing shortly after Obama’s speech, Press Secretary Jay Carney declined to say who was on the team and referred questions to HHS.
Anyone who has been part of a federal project that involves technical work performed by contractors has got to be shaking his head today at the vision of outsiders swooping into a massive project and fixing complex mistakes. The attempt to integrate new people with very high opinions of their own technical prowess into this mind-numbingly complicated undertaking will involve a lot of unpleasant meetings that waste the time of people who should be working on the site, the endeavor will be severely hamstrung by the basic character of federal contracting work (in which the four corners of the contract are everything and rules matter more than goals), and it will all only delay the inevitable end game—which is that the contractors who screwed this up will need to be the people who unscrew it, they will do it slowly and clumsily, and they will get paid handsomely by the taxpayer for the additional work.
Putting a positive spin on things, they said that people appear to really value the opportunity to talk something as important as health insurance over with an actual human being. Still, it’s fairly obvious that heavy reliance on phone calls was not part of Plan A for the rollout. One major tell is that the phone number—1-800-318-2596—is just a random string of digits rather than something more memorable. Health and Human Services runs a 1-800-MEDICARE phone number for questions about Medicare, but they didn’t get 1-800-OBAMACARE or anything similar.
Now one question I had about this new emphasis on “alternate pathways” is whether that really solves the problem. After all, if you apply on the phone, that just means someone is on the other side of the phone call punching information into a computer. The officials assure us that the “data hub” that a phone answerer would be querying to run this part of the application does in fact work, so people should be able to sign up by phone regardless of problems with the customer-facing website. On the other hand, there are obviously substantial bottlenecks in terms of the actual number of people available to answer calls. This just isn’t the way the administration anticipated people signing up, and to get real volume of people in plans, they’re going to need to make the website work.
While the administration is urging patience, Democrats who will face voters in a little over a year don’t have the luxury of time. They’re having to make decisions now about how to position themselves if the administration continues to struggle with implementing the central piece of a law they supported.
Democratic political strategists are racing to find the safest ground for 2014 House and Senate candidates who support the law but don’t want to be dragged down if things don’t get better — and fast. “Democrats running in 2014 need to be for fixing health care and need to run hard against those that want to repeal and defund it. They shouldn’t own responsibility for problems with the law or its implementation,” said one Democratic Party operative.
In another potentially troubling sign for the White House, the No. 2 Democrat in the Senate, Dick Durbin of Illinois, said on “Fox News Sunday” that Sebelius will, at some point, have to testify on the Hill.
Several Democrats told POLITICO they aren’t getting good answers either, even in private.
Insurance executives said in interviews that they were frustrated because they did not know the government’s plan or schedule for repairs. Insurers have found that the system provides them with incorrect information about some enrollees, repeatedly enrolls and cancels the enrollments of others, and simply loses the enrollments of still others.
Correcting those errors, specialists said, could require extensive rewriting of software code. Insurers said it could be weeks before their data and the government’s could be reconciled…
According to one specialist, the Web site contains about 500 million lines of software code. By comparison, a large bank’s computer system is typically about one-fifth that size.
In New York, one of only 16 states that has its own exchange, not one person had succeeded in using the site to enroll in a plan as of Friday.
Donna Frescatore, director of the New York State of Health marketplace, said Friday that 134,000 people had registered and shopped on the state’s online health care site since its Oct. 1 launch, and thousands signed up to enroll in a plan.
But the state has repeatedly delayed electronically transmitting those users’ data to insurers offering health plans.
The department, which held off in order to verify the accuracy of the information users submitted, said it would transfer the first batch of enrollees’ data — which includes thousands of transactions — as early as Friday night.
Consumer Reports, which publishes reviews of consumer products and services, advised its readers to avoid the federal health-care exchange “for at least another month if you can.” “Hopefully that will be long enough for its software vendors to clean up the mess they’ve made,” the magazine said, having tested the site themselves over the course of the past three weeks.
Noting that only 271,000 of the 9.47 million people who tried signing up in the first week managed to create an account, Consumer Reports then provided a few tips to those attempting to slog through the application process. From attempting successive logins because “error messages . . . may not always match reality” to checking one’s inbox frequently because missing an e-mail a user will be timed out of the site and forced to start from square one, none of the suggestions guaranteed success.
“The whole thing it wasn’t just one bad decision,” Slate’s Jacob Weisberg said. “It was architected wrong. There was clearly nobody in charge of this process who could manage it. But this is a huge, complicated, difficult process, and I guess I’m disappointed that someone who had pretenses of being the first tech president didn’t have his head wrapped around it enough to take those problems on. Even the president should have known that you beta test a piece of software like this.”…
“One of the reasons the technology worked so well in the campaign and may not work so well here is we didn’t outsource the campaign technology to the lowest bidder,” Gibbs said.
“There should be a tech surge,” he continued. “There should be not just the best and the brightest in Washington, but the best and the brightest from Silicon Valley who make this work every single day…Those people should be brought in to do triage, to get this system working, because we don’t have an option. This really is Ed Harris in Apollo 13: failure isn’t an option. The website can’t stop. We have to fix it as we’re doing this enrollment. It all has to be simultaneous, which is going to require a lot of really smart people in the room working on this twenty-four hours a day.”
Among uninsured Americans, 59% now say an exchange is available in their state, up from 50% a month ago. Yet there is no shift in the share of uninsured who say they plan to get insurance because of the new law that requires individuals to sign up by the end of the year.
Most uninsured Americans (65%) say they plan to get health insurance over the course of the next six months, but just 26% say this is because of the new health care law while 38% say they had planned to get insurance anyway. These proportions are little changed from last month.
But the failed rollout has already raised ideological issues of broader significance. It has reinforced a widely held, preexisting belief that government-run health systems are bureaucratic nightmares. And it has added credence to the libertarian argument that some human systems are too complex to be effectively managed. Perhaps the problem with Obamacare is not failed leadership but rather the whole project of putting a federal agency, 55 contractors and 500 million lines of software code in charge of a health system intended to cover millions of Americans.
I am not a libertarian who argues against the need for programs such as Medicare and Medicaid. But Friedrich Hayek has this much going for him: He understood that the challenge of technocratic planning is always limited information: “The peculiar character of the problem of a rational economic order is determined precisely by the fact that the knowledge of the circumstances of which we must make use never exists in concentrated or integrated form but solely as the dispersed bits of incomplete and frequently contradictory knowledge which all the separate individuals possess.”
Which is why planning tends to fail, particularly in highly complex systems. “This is not a dispute about whether planning is to be done or not,” Hayek said. “It is a dispute as to whether planning is to be done centrally, by one authority for the whole economic system, or is to be divided among many individuals.”
So maybe the problem is not Obama or Sebelius but rather a government program that requires superhuman technocratic mastery.
“No one beta-tested the site, which is almost criminal if you think about it.”
“Five days before the launch, the president said it’s a website where you can compare and purchase affordable health care plans, the same way you shop for a plane ticket on Kayak. Who misled him? Who misled the president on this? Are you telling me five days before that somebody let the president go out to the American public to give this speech and say this and make this promise? In fact, the next line is: I promise you, this is a lot easier, it’s like booking a hotel or plane ticket. Who let him down?”
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