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White House meets goals for HealthCare.gov

02 December 2013, 07:02

Washington - Two months after the disastrous launch of a website that is a key component of President Barack Obama's healthcare law, administration officials said on Sunday they had met their goal of getting the HealthCare.gov site running smoothly but warned that it needs more fixes.

Obama adviser Jeffrey Zients said a five-week emergency "tech surge" had doubled the capacity of the online health insurance portal that is crucial to helping millions of people shop for insurance plans, while making it more responsive and less prone to errors.

The administration said the effort's key improvement was to increase HealthCare.gov's capacity to 50 000 simultaneous users, which would allow the site to handle a minimum of 800 000 users per day.

But Zients also warned that peak traffic volumes during the coming weeks could eclipse the new capacity as consumers rush to sign up before a 23 December deadline for coverage that begins 1 January.

That could delay some people from completing online applications for subsidised health coverage.

Officials also acknowledged that the site still may not operate smoothly for some visitors, even when traffic volumes are within its capabilities.

Even so, officials said, the site is dramatically better than when it was launched on 1 October. It was overwhelmed by users in a debacle that embarrassed Obama, fuelled Republicans' complaints about the Democratic president's healthcare overhaul, and threatened to make his signature domestic achievement a drag on Democrats heading into the 2014 elections, when control of Congress will be up for grabs.

"The bottom line: HealthCare.gov on 1 December is night and day from where it was on 1 October," Zients told reporters a day after the administration's self-imposed 30 November deadline for making the website operate properly for the "vast majority" of users.

"We've widened the system's on-ramp - it now has four lanes instead of one or two," he said. "We have a much more stable system that is reliably open for business."

Cautious optimism and skepticism

The Zients team's success could mark a more upbeat chapter for the Patient Protection and Affordable Care Act, which also is known as Obamacare and is designed to help provide coverage to millions of uninsured and under-insured Americans.

If HealthCare.gov remains stable enough to handle millions of applications for insurance and for government subsidies to help lower income people pay for coverage, it will help tamp down a major crisis of Obama's administration.

An improved website won't solve all of Obamacare's problems, however.

There are many questions on whether the program will be able to enroll the estimated 7 million people it needs by the end of March, including millions of healthy, young enrollees who are needed to keep the program's costs in check.

"The issue is really the management capacity of the Obama administration," said Robert Blendon, a Harvard University expert on healthcare policy and public opinion.

"If the website really is still working a week from now, it'll make people feel that at least they have the capacity to turn things around and move ahead."

But a repeat of problems that plagued the site's launch could leave hundreds of thousands of people without coverage and deal a staggering blow to Obama's legacy and the 2014 election prospects of congressional Democrats, already on the defensive over the programme's recent problems.

Republicans, who view the 2010 law as an unacceptable expansion of government that will limit healthcare choices and kill jobs, were quick on Sunday to say the administration overstated gains on the website.

"Have they made some progress? Yes. They brought in some private-sector folks to try to get the functionality up," Representative Mike Rogers of Michigan said on NBC's Meet the Press.

But, he said, "It still doesn't function right".

Democrats sounded a cautious note. Some party members have called for a delay of the "individual mandate",  which requires Americans to be enrolled in coverage by 31 March or pay a penalty.

"This is going to take some time before it's up and kicking and in full gear," Representative Chris Van Hollen, a Maryland Democrat, said on Meet the Press.

Asked whether the individual mandate still needs to be delayed, Van Hollen replied: "As of today, no ... let's see how this is working."

Anecdotal evidence suggested few problems with the website as of midday on Sunday.

Amanda Wood, 25, a uninsured New Jersey resident, said she had avoided using the website because of the technical problems, but tried it just before Thanksgiving after a friend told her she didn't encounter problems with it.

Wood, a sales associate at an arts and crafts store, said navigating the site was "surprisingly easy" given "all those negative things" she had heard.

"I went on and it didn't really give me problems," said Wood, who said she created an account and shopped "a little bit, but I wasn't 100% sure what I wanted to pick yet".

Asked about her priority for choosing a plan, Wood said: "Cheap." Wood, who believes she will eligible for an insurance subsidy, said the prices for coverage offered on the website "seemed pretty reasonable".

'Dramatic progress'

Zients, who is slated to leave his HealthCare.gov post and become director of Obama's National Economic Council on 1 January, attributed his team's success to a new management structure that he said replaced inadequate oversight and coordination, slow decision-making and a lack of centralised accountability.

His team, beefed up by specialists from high-profile tech companies including Google and Oracle, eliminated hundreds of software bugs and hardware issues that had kept the site down for about 60% of October. HealthCare.gov's uptime is now above 95%, officials said.

But HealthCare.gov, which serves consumers in 36 states, will face increasing pressure from consumers ahead of the 23 December deadline to enroll for benefits for the new year.

Craig Garthwaite, a health economist at Northwestern University's Kellogg School of Management, said Sunday's announcement represented "dramatic progress", but that the fixes mainly brought the website to "the baseline of what we need the site to be able to do".

Other analysts also cautioned that while the consumer experience was improved, the administration has not resolved problems at the crucial "back end" of HealthCare.gov's technology system, where it interfaces with insurers.

Officials are working to correct errors in the consumer enrollment data sent to insurers and have not built in several necessary functions, including one that will enable the government to pay federal subsidies to insurers on behalf of low-income enrollees.

Without those functions working properly, HealthCare.gov and websites for 14 state-run marketplaces could have difficulty operating in 2014.

- Reuters

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