If the system’s front end works as smoothly as the Obama administration says it does, that means more applicants will get to the back-end functions of HealthCare.gov, where the insurance company needs to know who signed up for their product. We know a lot less about how prepared those systems are for a possible flood of enrollments and how they will perform in the coming weeks.
Suderman shares Kliff’s concerns:
Given its history, the administration’s claims have to be taken with a cargo ship full of salt—especially since there’s no good way to independently confirm that the website is working as well as the administration claims. You just have to take their word for it.
Even if the website appears to be working on the user end, there’s no guarantee that less visible functions are performing adequately. Insurers have been reporting dropped or incorrectly transmitted enrollment data since the exchanges launched. And according to The New York Times, the repair team prioritized front-end fixes for consumers over accurate insurance-company connections. So the site might appear to be working just fine, until you try to actually use the insurance that you thought you purchased.
Garance explains the above chart:
[T]he Department of Health and Human Services released a report that detailed just how badly the site was functioning in October and early November. According to the Healthcare.gov Progress and Performance Report, the site was offline more than it was online in at the start of November … Zients said uptime in October was similar to what was seen in that first week of November. That means that by the time President Obama spoke in the Rose Garden on October 21 to urge people to use a 1-800 number instead of Healthcare.gov, the site had been functionally offline the majority of the time during its first three weeks.
Philip Klein puts the uptime numbers in perspective:
What information HHS did provide its new report isn’t very impressive if the comparison is with a typical commercial website rather than against the basket case that was healthcare.gov in October. For instance, an HHS chart – which Zients boasted about – shows system uptime now at 95.1 percent (excluding scheduled maintenance), which compares to 42.9 percent a month ago. But, the industry standard is for websites to be available for users 99.9 percent of the time. Anything below that is considered a failure and 95.1 percent is a disaster.
Overall, I think his criticisms of the consumer experience are not unreasonable, but probably mostly irrelevant; most state DMVs had terrible service, but very few people decided to pass on getting a license because of it. On the other hand, the back-end problems…that’s the critical question, and I agree with him (and Kliff) that we just have very little idea of what’s going on — and there’s a scary possibility that no one will know what’s going on until more people get through the system (which should happen in the next few weeks).
Ezra Klein weighs in:
[H]ere’s what’s indisputable: HealthCare.gov is improving, and fast. Or, to put it differently, HealthCare.gov will be fixed. In fact, for most people, it is probably fixed now, or will be fixed quite soon.
The repair job is likely proceeding quickly enough to protect Obamacare from the most severe threat to its launch: Democrat-backed legislation unwinding the individual mandate or other crucial portions of the law. So long as people can actually purchase insurance through the federal exchanges, congressional Democrats are likely to support the basic architecture of the legislation they passed in 2010.
Republicans realize the Web site is quickly improving, and are planning a multi-phase attack on the law’s other disruptions. There are the insurance cancellations, of course, but there also going to be people who happily buy new insurance only to find their doctor isn’t covered, and there will be people who end up paying higher premiums in the new market, and there will be employers who raise deductibles to keep from paying the 2018 tax on high-value insurance plans, and so on.
Avik Roy attacks the premium prices:
Yes, the website will improve over time. But the cost of insurance on the website will not. And the cost of insurance for everyone else is also going up. And many of the law’s “winners”—mainly low-income people qualifying for subsidies—already vote Democrat, if they vote at all.
If anything, Americans are only beginning to become aware of the fact that they will pay more for health insurance under Obamacare. “I was all for Obamacare until I found out I was paying for it,” said one Californian when she first saw her bill. The President and his Democratic allies have been assuring Americans that they will see no changes to their health coverage under the law. That isn’t true. And one year from now, we’re likely to see voters make their dissatisfaction known.
And Jonathan Cohn has questions:
One more lingering—but very substantial—issue is the status of people who tried to apply during the first few weeks, when the system was at times barely functional. Many of those people essentially got stuck at some point in the process and have been unable to complete the process since. Administration officials said that reaching out to those people, so that they can finish applications and obtain insurance in time for January 1, is at the top of their to-do list.
Will the administration succeed, so that these people get coverage in time? Will those 834 problems be addressed in time, so that people can actually use their insurance successfully? Will new problems materialize in the coming weeks, as more and more people try to use the system?
Those are among the very big questions that remain unanswered—and will for at least a few weeks.