The prognosis for HealthCare.gov

The ObamaCare online health insurance marketplace rollout has been a debacle. Can it recover in time?

Obama computer
(Image credit: (AP Photo/Charles Dharapak))

It has now been 21 days since HealthCare.gov went live, theoretically allowing Americans to sign up for health insurance through an online marketplace. Nobody thinks the rollout has gone well. President Obama will reportedly voice his displeasure on Monday, at a ceremony including people who have successfully enrolled in insurance plans through the site.

The official Obama administration line has evolved from blaming unexpectedly heavy traffic for many of the problems consumers (and journalists and gawkers) are having with the site — 19 million people have visited the site so far, the Health and Human Services Department (HHS) said Sunday — to acknowledging deeper problems and vowing to fix them, fast.

"Unfortunately, the experience on HealthCare.gov has been frustrating for many Americans," HHS said in Sunday's blog post. The team in charge of the site has been quashing bugs in the code, adding capacity, and getting rid of parts of the site that aren't working — like a confusing "virtual 'waiting room'" — HHS says, and "we will continue to conduct regular maintenance nearly every night to improve the experience," now with a "tech surge" of help.

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Our team is bringing in some of the best and brightest from both inside and outside government to scrub in with the team and help improve HealthCare.gov. We're also putting in place tools and processes to aggressively monitor and identify parts of HealthCare.gov where individuals are encountering errors or having difficulty using the site, so we can prioritize and fix them. We are also defining new test processes to prevent new issues from cropping up. [HHS]

That's all fine and good — though Slate's Matthew Ygelsias is dubious about the "best and brightest" promise: The allusion to David Halberstam's book about "how a bunch of smart guys blundered the country into the Vietnam War" isn't exactly "the reference you want to make when launching your ambitious initiative."

But can the website be fixed in time to help enroll 7 million people by March 31, in line with government targets?

Here's what we know: According to HHS, about 476,000 applications for health insurance have been submitted through the federal site and the generally less-giltchy exchanges run by 14 states. Last week, The Associated Press said an internal HHS memo predicted that about 494,620 people would enroll in the first month, and 3.3 million by December 31.

But those two numbers — 476,000 applications submitted and 494,620 expected new enrollees — don't tell us much. Applications can include more than one person, on the one hand, but HHS won't say how many of those applicants have actually enrolled in insurance policies until mid-November. And the number of enrollees is the only one that counts.

And some federal contractors working on fixing the website think HealthCare.gov is so broken "that it might not operate smoothly until after the December 15 deadline for people to sign up for coverage starting in January," say Sharon LaFraniere, Ian Austen, and Robert Pear in The New York Times, adding that this prognosis "is not universally shared." One programmer tells The Times that 5 million lines of code may have to be rewritten for the site to run properly.

If that's not daunting enough, here's some context:

According to one specialist, the website contains about 500 million lines of software code. By comparison, a large bank's computer system is typically about one-fifth that size. [New York Times]

The New York Times article runs though some of the problems behind the site's array of glitches. The big ones seem to be that the Center for Medicare and Medicaid Services was, for some reason, assigned to make sure the separate databases and pieces of software from 55 outside contractors work well together; and due largely to changing government requirements, the site "went live on October 1 before the government and contractors had fully tested the complete system."

Anybody who has been through the launch or even relaunch of a website can tell you that's a recipe for disaster.

You can't blame Republicans for indulging in a little schadenfreude over the glitches marring the launch of the health-care exchanges. They warned repeatedly that ObamaCare wasn't ready for prime time, after all.

But some of the critiques are also kind of silly. "In the 21st century, setting up a website where people can go on and buy something is not that complicated," Sen. Marco Rubio (R-Fla.) told Fox News Sunday. That may be true if you're selling T-shirts or coffee mugs; subsidized private health insurance is a different beast.

That may not matter politically. "The rocky website rollout will not in itself doom ObamaCare," says Michael Scherer at TIME, but it's time for Obama to stop explaining HeathCare.gov's problems and get mad about them:

As a president who continues to pin his policy prescription around a bigger government hand in economic development, Obama does not have the option of simply allowing his website to muddle along. His legacy will not hold up if his signature accomplishment fails to attract the uninsured. This is why he needs to stop apologizing for the failure, make some changes, and show that he can get the job done. [TIME]

The president and his team will start that process on Monday, and they probably have about six weeks to turn this around. Looking at human nature and the rollout of ObamaCare's model program in Massachusetts, the Obama administration is expecting most people — especially the younger, healthier people needed for the program to succeed — to enroll close to the December 15 and March 31 deadlines.

"I think that if we get that right, everyone will regret that the early weeks were choppy on the website," Treasury Secretary Jack Lew told NBC's Meet the Press on Sunday. "But the test is: Are people getting coverage and are they getting the care that they need? And we're confident we're going to be on track to do that."

There's a lot at stake in that optimism.

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Peter Weber, The Week US

Peter has worked as a news and culture writer and editor at The Week since the site's launch in 2008. He covers politics, world affairs, religion and cultural currents. His journalism career began as a copy editor at a financial newswire and has included editorial positions at The New York Times Magazine, Facts on File, and Oregon State University.