(Bloomberg) — President Barack Obama raised the stakes on his three-year-old health care overhaul Sunday, declaring that fixes to his administration’s troubled insurance exchange website make it ready to sign up 800,000 people a day.
The site, Healthcare.gov, is sure to be tested immediately today — “Cyber Monday” — when deals from online retailers draw more Americans to their computers and the Internet.
The site’s stated new capacity of 50,000 simultaneous users hasn’t been proven in the real world, and U.S. officials aren’t certain the site will hold up, according to a person familiar with the repairs who asked not to be identified because the information isn’t public. At the same time, the reduced error rate of 0.75% per page, down from 6% in October, still means many users will encounter a glitch in clicking through multiple pages to enroll in a health plan.
If consumers find continuing problems with the site “it is going to help drive this to a huge advantage for the Republican party, for a broader agenda which will not be just fixing the website; it’ll be scaling back the law,” says Robert Blendon, a professor of health policy and political analysis at the Harvard School of Public.
The effect of the repairs may not be known until the middle of January, when the administration reports on enrollment in December. About 100,000 people signed up for coverage through the federal system last month, a roughly four-fold increase from October even as Healthcare.gov was undergoing repairs, said a person familiar with program’s progress.
The enrollment jump may be an encouraging trend for the administration, signaling that consumers are keeping an open mind about the U.S.-run exchange even as it suffered software glitches and breakdowns. Americans face a mid-December deadline to sign up for coverage beginning Jan 1.
In a report released yesterday by the Health and Human Services Department, the administration said it has fixed or improved more than 400 software issues and made the site between two and five times faster through a series of hardware upgrades, including new servers. The site’s average response time has fallen from eight seconds in October to less than one second over the past three weeks, the report said.
‘Night and day’
New monitoring tools were installed allowing technicians to keep an eye on the site’s traffic and any problems 24 hours a day, and a dedicated phone line called an “open bridge” connects programmers at different contractors’ offices to a command center in Columbia, Maryland.
“Healthcare.gov on Dec. 1 is night and day from where it was on Oct. 1,” said Jeffrey Zients, the management consultant President Barack Obama assigned to supervise repairs, on a conference call Sunday.
While the report cited the “dramatic improvements” in the website’s performance, others weren’t impressed.
“A good site will have a 100th of 1 percent error rate,” says Sucharita Mulpuru, an e-commerce analyst with Forrester Research Inc., in Cambridge, Massachusetts. “That’s not great.”
In addition, “the best sites are able to handle tens of thousands or even hundreds of thousands of sessions” by users at once, Mulpuru says.
Federal officials yesterday said they would continue working to improve the website. Technicians are now focusing on fixing the back-end systems that send data on customers and federal subsidy payments to insurers. Those systems, centered on a standard transaction form known as an “834,” are used to transmit key data about new customers to insurers.
The plan is to complete repairs over the weekend on parts of the website “that will significantly address the highest priority things we know are a particular concern for those transaction forms,” said Julie Bataille, a spokeswoman for the Centers for Medicaid and Medicare Services, on Sunday’s conference call with reporters.
The fixes will also include “significant changes” that will make it easier for insurers to enroll customers directly through their own websites, bypassing Healthcare.gov, she said.
Last month, CMS announced a pilot program with 16 carriers in Ohio, Florida and Texas to see if insurers could provide an alternative to the struggling federal site. “We are encouraged by the feedback that we are seeing,” Bataille said. The agency “believes this is something we’ll soon see more issuers be able to utilize across the country.”
Dan Mendelson, chief executive officer of Avalere Health LLC, a Washington-based consultant to health-care companies, said the U.S. report highlighted “some important progress.” Still, it was limited to “process measures” like page-view times, rather than enrollment and it was significant that the administration didn’t accompany its performance report with public appearances by the president, he said.
“They’re not expressing the kind of confidence that they would need to have by going out and saying, ‘OK, bring it on,’” Mendelson says. “You’re not going to get enrollment until they flip that switch and aggressively say that the government is open for business. That’s the Catch-22.”
Timothy Jost, a law professor at Washington & Lee University in Lexington, Virginia who has tracked the law’s implementation said expectations about the enrollment numbers from the website will now be higher.
“The president has taken a huge hit,” Jost says. “The Affordable Care Act has taken a huge hit. It’s going to take some time to work out of this.”
Over the last two weeks, groups known as navigators, who help people use the site, have said it was getting easier, though the progress was slow and there were frequent outages.
The site is “kind of hit and miss,” said Karen Basha Egozi of the Epilepsy Foundation of Florida, a U.S.-designated navigator, in an interview last week. “There have definitely been more hits lately than in the past. But I know there are cases where people still get locked out when they try to purchase a plan.”
“Dramatic progress has been made on improving healthcare.gov,” the administration said in its’ eight-page report. “There is more work to be done to continue to improve and enhance the website and continue to improve the consumer experience in the weeks and months ahead.”
The site seemed to be working better toward the end of last week, said John Foley, a supervising attorney with the Legal Aid Society of Palm Beach County, a navigator group in Florida. About a half dozen customers came to the group’s offices on Nov. 29 and all of them successfully navigated the site, although Foley said he wasn’t sure how many enrolled.
Yesterday, though, the site was sluggish and Foley encountered an error as he browsed health plans while speaking to a reporter.
“It’s still waiting. That was 20 seconds or 30 seconds. It just froze up; I’m done,” he said. “It’s still kind of glitchy. Now it just kicked me out. It went back to the front page. I’ve been here all afternoon and it’s been like that.”
The site wasn’t experiencing broad errors or outages on Sunday, Aaron Albright, a spokesman for the U.S. Centers for Medicare and Medicaid Services, said in an e-mail.
The goal of having the site “work smoothly for the vast majority of users” was set by Zients after its calamitous Oct. 1 debut. Technicians supervised by Zients fixed or improved more than 400 items on a “punch list” that grew quickly starting the week of Nov. 9, according to the report.
Register or login for access to this item and much more
All Employee Benefit Adviser content is archived after seven days.
Community members receive:
- All recent and archived articles
- Conference offers and updates
- A full menu of enewsletter options
- Web seminars, white papers, ebooks
Already have an account? Log In
Don't have an account? Register for Free Unlimited Access