Editorial: Opening Fumble; Rocky Start for Health Exchange
“It’s frustrating,” said Scott Anderson about the dysfunctional online service that has thwarted many people’s best efforts to use it, putting them at risk of missing a looming deadline. “ ... We are apologetic and regretful that they find themselves in this position.”
No, Anderson isn’t a federal official involved in the Obamacare launch. He’s the senior policy director for the Common Application, which launched an updated version of its online college application service late this summer and encountered so many problems that numerous schools pushed back their application deadlines. Its predicament is a useful reminder that the launch of just about any major computer system — let alone one involving a huge, complicated public interface — is almost certain to reveal serious flaws. A New Yorker piece about the dysfunctionality of the Healthcare.gov site recalled that the FBI spent more than a decade and $1 billion making its basic information management system, first introduced in 2001, function properly.
All of which is intended to provide context, not excuses, for the problems plaguing the online marketplace that was supposed to provide a convenient portal for people to compare insurance options, determine their eligibility for subsidies and buy a policy. The functionality of the system is so low that users, to use that term loosely, often can’t get past registration. Even states such as Vermont that have developed their own insurance exchanges and websites are encountering problems, largely because they’re connected to the federal system.
Regardless of the magnitude of the task — 55 contractors worked on the website, to give some sense of its complexity — there’s ample evidence that the Obama administration’s fumbling made the launch of its signature program even more challenging than it needed to be. The administration was late in defining the requirements of the system, plowed ahead with the Oct. 1 launch despite numerous warnings that the website was far from ready, and has been anything but forthcoming about keeping the public updated.
On the bright side, at least for those hoping for the program’s success, is the fact that there’s still time to fix the system. Enrollees who want coverage to begin on the first day of 2014 have a Dec. 15 deadline for signing up, while the administration announced Wednesday that people who are required to purchase insurance through the marketplace now have until March 31 to sign up. If the intensive, high-profile effort to fix the system announced by President Obama earlier this week falters, the deadline can be pushed back again.
On the other hand, analysts warn that the website’s problems are too fundamental to be regarded as glitches and warn that a fix might take much longer than is being promised. Moreover, a faltering start can have permanent consequences. One of the keys to the success of the health reform law is that participation be sufficiently widespread to keep insurance premiums affordable. If enough people are frustrated by the nonfunctioning website or opt not to even try it because of bad publicity, the success of the program will be in jeopardy. Initial reports are discouraging, even factoring in their preliminary nature: Vermont, which hopes to eventually see 100,000 private insurance plans sold via the marketplace and 170,000 people sign up for Medicaid, reported that only about 7,000 people had created an account through Vermont Health Connect after two weeks.
Our hope is that this rocky start will have no more impact on the program’s long-term success than the many horror stories surrounding the 2003-05 launch of the prescription drug benefit that is now an essential component of Medicare. What’s ultimately at stake here is not the Obama administration’s legacy or potential campaign fodder for Republicans, but the ability of millions of Americans to live free from the fear of being impoverished by illness or accident.