Obamacare Site Repair Goals Reached

Bloomberg News

The Obama administration said today it has met its self-imposed goal to have the online federal health exchange working smoothly for most consumers who use it.

Healthcare.gov has been plagued by software errors and delays for two months. That's spurred criticism by foes of the 2010 health-care law, prevented many Americans from enrolling in new plans and hurt President Barack Obama in the polls. While the fixes announced today address the site's public face, health officials said they were continuing to work on the site's ability to transmit data to insurers on the back end.

The effort to date has cut error message rates to less than 1 percent per page from about 6 percent in October, according to an administration report released today. And after initially faltering with 1,100 users at a time, the site can now handle 50,000 at a time, or about 800,000 per day, the report said.

'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 with reporters today.

Moving forward, technicians will focus on fixing the systems that transmit data on customers and federal subsidy payments to health insurers, federal officials said on the call. Those systems, centered on a standard transaction form known as an '834,' are used to transmit key data about new customers to insurers.

Weekend Repairs

Technicians working on the issue plan to complete repairs this weekend '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.

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.'

The administration is releasing enrollment data once a month, with the next report not expected until mid-December. As a result, it may be impossible to tell immediately how well the technical fixes are working. Opponents, though, are sure to look for any signs of a slowdown or continued errors.

'Important Progress'

'They clearly are reporting some important progress,' said Dan Mendelson, chief executive officer of Avalere Health LLC, a Washington-based consultant to health-care companies, in a telephone interview today.

Still, the progress report was limited to 'process measures' like page-view times, Mendelson said. 'Ultimately, they will have to be judged on an outcome measure and the only meaningful one is enrollment.'

It's significant that the administration isn't accompanying today's report with public appearances by the president or other officials to get more people to healthcare.gov, 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 said. '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.'

'Hit and Miss'

Over the last two weeks, groups known as navigators, who help people use the site, have said it was getting easier to use, 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.'

Today's report said the administration would continue working to improve healthcare.gov.

'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.'

Zients Goal

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.

Uninsured Americans, or those losing coverage at the end of this month, have until Dec. 23 to sign up for plans effective Jan. 1. The federal website serves 36 states, including Texas, Florida, Illinois and Pennsylvania, while 14 states including New York and California run their own.

The state sites for the most part have not encountered the technical problems of healthcare.gov.

The website is a crucial piece of the 2010 healthcare law and its success -- or failure -- will have implications for the nation's $2.7 trillion health-care system. The outcome will help define Obama's legacy and influence the legislative agenda in a divided Congress, where Senate Democrats facing re-election next year have called for changes in the law.

'Big Benchmarks'

'The administration has hit the big benchmarks they set out, 50,000 people at one time, 800,000 people a day,' Representative Chris Van Hollen, a Maryland Democrat, said on NBC's 'Meet the Press.'

Representative Mike Rogers, a Michigan Republican, said the healthcare site's security remains a problem. 'It still doesn't function right,' he said on the NBC show. 'The security of this site and the private information does not meet even the minimal standards of the private sector.'

The law seeks to extend coverage to most of the nation's 48 million uninsured by expanding state Medicaid programs for the poor and creating the government-run insurance exchanges to buy subsidized medical plans.

Ahead of the Dec. 23 deadline, the government plans to focus on helping people who've already tried to enroll complete the process, Bataille said. About 975,000 people completed applications for coverage in October and were determined eligible to make a purchase, but didn't select a plan, according to enrollment data released in November.

Seeking Returnees

'While we certainly want to and will invite new consumers into the site, our focus is on making sure those who have tried to enroll in the past several weeks are able to successfully complete that process,' she said.

The site is 'in the zone of about 80 percent of users being able to do that same process successfully,' Bataille said. White House press secretary Jay Carney on Nov. 18 that the administration wanted about 80 percent of people in states covered by the federal exchange who need insurance to be able to use the website.

The website attracted 2.8 million on its first day Oct. 1 and, initially, the administration blamed the large turnout for the site's problems. Since then, the government has cited significant problems in the site's development and software as leading to the breakdowns.

In the latest setback, the administration said last week that an automated system to pay insurers won't be ready by January as planned. The White House unveiled a temporary process in which the companies will receive estimated payments.

Larger Troubles

Republicans in Congress have described the website flaws as emblematic of larger troubles with the law.

'Americans are far less concerned about a website than they are about the availability and affordability of their health care,' Senate Minority Leader Mitch McConnell said in a statement.

'The White House has tried to dismiss stories about folks losing insurance by saying they had lousy plans to begin with, and that those Americans should be happy that the government is now forcing them to get a different one,' said McConnell, a Kentucky Republican. 'But what so many have discovered is that Obamacare is actually worse.'

Michael Steel, a spokesman for Republican House Speaker John Boehner, said, 'This isn't about a broken website, it's about a fundamentally flawed law.'

To contact the reporters on this story: Alex Wayne in Washington at awayne3@bloomberg.net; Alex Nussbaum in New York at anussbaum1@bloomberg.net

To contact the editor responsible for this story: Reg Gale at rgale5@bloomberg.net