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Health Insurance & Affordable Care Act

How Long Does Obama Have to Fix Healthcare.gov?

WebMD News from Kaiser Health News

By Julie Appleby

Mon, Oct 21 2013

They've got a few weeks.

But if federal officials can’t get the new online insurance marketplace running smoothly by mid-November, the problems plaguing the three-week-old website could become a far bigger threat to the success of the health law, hampering enrollment and fueling opponents’ calls to delay implementation, say analysts.

"The system needs to be operating reasonably efficiently - I’m not saying flawlessly - before the middle of November,” said Insurance Commissioner Sandy Praeger of Kansas, one of the 36 states relying on the federal marketplace because legislators opted not to do their own state-based market.

On Monday, President Barack Obama addressed the problems directly for the first time, saying “no one is more frustrated than me” and promising that technology experts from around the country were working with the administration “to get this working better, faster, sooner.”

Still, he did not offer details about the scope of the problems, a timeline for the repairs or the number of people who have successfully enrolled out of the more than 19 million site visitors.

The stakes are huge - not just because of public opinion, but practically, in terms of creating the broad insurance pools which are key to the law’s success. The marketplaces are supposed to be one-stop shops where individual consumers could compare policies, find out if they are eligible for subsidies, and enroll in coverage.  But without robust participation - and the government is counting on 7 million enrollees the first year -- the program could fall short of attracting the necessary numbers and balance between healthy and unhealthy consumers, potentially resulting in premium hikes in future years.

“If we’re not seeing a substantial improvement in next two or three weeks, we’ll be in a bad place,” said Dan Schuyler, an exchange expert at Leavitt Partners consulting firm. “We’re already behind the curve in getting to that 7 million mark.”

The risk in frustrating consumers is that those who are healthy or on the fence about enrolling may give up, leaving the unhealthy to persevere and enroll, which could drive up premiums in future years, potentially leading to what experts call “a death spiral,” where only the sickest people sign on. 

“The people who will go back will be precisely the ones who need health insurance because they’ve got ongoing problems,” said Joe Antos, economist at the American Enterprise Institute.

Experts outside the government debate the scope of the problems with little information coming from the Obama administration. What is known is that bugs have made it difficult, if not impossible for consumers to create accounts and have also resulted in insurers getting misinformation about those who do manage to enroll. The troubles have been most severe with the federal website, although a few of the 14 states operating state exchanges are also experiencing serious problems.

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