The Obamacare Saga: Ongoing System Glitches and the Shutdown

Washington DC

For many Americans watching the government shutdown — the manufactured political crisis that resulted from brinksmanship politics and Congress’ inability to compromise on a spending bill to fund the federal government into the new fiscal year — there is one key question that comes to mind. Was it worth it?

For the Republican party’s perspective, so clearly elucidated by Senator Ted Cruz of Texas during an August interview with radio host Rush Limbaugh, the reality is that if the cornerstone provision of the Affordable Care Act — the individual insurance exchanges — are allowed to take hold, the United States will find itself on the slippery slope to socialism and a destroyed health care system, with another entitlement program that will bankrupt the country.

Comparatively, the Democrat party’s reality is that the legislative confrontation could become a larger governance issue if they allow a minority to hold the government hostage, thereby undermining the system of majority rule.

Republicans in the House of Representatives refused to pass any spending bill that included funding for the health care reform — known popularly as Obamacare — while Senate Democrats prevented that bill from passing in the upper house. Which party should be faulted for the resulting partial government shutdown is a matter of debate, at least among lawmakers, but the fact is that the implementation of Obamacare was by no means stymied despite the shutdown.

In fact, government officials are in the process of repairing software and capacity problems that plagued the webportal, which links customers to the online marketplaces for the 36 states with federally-facilitated exchanges during its first week of operation.

The portal, healthcare.gov, was riddled with glitches since the first day enrollment was open, October 1. The hours of waiting, backlog of potential enrollees, problems calculating subsidies, and numerous error messages that characterized the first week of enrollment was a sign for Obamacare opponents that the health care reform was the proverbial train wreck that many lawmakers had promised. It is true, that at the most basic level, the insurance exchanges have to work for them to be successful, meaning exchange enrollees must be able to shop for coverage on the exchanges free from technical glitches (or at least, overwhelming technical glitches that could discourage them from purchasing plans).

As President Barack Obama noted months ago, glitches are a normal part of the rollout of any large government program, and administration officials have more often than not chalked up the technical problems with the federally-facilitated exchanges to overwhelming demand.

“Our top issue when it comes to the glitches has been the extraordinary number of people coming to check out plans and find out more about Obamacare. The number has obviously exceeded expectations,” White House spokesman Jay Carney said at a news briefing, covered by Reuters.

“To make further improvements, we are doing several things at once, including adding server capacity and making software changes to make the system more efficient to handle higher volume,” he added. According to the government, the webportal received 8.6 million unique visitors last week.

Yet, Internet technology experts told Reuters last week that high traffic numbers alone are not the cause of the glitches. They believe flaws in the systems architecture contributed to the problems. In particular, one expert explained that the site’s design triggered too many requests to the server simultaneously, disrupting the website’s functioning, much like when hackers attack a site. According to Carney’s explanation, a flaw within the account registration process was not able to handle the high traffic volume, causing a bottleneck.

Now, the Centers for Medicare and Medicaid Services “has put up a gate at the front end of the system that places visitors into a waiting room and lets them in at a particular pace, so that the surge in volume does not cause the problems that it caused in the past,” Carney said. “Thus far, we’ve reduced waiting room times by a third and are increasingly moving more users through the system, but we’re not satisfied with the performance.”

Health care officials point to the fact that the exchanges will be open for enrollment through the end of March as a reassurance; there will be plenty of time to work out the glitches. By then, a clear picture of the lasting problems with the system will be fully known — or even completely dealt with — and how successfully the reform was in making health insurance in America less expensive and reducing the numbers of uninsured will be more apparent. In another few years, say at the end of 2015, how Obamacare improved or hurt the American health care system will be even more clear.

What Steven Pearlstein, a professor of public and international affairs at George Mason University, suggested in an opinion piece for the Washington Post, is that lawmakers end this “unsatisfactory stalemate,” be resigned to the fact that there will be glitches in an initiative as large and complicated as Obamacare, and agree to a thorough review of the program after it has been in place for a full two years.

Then, a “respected group of independent experts such as the Institute of Medicine” can evaluate Obamacare and the study’s findings can be used as evidence in a special joint committee of Congress, which will hopefully “reflect the partisan makeup of the new Congress.” That panel would have the authority to propose any legislative changes it deems necessary, even repeal.

“Such a compromise would give both sides the opportunity to declare a moral, political, and policy win,” he wrote. “For Republicans, it would ensure a newly elected Congress has the opportunity to reform or even back away from Obamacare if, as Republicans claim, the country opposes it. For Democrats, Obamacare would proceed as enacted while they avoid giving in to ‘hostage-taking.’”

Follow Meghan on Twitter @MFoley_WSCS

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