Recent comments from government officials indicate that the primary problem with Web portal Healthcare.gov, which links customers to the online marketplaces for the 36 states with federally facilitated exchanges, is one of capacity. 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.
According to the explanation of White House spokesman Jay Carney, a flaw within the account registration process caused the exchanges to not be 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.”
Problems with capacity have contributed to low enrollment numbers, but anecdotal evidence from insurers shows that the technological problems extend further than website traffic and the already discovered software issues.
Data compiled by the nonpartisan research firm Millward Brown Digital show that Healthcare.gov received 9.47 million unique visitors through October 5, but that just 196,000 people began the 30-step enrollment process and only a small number finished, which is likely a reflection of continued technical problems as well as customers lacking the necessary information and patience to complete all the enrollment steps. In total, only 36,000 people — roughly 1 percent of those who attempted to register for the federal exchange — enrolled. But even still there were additional problems.
Insurance executives for more than a dozen different policies reported to The Wall Street Journal that problems included duplicate enrollments, spouses categorized as children, missing information, and erroneous eligibility determinations. In particular, Blue Cross Blue Shield of Nebraska told the publication that it was forced to hire temporary employees to fix the inaccuracies in submissions, while Medical Mutual of Ohio told the publication that one customer had signed up for three different plans.
Twenty-five individuals have enrolled in policies offered by Texas’s Scott & White Health Plan. “There are some missing data elements that are requiring a lot of research on our part,” Allan Einboden, the health plan’s chief executive, told the Journal. “If we’d received 5,000 and they all had to be worked, that’s a lot of extra administrative costs.”
These new problems could keep enrollment numbers even lower. “The longer this takes to resolve … the harder it will be to get people to [come back and] sign up,” Aetna (NYSE:AET) CEO Mark Bertolini told the Journal. “It’s not off to a great start,” he added, although he does believe the insurance marketplaces are “here to stay.”
For now, insurers have been able fix the problems manually, but if the 7 million individuals who the Obama administration expect to enroll do purchase coverage via the exchanges, insurers may not be able to keep fixing problems as easily.
During the first 16 days of the six-month enrollment period, the political circus in Washington has overshadowed the implementation problems. As Gail Wilensky, a Medicare director during the administration of President George H.W. Bush, told The Wall Street Journal of the GOP’s strategy, “all Republicans did was give [President Barack Obama] great cover for the complete screw-up on the opening of the exchanges.” But with the government shutdown over and the debt crisis temporarily averted, the GOP is now refocusing its attention on the Affordable Care Act.
Some Republican lawmakers have begun to investigate the site’s problems by asking the administration to detail the technical glitches and find the contractors and officials who might be responsible. The GOP-headed House Energy and Commerce Committed announced Thursday that it would hold a hearing next week on the implementation of Obamacare.
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