President Barack Obama and his HealthCare.gov website face another critical test starting this week, as Americans who have been unable to enroll in health coverage under Obamacare rush to a site that continues to face challenges.
A day after the administration said it met its weekend deadline for making HealthCare.gov operate smoothly for most users, networks of volunteer organizations are expected to resume enrollment activities after a long U.S. Thanksgiving holiday weekend, many of them with backlogs of would-be applicants waiting for access.
While saying HealthCare.gov had improved, Obama adviser Jeffrey Zients also warned that peak traffic volumes during the coming weeks could overwhelm it as consumers scramble to sign up before a December 23 deadline for coverage that begins January 1.
Enroll America, the nonprofit group that serves as a flagship for private sector enrollment efforts under Obama’s landmark healthcare law, said it planned to launch a new “Coverage is Coming” push, with more than 1,000 events over the next three weeks ranging from commemorations of World AIDS Day to community health summits and holiday toy drives, according to Enroll America spokesman Justin Nisly.
AIDS Alabama, a statewide non-profit organization that received a federal grant to help people enroll, had been relying largely on paper applications to sign people up until last week, when they noticed major improvement in the website, said Lauren Banks, the organization’s director of policy and advocacy.
One glitch the organization came across last week involved apparently incorrect information about tax subsidies, Banks said. For example, she said, people who appeared to be eligible for subsidies given their income levels were told they did not qualify.
Banks said the organization planned a radio campaign as part of a push to get people enrolled by December 23 so they could have coverage starting next year.
“We really are going to push super-hard the next 23 days to get people enrolled for the January 1st deadline,” Banks said.
The White House, which plans to hold public education events about the healthcare law throughout December, will hold a Youth Summit on Wednesday to help drive outreach and enrollment over the remaining four-month enrollment period.
The number who need coverage starting January 1 could include millions of uninsured Americans with preexisting health conditions and others who have been notified that their current health plans will expire at year-end because they do not meet Obamacare’s standards for benefits and consumer protection.
Zients said on Sunday a five-week emergency “tech surge” had doubled the capacity of the online health insurance portal that is crucial to helping people shop for insurance plans, while making it more responsive and less prone to errors.
The administration said the effort’s key improvement was to increase HealthCare.gov’s capacity to 50,000 simultaneous users, which would allow the site to handle a minimum of 800,000 users per day.
Officials acknowledged however that the site may not operate smoothly for some visitors even when the capacity has not been exceeded, and said they were still scrambling to repair and install functions at the crucial “back end” of the system that are needed to finalize enrollments with insurers.
“The real challenges remain, and that’s downstream,” said Rick Howard, research director for the technology consultant Gartner. “The real error rate will be in the billing transactions and how accurate the billing information is and how accurate the premium calculation is.”
Craig Garthwaite, a health economist at Northwestern University’s Kellogg School of Management, said Sunday’s announcement represented “dramatic progress,” but that the fixes mainly brought the website to “the baseline of what we need the site to be able to do.”
Officials are working to correct errors in the consumer enrollment data sent to insurers and have not built in several necessary functions, including one that will enable the government to pay federal subsidies to insurers on behalf of low-income enrollees. Without those functions working properly, HealthCare.gov and websites for 14 state-run marketplaces could have difficulty operating in 2014.
Even so, officials said, the site is dramatically better than when it was launched on October 1. It was overwhelmed by users in a debacle that fueled Republicans’ complaints about the Democratic president’s healthcare overhaul and threatened to make his signature domestic achievement a drag on Democrats heading into the 2014 elections.
The Zients team’s success could mark a more upbeat chapter for the Patient Protection and Affordable Care Act, also known as Obamacare. The law is designed to help provide coverage to millions of uninsured and under-insured Americans.
Longer-term questions remain about whether the program will be able to enroll the estimated 7 million people it needs by the end of March to be financially viable, including millions of healthy, young enrollees who are needed to keep the program’s costs in check.
“The issue is really the management capacity of the Obama administration,” said Robert Blendon, a Harvard expert on healthcare and public opinion. “If the website really is still working a week from now, it’ll make people feel at least they have the capacity to turn things around and move ahead.”
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