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HealthCare.gov's hidden flaws [Editorial]

InsuranceBarack ObamaAffordable Care Act (Obamacare)George W. BushAmazon.com Inc.White House

This much can be said for the Obama administration's boast on Sunday that it had met its self-imposed deadline for making HealthCare.gov work well for the vast majority of users two months after its launch: At least there was no "Mission Accomplished" banner.

It is, of course, not really fair to compare the White House's effort to publicize improvements in the Obamacare insurance exchange website with former President George W. Bush's celebration of victory in Iraq. Like Republicans' efforts to declare the website rollout President Barack Obama's version of Hurricane Katrina, there's an absurd mismatch in the scope and consequences of the presidential failures in question. But Mr. Bush's infamous photo-op should at least have served as a lesson to the Obama administration that the public's trust will not be regained by declaring success prematurely. And make no mistake, HealthCare.gov, while much improved, is still far from where it needs to be.

The Obama administration focused its efforts during the last two months on improving the customer experience with the website, an understandable priority given that the Affordable Care Act will only work if sufficient numbers of people sign up for insurance, and since the website's early failures both stymied those who were eager to sign up and scared away those who weren't necessarily excited about it in the first place. Pages now load faster — under a second rather than the eight second delays common early on — and more than 50,000 people can now use the site at once. Administration officials say that unscheduled downtime for the site is now less than 10 percent.

That's much better than the early days, when the site was down more than half the time, but it would still be considered disastrous by industry standards. President Obama promised a system that would make shopping for insurance as easy as buying a book on Amazon.com. Amazon, according to Panopta, a company that tracks the availability of online retail sites, hasn't had a single minute of unscheduled downtime this holiday season. It is joined in that distinction by 58 of the other big e-tail sites that Panopta monitors.

And downtime isn't the only issue. Many of those who tried to sign up for insurance in the early days of HealthCare.gov got hung up in the process and have been unable to complete their applications, even with the website's improvements. And perhaps even more significantly, big problems remain with the back-end functions of the site that could lead to more frustration down the road for insurers and customers alike.

Insurance industry officials report widespread errors in the transmission of data from the government's system to theirs. They are getting incomplete, erroneous or duplicate applications, or sometimes no information at all about customers who believe they have signed up for coverage. Given that the first insurance policies purchased on the website are supposed to go into effect on Jan. 1, that could be a huge problem. The insurance companies were not prepared for the task of correcting a large volume of errors for Obamacare enrollees, and many customers may not discover there's a problem until they show up at a doctor's office or hospital.

Moreover, the systems by which individuals and the government are supposed to pay for health insurance remain incomplete or flawed. Insurers say they're getting errors in reports of whether enrollees qualify for government subsidies, and administration officials admit that the software that will allow the government to pay its share of the premiums remains unbuilt.

As it stands, HealthCare.gov resembles an old Western town in which false fronts hide ramshackle buildings. Improved though it may be, it is still likely to produce errors that will frustrate consumers and insurance companies alike, and the administration needs to be forthright about that fact. Obamacare, as the president has said, is more than a website. It's a law that provides millions of people with the opportunity to get quality, affordable health care, and it eliminates some of the worst exclusions and limitations insurance companies have practices in the past. But the website is the chief mechanism by which people are to enroll, and if they don't, the entire system will come crashing down.

The incompetent roll-out of HealthCare.gov dealt a severe blow to the law's viability by diminishing public trust in the reforms far more than years of Republican attacks had managed. If whole new classes of problems crop up after the administration has assured the public that the website is fixed, the blow could prove fatal.

To respond to this editorial, send an email to talkback@baltimoresun.com. Please include your name and contact information.

Copyright © 2014, The Baltimore Sun
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InsuranceBarack ObamaAffordable Care Act (Obamacare)George W. BushAmazon.com Inc.White House
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