October 26, 2013


Sorry liberals, Obamacare's problems go much deeper than the Web site (Ezra Klein, October 25, 2013, Washington Post)

As Sarah Kliff and I wrote in our overview of the health-care launch's technical issues, the challenges right now can be grouped into three broad categories: problems with the consumer experience on the HealthCare.gov Web site, problems with the eligibility system, and problems with the hand-off to insurers.

The problems with the Web site are the difficulties consumers are facing when they try to log on and shop for insurance coverage. These problems -- error messages, site timeouts, difficulty logging in to an account -- make it hard for an individual to buy coverage through the marketplace. They are the reason why some people have made upward of 20 attempts at purchasing a plan. These are the problems that are being fixed fastest and that are the least serious.

The eligibility problems strike when consumers send in their information and the government's computer systems tell them whether they're eligible for Medicaid, health insurance subsidies or nothing at all. The system is returning incorrect data for many applicants -- meaning they might be eligible for Medicaid and not know it, or they might think they have subsidies that will later be revoked.

The insurance problems are seen by the insurance companies. Health plans are supposed to get a report when someone uses HealthCare.gov to buy their health insurance policy. Those reports are full of inaccurate data, such as the wrong address, or are being sent in duplicate. (One insurance company reported getting one of these reports, known as an "834 transmission," that said one individual had three spouses. This person was not, for the record, a polygamist.) And it's not just private insurers: The federal system is also failing to sign people up for Medicaid.

No one quite knows the extent of the problems in each of these areas. No one knows how long it will be until all these systems are working tolerably well. No one has any idea how long it'll be until they're working smoothly. And if that was all this was -- a multi-month delay and a lot of frustration and problems for people trying to sign up for health care -- that would be bad enough. That would be a story worth covering aggressively and constantly until the problems cleared up.

Posted by at October 26, 2013 8:46 PM

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