It’s no secret that I’m a fan of the Affordable Care Act. One need only scroll down the posts on here to see many on the topic. So as a supporter, one can imagine my disappointment with the lackluster debut of the health insurance exchange website healthcare.gov (yes, I’m being kind here…). And also why this post will be so surprising to many.
For those of you living in states that decided to run their own insurance exchanges, chances are that you are experiencing far less issues. Reports from Washington, California, New York, and Kentucky have been largely positive while Oregon’s rollout has been a little bit of a disaster.
But Oregon’s problems pale in comparison to the failure of the federally-run website, which is responsible for running the exchanges for the majority of the states. I don’t think I need to detail them out for anyone, especially if you pay attention to the news. To say that the website failure is disheartening is an understatement. The President, rightfully so, is mad as hell – as he should be. And Secretary Sebelius is taking the heat.
Here’s what is so upsetting. The Affordable Care Act is the President’s signature legislative achievement (you can all argue out there whether it’s the fault of the GOP or the President that no other major legislation has been passed – I’ll reserve my comments). The insurance exchanges, and tied with them the individual mandate, are the MOST visible portion of the law to the general public. The general public isn’t going to notice Medicaid expansion, nor will they notice the Prevention and Public Health Fund. The American people aren’t going to notice the efforts to boost primary care. And they’re only going to notice the benefits of free preventative services AFTER they already have health insurance. Those of us who support the law know that it’s “more than a website”, but the website is the public face of the law to many.
The fact that the government had months to design the website only adds salt to the wounds. But they obviously missed the mark, especially when U.S. Chief Technology Officer Todd Park has said that the government expected HealthCare.gov to draw 50,000 to 60,000 simultaneous users – which was clearly a gross miscalculation. When Massachusetts launched its own website years ago, early problems hardly mattered because very few people used the website early on, and most people in the state were already insured. The country as a whole is a completely different picture, and the federal government should have been prepared for an onslaught of users, especially given the amount of press and attention the law has garnered over the last 5 years. The people finally had a tangible component of the law. Hell, I was tempted to check it out even though I have insurance AND live in Massachusetts.
No, the government couldn’t sit back and wait and see – a point that should have been hammered home to every individual working on the website. Because the expectation that 50 or 60 thousand people would use the website on day 1 was blown out of the water, and the government should have expected far more. As Steven Stromberg notes, “The government’s health-care mavens shouldn’t just have expected high Web traffic, they should have expected that high interest would mean that people’s impressions about the site would be formed early-on, impressions that would be hard to dispel later.”
The final truly upsetting part is that the government shutdown, which highlighted congressional dysfunction in Washington DC, provided the perfect opportunity for the White House and the Department of Health and Human Services to prove just how much good the Affordable Care Act could actually do. A perfect opening to the exchange was unlikely (as with any new major technological undertaking), but a good opening with less glitches would have provided the President ample fuel to blast the health law opponents. Instead, the website’s failure has done the exact opposite.
The good news, if there is any to be had, is that supposedly the feds know what needs to be fixed and are working hard along with insurers to fix the website. The bad news is no one really knows how long that will take.