WASHINGTON (USA TODAY) -- Two weeks into the launch of the federal health
insurance exchange, the website is still plagued with problems, leading
critics to wonder if the problem is worse than it appears.
are two key issues at the core of the problem, said Dan Schuyler, a
director at Leavitt Partners, a health care group by former Health and
Human Services secretary Mike Leavitt. One is the volume, which HHS
estimates at 14.6 million unique visitors, and the second is the
The main problem, Schuyler said, could be "core
fundamental design flow," but it's impossible to know because HHS is
saying so little. "Only the contractors and HHS know that," he said.
need to figure out the problem soon, Schuyler said, if the government
is to meet its goal of 7 million new health customers signing up on the
exchanges by March 31. "That's 39,000 enrolled a day, and we're not
seeing anywhere near that volume," Schuyler said. "If they don't get it
fixed within two or three weeks, we're going to have a backlog of
consumers who won't be able to enroll."
HHS didn't have enough
time to test its system for "one of the most complex IT platforms
undertaken by the feds or the states," Schuyler said.
HHS did not
respond to a request for information, and its website states that there
are too many media requests now to answer all of them. However, at the
end of the first two weeks, HHS issued a statement:
"We won't stop
improving HealthCare.gov until its doors are wide open, and at the end
of the six-month open enrollment, millions of Americans gain affordable
coverage," said HHS spokeswoman Joanne Peters.
criticized the problems in a Tuesday interview with KCCI, a Des Moines
TV station. "I am the first to acknowledge that the website that was
supposed to do this all in a seamless way has had way more glitches than
I think are acceptable and we've got people working around the clock to
do that," he told the Iowa station. "We've seen some significant
progress but until it's 100% I'm not going to be satisfied."
Millward Brown Digital released an analysis showing that 36,000 of the
9.47 million people who visited the site the first week made it to the
enrollment page at healthcare.gov, with the assumption that only a small
percentage of the visitors were able to enroll. HHS has not released
enrollment numbers. Millward Brown is an international market-research
HHS Secretary Kathleen Sebelius is scheduled to make an
announcement Wednesday morning at a speech in Cincinnati about the
number of insurance applications the exchanges have received since Oct.
Schuyler described the system as analogous to building a house.
The core is the foundation, and the ancillary pieces are the windows
and deck. If the problem is core, that would be similar to deciding that
the ranch house the government already built needs a basement. If it's
ancillary, they're just replacing single-pane windows with double-pane
"This feels like a core issue," he said, "but I think we'll have a little bit more insight over the next two weeks."
said he's concerned that the easy pieces of code - logging in and
creating an account - shouldn't be causing a problem, and it worries him
that the more complex areas, such as verifying identity, will also
cause problems after the "upfront" problems are fixed.
Part of the
problem with the federal exchange is that HHS had to wait until the
states had all decided if they were going to have their exchanges before
the federal government could build and test their program, said Mark
Pauly, professor of health care management at the University of
As a member of the first Bush administration, Pauly
helped develop the idea of the requirement for individuals to buy health
insurance, which is the reason for the creation of the health care
However, "I think the history of Medicare Part D is
that people eventually figure out their problems, or they get fired and
somebody else fixes their problem," Pauly said. "I'll state the obvious:
It's going to take time."
They do have time, Pauly said, adding
that if he were looking for insurance, he'd probably give the government
some time before heading for the website.
HHS should focus on making the exchanges more shopper friendly, said Joel Ario, managing director at Manatt Health Solutions and former director of health insurance exchanges under Obama.
Now, shoppers want to see what plans are available and
how much those plans will cost, and they need to be able to do that
without creating an account - especially if people haven't been able to
get past that step without being booted out of the system.
"I think the concerns are more talk among the careful observers," he said. "The consumers - it's more curiosity. They want to see what's available at this point."
A few weeks into the open enrollment of the new health care law and some people say they can't sign up. Others say it's been smooth.
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