In its self-evaluation, the White House gave its repair efforts a passing grade – funny how that works when you are judging your own work (PDF). You can find lots of happy graphs in the Progress Report but the real problems are alive and well.
The web pages may load faster, but insurers are already pointing out that the most important part of the system – the back end – is still not working. The Advisory Board reports that:
“…while the team has prioritized fixing the front-end experience for consumers, they have delayed some ‘back-end’ fixes for insurers, who use the site to receive applications and bill the government for subsidy payments. As a result, insurers are still receiving inaccurate or incomplete data on enrollees and their subsidies.
Health plans stress that those fixes need to be made for consumers to be successfully enrolled in coverage that begins in less than thirty days.”
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The New York Times reports the same problems:
“‘Until the enrollment process is working from end to end, many consumers will not be able to enroll in coverage,” said Karen M. Ignagni, president of America’s Health Insurance Plans, a trade group.
The issues are vexing and complex. Some insurers say they have been deluged with phone calls from people who believe they have signed up for a particular health plan, only to find that the company has no record of the enrollment. Others say information they received about new enrollees was inaccurate or incomplete, so they had to track down additional data — a laborious task that will not be feasible if data is missing for tens of thousands of consumers.”
The 834 problem was identified more than a month ago and is still not fixed. An 834 transaction is a benefit enrollment and maintenance file used by everyone – employers, unions, Medicare Part D and payers – to enroll people in a health benefit plan. That is the crucial part of the back end that is not working with HealthCare.gov.
Mara Liasson on NPR said that in addition to technical improvements, the repair team has addressed the “root causes” of the problems with the site:
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- Poor monitoring
- Bad hardware
- Slow decision making
- Unclear lines of authority
What a joke. Anyone who has worked for even a medium-sized company knows that cultural problems like that would take years, not 30 days, to fix.
The New York Times article also says that Obama prioritized fixes to the consumer-facing side of the site, instead of the back end that makes everything work (check out the paper’s full graphic to see how HealthCare.gov works). This will turn out to be a fatal error because it’s only the back-end part that really counts. Yes, the site has to be able to support tens of thousands of users simultaneously, but if it can’t deliver the right data to the right place, the total number of sign-ups doesn’t matter.
Once this problem becomes obvious to everyone, the administration will face an even more difficult PR challenge: restoring confidence and trust from people who did their part in signing up for insurance, but still are not covered.
[Image from New York Times graphic]