Health Care
10:51 am
Sat November 30, 2013

How Will We Know If HealthCare.gov Is Fixed?

Saturday is the day the Obama administration set as its deadline for making HealthCare.gov a "smooth experience" for most users.

A tech-savvy team of engineers, database architects and contractors has been working through the holiday to ensure the White House makes good on that promise, but judging the success of their efforts may take some time.

How will we know whether the website is fixed? NPR's health policy correspondent Julie Rovner says that partly depends on how you define "fixed." She joins Weekend Edition Saturday host Scott Simon to explain what that means.


Interview Highlights

What "fixing" HealthCare.gov means

Remember the promise is to have it working for what they call the "vast majority of users," by which the administration means 80 percent of visitors to the site.

That means 1 of every 5 people will still need to use a call center, an in-person counselor, or a paper application due to a technical problem or because his or her individual situation is too complex to be handled online. So Amazon or Orbitz this is not.

But then again, this is not buying a TV or a plane ticket, either. Many people have pointed out that spending a couple of hours buying health insurance online is still a lot faster than the old way, when you might have had a 50-page paper application and a process that literally took weeks.

How the administration has been fixing the website

There was a little show and tell earlier this week, where the White House actually showed reporters some of the 300 or so people who have been working pretty much around the clock from various centers located in the Washington, D.C., suburbs.

They've got a separate hardware team doing upgrades to increase the website's capacity, for example — they're saying it should be able to handle 800,000 separate visits per day going forward.

Then another team is working on software. They're fixing bugs and trying to make the website more user-friendly for consumers.

Will anyone be able to tell if the site is really fixed?

That's the really frustrating part. I'm not sure we will, at least not at first. We do already know it's working better than it was in October — which, frankly, was a pretty low bar to get over. The administration has all kinds of fancy metrics to show how well the website is working, but we don't have our own independent access to them.

We do know a big test is likely to come on Monday, when people who have been talking to relatives over the long holiday weekend — or who wake up and suddenly realize it's December and they want coverage in January — all try to sign on at once.

Key parts of the site that must wait

Insurance companies are getting increasingly worried. It seems that while so much effort has been going into what they call the "front end" of the site — where consumers go to compare insurance plans and sign up for coverage — some parts of the "back end" of the site — where insurance companies actually get paid — haven't even been built yet.

The administration says it will get that done before money has to begin to change hands sometime in January, but given that nothing up until this point has happened on schedule, that doesn't make insurance companies feel a whole lot better about things.

One piece of the site that will wait an entire year

Small businesses were supposed to be able to sign up online to enroll their employees through the federal website starting this month. That was already delayed from Oct. 1. Now that won't happen online until next November.

They can still compare plans online, but they'll have to use paper applications and go through an insurance broker or agent or an insurance company directly, unless they're in one of a handful of states that's got its small-business exchange up and running.

The administration has been pretty candid about this — they've said their top priority is to make the website work for consumers first, and pretty much everything else is taking a back seat.

Copyright 2013 NPR. To see more, visit http://www.npr.org/.

Transcript

SCOTT SIMON, HOST:

This is WEEKEND EDITION from NPR News. I'm Scott Simon. And today is the day. The Obama Administration pledged to have federal website fixed for people who need to sign up for health insurance. The administration itself set November 30th as the deadline for making Healthcare.gov a, quote, "smooth experience." The Health and Human Services Department announced it would shut down site for 11 hours last night. After applying new upgrades, they hope the site will be able to handle a rush of new users in coming days. We spoke with NPR's health policy correspondent Julie Rovner and asked how we'll know whether the website has been fixed.

JULIE ROVNER, BYLINE: Well, partly it depends on how you define whether or not it's fixed. Remember, the promise is to have it working for what they call the vast majority of users, by which the administration means 80 percent of visitors to the site. That means one of every five people will still need to use a call center or an in-person counselor or a paper application due to a technical problem or because his or her individual situation is too complex to be handled online. So, Amazon or Orbitz this is not. But then again this is not buying a TV or a plane ticket, either. Most people have pointed out that spending a couple of hours buying health insurance online is still a lot faster than the old way, when you might have had a 50-page paper application and a process that literally took weeks.

SIMON: How's the administration gone about trying to fix the problem?

ROVNER: Well, there was a little show and tell earlier this week where the White House actually showed reporters some of the 300 or so people who've been working pretty much around the clock from various centers located in the Washington D.C. suburbs. They've got a separate hardware team doing upgrades to increase the website's capacity for example. They are saying it should be able to handle 800,000 separate visits per day going forward. Then there's another team working on software. They're fixing bugs and trying to make the website more user friendly for consumers.

SIMON: So, to be able to tell if the website is really fixed, is it as simple as just logging in and trying to get health insurance?

ROVNER: No, it really isn't. It's going be very difficult for people outside to tell, and that's what really frustrating. We already do know that it's working better than it was in October. That's a pretty low bar to get over. The administration itself has all kinds of fancy metrics where it can tell the error rates, how fast it takes pages to load. But people on the outside don't have independent access to that information, so we're going to kind of have to take their word for how well it's working. But we do know that a really big test is likely to come on Monday. That's when people who've been talking to relatives over the long holiday weekend or who wake up and suddenly realize it's December and they want coverage in January all try to sign on at once. So, there's going to be a lot of people trying to get on on Monday.

SIMON: And in addition to all else, the administration's actually delaying an entire piece of the website for another entire year?

ROVNER: That's right. Small businesses were supposed to be able to sign up online to enroll their employees through the federal website starting this month. That was already delayed from October 1st. Now, that won't happen online until next November. They can still compare plans online but they'll have to use paper applications and go through an insurance broker or an agent or an insurance company directly, unless they're one of a handful of states that actually has its small business exchange up and running. The administration's been pretty candid about this. They've said their top priority is to make the website work for consumers first. Pretty much everything else taking a back seat.

SIMON: NPR's Julie Rovner. Thanks so much.

ROVNER: Thank you. Transcript provided by NPR, Copyright NPR.