Will Obamacare get its act together in time?

HealthCare.gov, which under Obamacare is the federally run exchange for 36 states, is still overwhelmed four days after going live. It will undergo 'scheduled maintenance' this weekend, officials announced late Friday.

By , Staff writer

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    A busy screen appears on the laptop of a certified application counselor as he attempts to enroll an interested person for Affordable Care Act insurance, at the Borinquen Medical Center in Miami on Oct. 2. The federal government's online marketplace, HealthCare.gov, will undergo 'scheduled maintenance' this weekend, following a problem-filled four days since it opened Oct. 1, the Department of Health and Human Services announced late Oct. 4.
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[Updated 8 p.m. EDT] HealthCare.gov, the federal government’s online marketplace that serves as the portal to its new health-insurance program, will undergo “scheduled maintenance” this weekend, following a problem-filled four days since it opened Oct. 1, the Department of Health and Human Services (HHS) announced late Friday.

Stories of frustration had been piling up about the site: People who can’t register. People who preregistered before opening day, but can’t log in. People who get five or six screens in, then the site crashes.

The site serves the residents of the 36 states that opted not to set up their own online health insurance marketplaces, or “exchanges,” under the Affordable Care Act (ACA).

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“The enhancements we are making will enable more simultaneous users to successfully create an account and move through the application and plan shopping process,” HHS said in a press release.

During the scheduled maintenance, the call center (800-318-2596) will still be available to assist consumers, the release said.  

“We expect that Monday, less than a week after the marketplace opening, there will be significant improvements in the online consumer experience,” HHS said.

HHS touted statistics that showed great interest in the new ACA health-insurance program: HealthCare.gov has received 8.6 million unique visitors. The call center has received 406,000 calls. And there have been 225,000 requests for online chats.

So far, there’s no public information on how many people, if any, have successfully signed up for insurance via HealthCare.gov. Reporters desperate to find someone who had enrolled found 21-year-old Chad Henderson in Georgia, now enjoying his 15 minutes of fame. But his story fell apart after a Washington Post reporter tracked him down and interviewed him (with an assist from the libertarian site Reason.org).

Among the states that set up their own exchanges, there are some bright spots, foremost among them Kentucky and Connecticut. California and Colorado, too, are enrolling people, after some overloading issues. Maryland has had a lot of challenges. The system there is working, but it’s maddeningly slow, say people who visited the site.

None of the problems are shocking, and can be overcome, say management experts.

“I spend most of my time working with CIOs [chief information officers] of large enterprises, and when we look at something like this – the complexity of the different states and the pent-up energy and demand and ideas around signing up – it certainly wasn’t surprising that there were problems,” says Eric Johnson, dean of Vanderbilt University’s Owen Graduate School of Management, in Nashville, Tenn.

The challenge, though, isn’t just getting HealthCare.gov and the other exchanges up to speed. It’s getting them to function smoothly soon enough to accommodate the flood of people who want to sign up for health insurance – with a possible federal subsidy – in time to start coverage on Jan. 1. To be covered on Jan. 1, one must enroll by Dec. 15. (The open enrollment period, though, goes all the way to March 31.)

What’s more, all this is happening under the klieg lights of intense media scrutiny, plus the political pressure of conservatives looking for any sign that Obamacare is a failure.

Liberal groups – and the Obama administration – are trying to build a competing narrative: that the problems, which are being addressed, are a result of the massive public demand for affordable health insurance.

“There are separate issues, enrollment and optics,” says Caroline Pearson, vice president of Avalere Health, a health-care consulting firm. “I think they’ve got till early November” to get the sites running smoothly so people can enroll by Dec. 15.

Ms. Pearson expects the people who are trying to enroll now will keep trying until they succeed, since they are probably the most motivated customers. But on the “optics” front, it’s the less-motivated people – the ones who aren’t happy about the mandate and perhaps tempted just to pay the fine and not buy insurance – who may be turned off by the bad press around the rollout.

Anyone, for example, who sees even just the headline on Friday’s Wonkbook column in The Washington Post by the reliably liberal Ezra Klein and Evan Soltas would be taken aback: “Obamacare’s Web site is really bad.” Not only was the site not close to ready for the level of traffic it’s been getting, it’s “badly coded,” Messrs. Klein and Soltas say, citing software designers.

“The good news for Obamacare is that lots of people want to sign up,” they write. But “the fact that the traffic is good news for the law doesn't obviate the fact that the site's inability to absorb that traffic is bad news for the law.”

The folks at Avalere Health created accounts at HealthCare.gov before Oct. 1, but still can’t log in.

“We’ve been trying all week,” says Pearson. “But there have been signs of progress. We can get further into the log-in process each day. But the issue is, you have to create an account before you can access the data and shop. That’s the part that seems not to be functioning and where we get stuck.”

Johnson, the dean at Vanderbilt’s business school, says the Obama administration needed a better communication plan, given all the curiosity and pent-up demand. He suspects a lot of people on the site are just looking for information and trying to understand how much the various plans would cost them.

“Had they been able to do a ‘soft roll’ – a rollout that allowed people to see some more of the information in the first week or two before making decisions – that would have helped dramatically,” Johnson says. "It becomes bigger than life, because it’s received so much media attention, and yet so few details were available other than this big bang approach.”

Not all the headlines have been terrible. A “review” of HealthCare.gov in Thursday’s USA Today calls the site “a winner despite the glitches.”

The writer, Tim Mullaney, praises the simplicity of the writing and intuitive placement of information. He also gives the core product a thumbs-up: The site offers a choice of cheap, affordable plans.

“Any e-commerce veteran can tell you: If a start-up’s business proposition is sound and it delivers what it promises, it survives early days when websites crash and chaos reigns,”  Mr. Mullaney writes.

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