Healthcare.gov's Problems: What We Know So Far
While U.S. officials haven't talked in detail, a number of factors contributed to the malfunctioning website.
Thu, November 07, 2013
IDG News Service (Washington, D.C., Bureau) — More than a month after it went live, a couple of large questions remain about the U.S. Department of Health and Human Services' botched launch of HealthCare.gov.
The problems with the insurance-shopping website include outages, slow page loads and the inability of users to complete coverage applications. Some insurance providers say they have been receiving inaccurate application information from the website.
The problems appear related to a number of factors, but HHS officials have talked little about the specific technology problems.
A basic question: What is HealthCare.gov?
HealthCare.gov is a key piece of the Affordable Care Act, the law often called Obamacare, passed by Congress in 2010. The website is one way for uninsured U.S. residents to shop for new health insurance plans, although people can also apply through the mail, on the phone and at some in-person locations. Sixteen states and the District of Columbia are running their own health insurance marketplace websites, while 34 states, including Texas, Florida, Pennsylvania and New Jersey, opted to be part of the HealthCare.gov marketplace.
One of the goals of the Affordable Care Act was to open up pooled insurance markets where people without insurance could shop for inexpensive insurance plans. The law prohibits participating insurance companies from rejecting applicants because of pre-existing conditions, and it bans lifetime limits on insurance benefits.
HHS officials say they have committed US$630 million to the website. Many of the fixes happening now will be including in the money paid to contractors to build the site, HHS Secretary Kathleen Sebelius said in a Senate hearing Wednesday.
HealthCare.gov is made up of two main components, the data hub and the marketplace, or exchange.
The hub, which experienced problems in the first couple of days after launch but has been generally stable since then, helps verify applicants' eligibility for insurance coverage and for subsidies. The hub provides a connection to federal data sources needed to verify consumer application information for income, citizenship and immigration status, among other things. It does not store any information, and is not a database.
The marketplace, or exchange, is the part of the website where users can apply for insurance coverage and compare plans available. Many of the site's continued problems appear to be related to the marketplace.
Questions about the site's problems
The specific technology problems remain a mystery, with HHS officials speaking in general terms during briefings and congressional testimony. One of the main problems appears to be software and database integration issues.
Still, there are some other problems we can piece together, based on press briefings from Centers for Medicare and Medicaid Services (CMS) and congressional testimony from contractors, Sebelius and CMS Administrator Marilyn Tavenner.