Is healthcare.gov working well now, as the Obama Administration claims that it is? Some of Monday’s media coverage is skeptical. On the front page of the Times, there is an article with the headline “INSURERS CLAIM HEALTH WEBSITE IS STILL FLAWED.” The Wall Street Journal went with “INSURERS SEEK TO BYPASS HEALTH SITE.”
Given the problems that the online exchange has experienced in the past couple of months, reporters are right to be skeptical. Despite the numerous fixes that have been made to the site and the extra capacity that has been added, there are still frequent reports of it going down. And a couple of weeks ago, Henry Chao, a senior official at the Centers for Medicaid and Medicare Services (C.M.S.), the agency responsible for healthcare.gov, conceded in a testimony on Capitol Hill that much of its back end—the bit responsible for billing and payments—remains to be built.
Still, the functionality of the site does appear to have improved considerably. At least, that’s what I found when I tried it out again yesterday, acting as a potential purchaser of a family plan. On my first visit to the site, back in October, immediately after it was launched, I got practically nowhere; it was frozen. This time, it was working and was far more user friendly. Its Web pages loaded almost instantaneously, the navigation tools were easy to use, and the forms I filled in were self-explanatory. Before long, I had received an e-mail with an identification number and confirmation that I had created an account. That’s progress.
However, I didn’t get the opportunity to submit an application, or even to choose a plan. After filling in forms and fiddling around for about forty minutes, I reached a screen that said, “You have started an application for health coverage, but our verification system is temporarily unavailable. Without completing verification you cannot submit your application …” According to other reports I’ve seen, this still happens often. The verification process is proving difficult to fix, which is hardly surprising, since almost a dozen federal agencies are involved in confirming the veracity of the information that applicants are asked to supply. All too frequently, the result is you spend half an hour or longer on the site, creating an account and inputting information about your family, your income, and your citizenship status. You think you are doing pretty well. Then you get blocked—or, at least, I did.
That’s frustrating. But this time I did manage to elicit some valuable information about the insurance policies on offer through the exchange, and how much they cost.
One of the big drawbacks with the site when it launched was the lack of a “shopping” feature. Before users could find out what policies were available in their area, they had to register, create an account, and supply copious amounts of information about their family members, their Social Security numbers, their citizenship status, and their income. Then they had to wait for all that stuff to be verified. Which takes time—often, a long time.
Some Republicans have claimed that the Administration deliberately omitted the shopping feature because it was worried about the users experiencing “sticker shock” if they saw the prices of the insurance policies (although those prices didn’t account for the generous subsidies many people would get). In Congressional testimony a few weeks ago, Henry Chao told a different story. The “shop around” feature failed testing, and that was why it was left out, he insisted. Nobody at the White House was involved.
Whatever really happened, the shopping feature is now part of healthcare.gov, and it’s prominently displayed on the home page. Consequently, the site feels more like one of the state exchanges that have been working pretty well, such as the California site, CoveredCa, which has a “Shop and Compare” tool on its home page, illustrated by picture of a calculator. If you click on it, and click again, you arrive at a page that asks you for your Zip Code, your household income, and the number of people in your family, plus their ages. Once you enter this information, the site shows you all the insurance policies available in your area, and how much they will cost you. If you want to buy one, you go to the home page and start filling out an application.
That’s pretty much how commercial e-commerce sites work, and it’s also how President Obama promised that healthcare.gov would function. On October 1st, he said, “Just visit healthcare.gov, and there you can compare insurance plans, side by side, the same way you’d shop for a plane ticket on Kayak or a TV on Amazon.”
Given the persistence of various technical problems on healthcare.gov, it still can’t be compared to the big consumer sites. But from a user perspective it is getting closer. On the home page, there is now a button that says “See Plans Before I Apply.” Once you click on it, the next page asks for the type of insurance plan you are looking for (family or small business), the county and state where you live, and the ages of your family members. When I entered information as if I lived in Travis County, Texas—one of the states that isn’t operating its own exchange—and was the thirty-five-year-old parent of two young children, the site showed me ten available family plans. They range from a Humana Connect Basic plan, for a hundred and thirty-one a month with an annual deductible of twelve thousand seven hundred dollars, to an Ambretta Bronze 4+ Vision plan, which costs seven hundred and two dollars a month, with an annual deductible of eight thousand dollars. (Silver and gold plans are also available; the prices don’t account for subsidies.)
This is precisely the sort of information that individuals and families who don’t have any health-care coverage need to have at their fingertips. On some of the state exchanges, such as CoveredCa, there is a cost calculator that people can use to figure out if they qualify for subsidies. For some inexplicable reason, healthcare.gov still doesn’t have a subsidy calculator of its own. To find out how much they would end up paying for various policies, its users have to fill out a full application. But now at least the home page features a link to an external subsidy calculator—one operated by the Kaiser Family Foundation.
That’s the sort of tool that should have been there from the beginning. One of the most bewildering things about the rollout is how the Administration managed to launch a site that was so unfriendly to consumers. One answer I’ve seen is that the C.M.S. didn’t have the technical know-how to create a consumer-friendly experience. That appears to be wrong: medicare.gov, the official site of the retiree health-care system, is much easier to navigate than healthcare.gov was when it launched. Earlier today, without submitting any personal details except my Zip Code, I used that site to get details, including the monthly premiums and the participating pharmacies, of twenty-six prescription-drug plans that are available in my area. If, from the beginning, healthcare.gov had been modelled on medicare.gov, or on CoveredCa, it would be much easier to use, and it wouldn’t be as buggy—at least, not on the front end.
Some substantial improvements have finally been made, and there’s no reason to doubt that there are more to come. But there’s still a lot of work to be done. Until Americans can routinely use the site to find insurance policies, compare them, and enroll in them all at one sitting, without having to wait hours or days to complete the various parts of the application process, the online exchange can’t be considered a success.
However, I didn’t get the opportunity to submit an application, or even to choose a plan. After filling in forms and fiddling around for about forty minutes, I reached a screen that said, “You have started an application for health coverage, but our verification system is temporarily unavailable. Without completing verification you cannot submit your application …” According to other reports I’ve seen, this still happens often. The verification process is proving difficult to fix, which is hardly surprising, since almost a dozen federal agencies are involved in confirming the veracity of the information that applicants are asked to supply. All too frequently, the result is you spend half an hour or longer on the site, creating an account and inputting information about your family, your income, and your citizenship status. You think you are doing pretty well. Then you get blocked—or, at least, I did.
That’s frustrating. But this time I did manage to elicit some valuable information about the insurance policies on offer through the exchange, and how much they cost.
One of the big drawbacks with the site when it launched was the lack of a “shopping” feature. Before users could find out what policies were available in their area, they had to register, create an account, and supply copious amounts of information about their family members, their Social Security numbers, their citizenship status, and their income. Then they had to wait for all that stuff to be verified. Which takes time—often, a long time.
Some Republicans have claimed that the Administration deliberately omitted the shopping feature because it was worried about the users experiencing “sticker shock” if they saw the prices of the insurance policies (although those prices didn’t account for the generous subsidies many people would get). In Congressional testimony a few weeks ago, Henry Chao told a different story. The “shop around” feature failed testing, and that was why it was left out, he insisted. Nobody at the White House was involved.
Whatever really happened, the shopping feature is now part of healthcare.gov, and it’s prominently displayed on the home page. Consequently, the site feels more like one of the state exchanges that have been working pretty well, such as the California site, CoveredCa, which has a “Shop and Compare” tool on its home page, illustrated by picture of a calculator. If you click on it, and click again, you arrive at a page that asks you for your Zip Code, your household income, and the number of people in your family, plus their ages. Once you enter this information, the site shows you all the insurance policies available in your area, and how much they will cost you. If you want to buy one, you go to the home page and start filling out an application.
That’s pretty much how commercial e-commerce sites work, and it’s also how President Obama promised that healthcare.gov would function. On October 1st, he said, “Just visit healthcare.gov, and there you can compare insurance plans, side by side, the same way you’d shop for a plane ticket on Kayak or a TV on Amazon.”
Given the persistence of various technical problems on healthcare.gov, it still can’t be compared to the big consumer sites. But from a user perspective it is getting closer. On the home page, there is now a button that says “See Plans Before I Apply.” Once you click on it, the next page asks for the type of insurance plan you are looking for (family or small business), the county and state where you live, and the ages of your family members. When I entered information as if I lived in Travis County, Texas—one of the states that isn’t operating its own exchange—and was the thirty-five-year-old parent of two young children, the site showed me ten available family plans. They range from a Humana Connect Basic plan, for a hundred and thirty-one a month with an annual deductible of twelve thousand seven hundred dollars, to an Ambretta Bronze 4+ Vision plan, which costs seven hundred and two dollars a month, with an annual deductible of eight thousand dollars. (Silver and gold plans are also available; the prices don’t account for subsidies.)
This is precisely the sort of information that individuals and families who don’t have any health-care coverage need to have at their fingertips. On some of the state exchanges, such as CoveredCa, there is a cost calculator that people can use to figure out if they qualify for subsidies. For some inexplicable reason, healthcare.gov still doesn’t have a subsidy calculator of its own. To find out how much they would end up paying for various policies, its users have to fill out a full application. But now at least the home page features a link to an external subsidy calculator—one operated by the Kaiser Family Foundation.
That’s the sort of tool that should have been there from the beginning. One of the most bewildering things about the rollout is how the Administration managed to launch a site that was so unfriendly to consumers. One answer I’ve seen is that the C.M.S. didn’t have the technical know-how to create a consumer-friendly experience. That appears to be wrong: medicare.gov, the official site of the retiree health-care system, is much easier to navigate than healthcare.gov was when it launched. Earlier today, without submitting any personal details except my Zip Code, I used that site to get details, including the monthly premiums and the participating pharmacies, of twenty-six prescription-drug plans that are available in my area. If, from the beginning, healthcare.gov had been modelled on medicare.gov, or on CoveredCa, it would be much easier to use, and it wouldn’t be as buggy—at least, not on the front end.
Some substantial improvements have finally been made, and there’s no reason to doubt that there are more to come. But there’s still a lot of work to be done. Until Americans can routinely use the site to find insurance policies, compare them, and enroll in them all at one sitting, without having to wait hours or days to complete the various parts of the application process, the online exchange can’t be considered a success.
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