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Glitches far from fixed for online insurance exchange shoppers

Beset with glitches and registration problems, the launch of the online insurance exchanges at the start of October were rockier than expected. For an update on the status of the site and user experiences, Ray Suarez talks to Sarah Kliff of The Washington Post and Louise Radnofsky of The Wall Street Journal.

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    Now, as the federal government restarts its engines and the debt ceiling battle fades away, we return to the matter that triggered Republican anger at the outset: the rollout of the health insurance exchanges mandated by the Affordable Care Act.

    The online launch of the federal version, a marketplace at healthcare.gov that operates in more than 35 states, has been beset by glitches.

    Ray Suarez has our update on the problems plaguing the site.


    Under mounting criticism, the Obama administration is acknowledging the difficulties a bit more explicitly this week. During an appearance in Cincinnati on Wednesday, Health and Human Services Secretary Kathleen Sebelius said: "I will be the first to tell you that the Web site launch was rockier than we wanted it to be. Two weeks later, there are vast improvements, but we are still not satisfied."

    We check in with two chronicling this story extensively, Sarah Kliff of The Washington Post, and Louise Radnofsky of The Wall Street Journal.

    Well, Sarah, let me start with you. The much-publicized problems of the rollout, if you go today, what is waiting for you there?

  • SARAH KLIFF, The Washington Post:

    That's a good question, and it actually varies by person right now.

    I myself was able to log into the federal Web site for the first time on Wednesday, and I hear from some readers who actually enrolled in insurance, some of them have gotten help from the federal government paying for their premiums. Others are stuck at error messages. Others can't even get through the application process.

    And I think that's why you see the administration at this point acknowledging the fact it's been a rocky rollout, is that we're 18 days into the open enrollment process, and it still really runs the gamut what experience people are having.


    You did it in the state of Virginia?


    Yes. Yes.


    Was this something that took multiple tries?


    It did. I actually cannot tell you how many tries it took, because it was so many. And I was able to get in on Wednesday, so that's still over two weeks into the launch.

    Once I was able to use the Web site, it was actually a smooth experience, a few wait screens here and there. But I still hear from a lot of readers and people I have been interviewing who can't get that far, which suggests that the problems are still far from fixed.


    Louise, has there been a tapering off of traffic, and has that allowed the government to catch its breath, pay a little catchup with its technical gremlins?

  • LOUISE RADNOFSKY, The Wall Street Journal:

    Well, it sounds like there's been a tapering off of traffic just people who are turning up at the site at all, but also the federal government put a fix on the Web site last Thursday with little signs there allowed people to browse anonymously for the first time.

    And so that reduced the people who were then having to set up accounts in order to window shop and reduced the flow of people who already had coverage and were just curious about what premiums looked like, which meant that in turn it seems like the number of people who are successfully creating accounts or trying to has gone up to one in four now. What we're also seeing, though, is there are problems that are following from that.


    Now, when you say successfully creating accounts, that's a precondition for actually even shopping and buying, right? You first have to identify yourself and set yourself up as a user on the site, right?


    It's no longer a precondition for browsing, but for shopping seriously, it is. You have to tell the site who you are and have it essentially verify that you're telling the truth.

    And we have had — like Sarah, I have heard from readers who are struggling at the identity verification stage with some corresponding identity issues of their own: I am who I say I am. I have been the same person for 45 years. Why don't you believe me?


    Now, Sarah, it's a six-month window for signing up, so in fact there's a long time before this is over. But if you want to be covered on January 1, the first day this new insurance takes effect, by when should these problems be cleared up in order to have a trouble-free experience, be all signed up and certified so that, when January 1 comes, you're covered?


    So the very last day you can sign up and be covered by January one is December 15. That gives the insurance companies about two weeks to process the paperwork.

    When I talk to advocates, right now, they're not worried. They point out what you pointed out, that this is a long enrollment period. They will say it's a marathon, it's not a sprint. But they say if by the end of this month, especially if by Thanksgiving these problems aren't fixed, that's a really big problem, because you really need to give people some time to weigh these decisions.

    We're talking about a big financial decision of purchasing an insurance policy. So, really, if these aren't fixed by early November, mid-November, then I think that's a really significant problem for the administration.


    Well, Louise, with that in mind, have a lot of resources been thrown at getting this fixed?


    We think so.

    The administration has said it has a plan — it hasn't been very forthcoming about what the details of that plan are — and that it's working around the clock to get it fixed, but its timeline for getting is fixed is as soon as possible, which is not necessarily the sort of timeline that the advocates would like. They'd like some reassurances that it will be done now.

    We're also hearing from members of Congress, Democrats across the board who are saying that they want it done on a timeline that is now.


    Now, a wait screen is one thing. It's maddening, but it's a wait screen. There are reports now — and help me out with this — that people who are submitting their information online are finding out that the data that's been recorded is incorrect, that the site is actually not taking up the data they enter properly.



    Well, we have reported this morning that insurers are finding that the trickle of people who are making it to the final stage and actually enrolling in an insurance plan are turning up, for example, in triplicate, or we had an insurer who found one person who turned up with three spouses. They were actually dependents.

    And right now, while very few people are coming through all the hurdles because they're getting stopped in some cases at earlier stages or they're genuinely weighing the decision, and it's slowing them down, they can handle this, the insurers. They're able to manually go through the forms and check for errors, but that's because they're getting 50, 60 enrollees.

    The fear is that when the initial barriers come down, more people start coming through, the volume at that point, if there are still glitches in the way that the information is conveyed to insurers, could become a real problem. And that could also impact on the back-end deadlines, like December 15.


    Is it a different story, a better story, perhaps, in those states that are running their own exchanges, rather than having the federal government do it?


    It runs the gamut a little bit.

    There are a few states that have been standouts. Kentucky, for example, is one that has enrolled thousands, tens of thousands of people already. Washington State has seen a lot of success with their marketplaces.

    Then you look at a state like Hawaii that really wanted this to work. They only got their Web site up just this past Tuesday, two weeks after it was supposed to be up. Oregon announced today they haven't been able to enroll anyone into private health insurance plans. And Hawaii and Oregon are states that really wanted this to work. They decided to take on the efforts of setting up these marketplaces.

    So you do really see a big span among the state-based exchanges of how well this is going for them right now.


    Is there a targeted number, a whisper number, you might say, that the federal government wanted to hit, that the Obama administration wanted to hit by this first month of the rollout? And is there a shot at actually reaching that level?


    Well, the Congressional Budget Office projected that seven million people would come in over the open enrollment season overall.

    There's an internal memo that I think has been floating around reported by the Associated Press that had a first month target that I think was 50,000. So they were always planning — and they told us this too — they were always planning for October to be slower than November to be slower than December, that people would be motivated by deadlines.

    And they expected even that some people might miss the initial deadline. but sign up early in the new year, and not be subject to the mandate. It's not clear, of course, whether they're hitting that target, because we haven't seen those numbers.


    Will they be slowed up, those numbers, by the government shutdown?


    There's not a reason why they should be slowed up by the government shutdown. The administration said they want to release them in November because they want to make sure that they're accurate. That's one of the reasons that they want to match all the different data entry sources, the paper forms, the call center forms and the Web site.

    The other thing is, they want to make sure there aren't duplicates. And what we're hearing from insurers are, there are duplicates.


    Now that the titanic political struggle is over, is it likely that this is going to get — its troubles and its successes likely to get a lot more attention in the coming weeks?


    I think so.

    It was actually — in a way, it was a good time for the administration to launch a Web site that didn't work very well, on October 1. There was all this focus on the federal government shutting down. And really that's been the big story that all of our colleagues have been covering. Healthcare.gov has certainly been a top news item, but it's definitely been pushed out of first place by the shutdown.

    Now that the government has reopened, I think a lot of the focus is going to move back to this Web site, which makes it even more imperative and even a higher agenda item for the White House to get it fixed and get it running accurately now that people are really starting to come to it even in higher numbers.


    Sarah Kliff of The Washington Post, Louise Radnofsky of The Wall Street Journal, thank you both.


    Thank you.

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