D-Day for HealthCare.gov fixes

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Today marks the deadline for federal health officials to fix massive problems with ObamaCare’s enrollment website.

Meeting the Nov. 30 deadline would provide a major boost for the administration, which has been mired in unprecedented conflict over its healthcare rollout for two straight months. It would also help push back against criticism surrounding the administration's decision to delay the law's online sign-up system for small businesses.

Another month of serious problems at HealthCare.gov would be disastrous.

Without a smoothly running site, it will be difficult for the administration to enroll the millions of people necessary for stability on the new insurance exchanges.

A paltry enrollment number would likely raise next year's prices on the marketplaces and cause insurers to withdraw their plans.

It would also take a political toll on Democrats in the 2014 midterm elections, when ObamaCare is already expected to be a major issue.

“It will not look good for the administration if they miss yet another deadline,” said Jennifer Tolbert, director of state health reform with the Kaiser Family Foundation.

“There are a lot of moving parts here, but ensuring that access point for consumers is vitally important.”

Equally certain are the advantages to the administration if the website does run smoothly.

A functioning HealthCare.gov would provide momentum for the remaining four months of ObamaCare enrollment, guaranteeing that interested people can sign up online for coverage.

According to federal health officials, HealthCare.gov can now manage the 50,000 concurrent users it was originally designed to handle starting Sunday.

Tech teams have addressed long lists of technical fixes, improving the user experience by lowering error rates and page load times.

By most accounts, HealthCare.gov has substantially improved since its failed debut on Oct. 1. And yet, as of this week, the site's performance remained frustratingly variable for some users.

Perhaps in light of those problems, the White House has repeatedly sought to lower expectations for Nov. 30.

The system experienced its latest unscheduled outage on Monday, and some visitors reported periods of latency and unresponsiveness throughout the day.

The agency responsible for the site acknowledged these issues and predicted that some, including intermittent outages, will continue into next month.

“The system will not work perfectly on Dec. 1, but it will work much better than it did in October,” Centers for Medicare and Medicaid Services spokeswoman Julie Bataille told reporters this week.

Monday's outage highlights the site's fundamental unpredictability at this stage and the flaws that have not yet been discovered, which could give the administration trouble for months to come.

The next big test will come in December, as consumers hoping for coverage that starts in January begin to shop.

The deadline to sign up for those health plans is Dec. 23 and is expected to create the enrollment site's largest wave of traffic to date.

Administration officials say they have a system in place to cope with high volumes that HealthCare.gov may not be able to manage.

Visitors will be queued and told to come back at a later time, when they will be placed in the front of the line, according to CMS.

Some reports from this week suggested that the White House urged allies to hold back on promoting HealthCare.gov to reduce the flood of traffic.

But Health and Human Services (HHS) Secretary Kathleen Sebelius defied this Tuesday when she confidently urged state and local leaders to direct people to the site.

“Don't hesitate to recommend people go to HealthCare.gov and sign up,” Sebelius said on a phone call with the state and local officials.

“We are definitely on track to have a significantly different user experience by the end of the month,” she said.

What comes next will depend on the power of anecdotes surrounding the site's success or failure for individual users, experts said.

Both Republicans and Democrats will be seeking to boost their narratives about the law when the House returns from Thanksgiving recess.

But the rollout’s fate hinges on more than just the site's average user experience.

On top of the ultimate hurdle — getting the right mix of sick and healthy consumers to sign up for coverage — the administration needs to address problems with the sign-up system that consumers will never see.

One example is the process that transmits applicants' information to insurance companies, which remains flawed. Without improvements, the system will create problems for new policyholders when they try to use their plans.

“All of this has to work in tandem,” said Tolbert, who reports she successfully helped a friend sign up for coverage on HealthCare.gov on Nov. 23.

“All the pieces have to start working much better than they have been … That said, I have a little more confidence now based on my own experience that the website is improving.”