ObamaCare crash not just traffic

Problems plaguing online enrollment in ObamaCare are not just due to high traffic, but are being compounded by structural problems at healthcare.gov, the federal government portal where people can shop for medical insurance.

The Obama administration is now scrambling to fix technical troubles that contributed to a bruising debut last week for the new insurance marketplaces. 

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“I think there’s growing consensus that it’s not just volume,” said Caroline Pearson, a vice president at the consulting firm Avalere Health who focuses on the healthcare law.

Healthcare.gov — the main portal for consumers in 36 states to compare their coverage options — was taken offline for maintenance over the weekend and was scheduled to come down for repairs again at 1 a.m. Tuesday.

In addition to adding capacity to better deal with heavy traffic, the fixes included software upgrades and changes to the type of hardware used for certain functions, the Health and Human Services Department (HHS) said Monday.

The initial problems with healthcare.gov mostly prevented users from creating an account — a prerequisite to comparing or buying insurance. That means few people have been able to even begin the process of shopping for coverage.

Although some “glitches” were considered inevitable in the launch of the new insurance marketplaces, observers said the problems have been worse than expected.

“I didn’t necessarily anticipate that we wouldn’t be able to get online at all,” Pearson said.

She was more concerned about problems with the accuracy of the plan information consumers would see once they began comparing plans, and the process for determining the amount of tax subsidies consumers should receive.

More people would have to make it to the enrollment process before it’s possible to tell whether those systems are working well, she said.

But a source close to the insurance industry said things aren’t looking good so far. State and federal systems appear to have problems communicating with each other, and insurers aren’t confident in the accuracy of subsidy calculations for the few consumers getting that far in the process.

“It just sounds like a nightmare,” the source said.

The White House focused on the site’s traffic, it logged 8.6 million visits last week, as it sought to explain why hardly anyone was able to actually buy insurance through the website.

“Saturday Night Live” mocked that explanation during its “Weekend Update” segment.

“You can’t campaign on the fact that millions don’t have healthcare and then be surprised that millions don’t have healthcare,” “Update” anchor Cecily Strong said. “How could you not be ready? That’s like 1-800-FLOWERS getting caught off guard by Valentine’s Day.”

Technical experts attributed some problems to heavy traffic but said a long list of other flaws could be explained by errors in the site’s construction and coding.

James M. Turner, a software engineer and blogger, called the enrollment system’s debut “pretty bad.”

“It’s probably the most broken release — as opposed to a beta site — that I have ever seen,” said Turner, who works for mobile app company Beeonics and contributes posts to oreilly.com, a tech news site.

“Last week, there were clearly load issues due to traffic, as if the site couldn’t get back to you fast enough. … Now the site is relatively responsive, but it’s still broken because the basic design of getting through the system is broken,” Turner said.

HHS says it has made progress since launching the site last Tuesday. Improvements made over the weekend cut the site’s wait times in half, the department said, and wait times at enrollment call centers have been cut to less than a minute.

“Our work to expand the site’s capacity has led to more people successfully applying for and enrolling in affordable health coverage online. … But we won’t stop until the doors to HealthCare.gov are wide open, and at the end of the six-month open enrollment, millions of Americans gain affordable coverage,” HHS spokeswoman Joanne Peters said.

But while it has touted the number of visits to healthcare.gov, HHS has not said how many people have actually enrolled in coverage through the site. White House press secretary Jay Carney said Monday that the administration would provide monthly enrollment updates.

Some state-based insurance exchanges have fared better than the federal system. The most successful state exchanges allow people to compare plans without creating an account, unlike the federal version, Pearson said.

Joel Ario, who led HHS’s Office of Health Insurance Exchanges until 2011, said the department should temporarily scale back the site and simply allow users to comparison shop without creating an account.

“People must be able to shop and browse,” said Ario, now a managing director at Manatt Health Solutions. “If that’s a problem, it needs to be fixed right now. “

Last week, Obama downplayed the problems and compared the exchanges’ debut to the launch of an Apple product with minor glitches.

Gregory Ferenstein, a technology journalist who blogs for TechCrunch, said most of his readers “thought that comparison was pretty hilarious.”

“If Apple had a screwup as bad as healthcare.gov, users would have been in revolt,” Ferenstein said.