HealthCare.gov's Rocky First Month Leaves Plenty Of Questions

Nov 1, 2013
Originally published on November 1, 2013 4:49 pm

When the federal health exchange marketplace opened Oct. 1, we visited jazz musician Suzanne Cloud in Philadelphia. She tried to start an account early in the morning, but technology thwarted her plans.

She wasn't alone, as it became clear quickly that the unprecedented system for Americans in 36 states to shop and enroll for health insurance was broken in several places. A week into her failed attempts, Cloud stayed positive.

"I keep reassuring folks who are saying, 'Oh my God, I can't get in.' I go, don't worry, you will," Cloud said, in early October.

So now that one month has passed, we visited Cloud again. After trying to get through to shop and enroll in health insurance every three days or so for the past month, she's still blocked.

"I haven't even seen the marketplace yet," she says.

Despite Obama administration claims that the system is improving daily, things haven't gotten easier for Cloud and other users. The system's been intermittently out, going down at least twice this week for a total of about 36 hours.

Metrics on the system's status or improvements are difficult to get and interpret. Early numbers in administration "War Room" notes released by the House Oversight Committee show that the health exchanges enrolled only 248 Americans in the first two days after the marketplace opened. But Health and Human Services Secretary Kathleen Sebelius testified this week that full enrollment data are still unclear.

"The system isn't functioning, so we aren't getting that reliable data. Insurers who I met with said that is the case," Sebelius said.

Behind the scenes, a few dozen programmers with experience at technology companies Google and Red Hat joined the "tech surge" to clean up the broken site code. But adding dozens of new contract tech workers means they have to get paid. So we asked Julie Bataille, spokeswoman for the agency overseeing HealthCare.gov, for the total taxpayer cost committed for the federal exchange, and she said, "Total IT spending is in the neighborhood of about $630 million."

That kind of money could buy you the NBA's Miami Heat franchise or the entire mall clothing brand Hot Topic. It could also run the city of Louisville, Ky., for a year.

"The talent that [the government] did have was very expensive," said Clay Johnson, a programmer who built President Obama's 2008 campaign site. He estimates the HealthCare.gov system could have been built for a tenth of the cost had the government hired better talent — and taken a more open, agile approach to software development. Now, the tech surge is led by contractors who built the broken system in the first place.

"I'm pretty outraged at the fact that it's more profitable for a contractor to screw up than it is for them to do their job," says Johnson, who's been a fierce critic of the government's procurement structure.

As the cost picture becomes clearer, the administration is promising full enrollment numbers by mid-November. Nov. 30 is the administration's self-imposed deadline for fixing the site.

Cloud says she's not giving up, despite her month of failed attempts. After her online and phone registrations hit snags, she'll now apply on paper. She received a paper application Thursday night.

"I guess I'll fill it out. You know, what else can I do?" Cloud says.

Who else will enroll, and will they be satisfied with the insurance plans? The answers to those questions have not only policy implications but political ones, too.

Copyright 2014 NPR. To see more, visit http://www.npr.org/.

Transcript

ROBERT SIEGEL, HOST:

It's been a difficult few weeks for President Obama's signature health care law. There's the broken website that even the administration has called a debacle, plus the hundreds of thousands of cancellation notices sent to policyholders. From the outset, almost nothing has gone right. As NPR's Elise Hu reports, the administration is now racing to fix the site healthcare.gov and to limit the political fallout.

ELISE HU, BYLINE: When it opened October 1st, we visited jazz musician Suzanne Cloud in Philadelphia. She couldn't wait to log in to healthcare.gov, but technology thwarted her plans.

SUZANNE CLOUD: It kind of went (makes sound) and something went wrong.

HU: She wasn't alone, as it became clear quickly that this unprecedented system for folks in 36 states to shop and enroll for health insurance was broken in several places. A week into her failed attempts, Cloud stayed positive.

CLOUD: I keep reassuring folks who are saying, oh, my God, I can't get in. I go, don't worry, you will, you know.

HU: So now that a month has passed, we visited Cloud again at her Philadelphia home on Halloween night.

CLOUD: What are you?

HU: A zombie.

CLOUD: A zombie? Everybody's coming as zombies this year.

HU: Turns out it's HealthCare.gov that Cloud still needs to come back to life.

CLOUD: Right now, I haven't gotten anything yet. I haven't even seen the marketplace yet.

HU: She's attempted to get through the full site registration, shopping and enrollment process every three days or so for the past month. But the system's been intermittently out, going down at least twice this week.

CLOUD: Whenever I try to click on the thing that will take me to the next step, it goes to a page that says not authorized or no page found or something like that.

HU: Early numbers in notes released by the House Oversight Committee show that the health exchanges enrolled only 248 Americans in the first two days after the marketplace opened. But Health and Human Services Secretary Kathleen Sebelius testified this week that full enrollment data is still unclear.

SECRETARY KATHLEEN SEBELIUS: The system isn't functioning, so we are not getting that reliable data. Insurers who I met with said that that is the case.

HU: Behind the scenes, a few dozen programmers joined a tech surge to clean up the broken site code. Adding dozens of new contract workers means they have to get paid. So we asked Julie Bataille, spokesperson for the agency overseeing HealthCare.gov, for the total taxpayer cost committed for the federal exchange.

JULIE BATAILLE: Total IT spending is in the neighborhood of about $630 million.

HU: $630 million could buy you the NBA's Miami Heat franchise.

(SOUNDBITE OF ARCHIVED SPORTSCAST)

UNIDENTIFIED MAN: It's back-to-back titles for the Heat.

HU: Or pay for one year of running the city of Louisville, Kentucky.

(SOUNDBITE OF MUSIC)

HU: Or the entire mall clothing brand Hot Topic.

CLAY JOHNSON: The talent that it did have was very expensive.

HU: Clay Johnson is a programmer who built President Obama's 2008 campaign site. He estimates the HealthCare.gov system could've been built for a tenth of the cost had the government hired better talent and took a more open, agile approach to software development. Now, the tech surge is led by contractors who built the broken system in the first place.

JOHNSON: I'm pretty outraged at the fact that it's more profitable for a contractor to screw up than it is for them to do their job.

HU: As the cost picture becomes more clear, the administration is promising full enrollment numbers by mid-November. And November 30th is the administration's self-imposed deadline for fixing the site.

CLOUD: OK.

HU: Suzanne Cloud says she's not giving up, despite her month of failed attempts. After her online and phone registration hit snags, she'll now apply on paper.

CLOUD: I guess I'll fill it out. You know, what else can I do?

HU: Who else will enroll and will they be satisfied with the plans? The answers to those questions not only have policy implications but political ones, too. Elise Hu, NPR News, Washington. Transcript provided by NPR, Copyright NPR.