On October 1, 2013, the federal government opened the Health Insurance Marketplace established through the Affordable Care Act (ACA), and millions of Americans in 36 states logged on to www.healthcare.gov
to explore their insurance options. While many celebrated the launch, the website itself provoked considerable consternation as cyber gridlock prevented large numbers of would-be users from accessing the site.
Since that time, government efforts to resolve technical problems have reportedly improved the ability of consumers to log on and explore the site, but additional design flaws and programming issues unrelated to the initial high volume of traffic continue to plague the online exchange. Insurers report that they do not trust the information they are receiving because the system sometimes generates duplicate and/or conflicting reports for the same enrollee. Consumers also report a host of difficulties with basic functions such as creating their user names and navigating between pages.
During an October 21, 2013, press conference, President Obama acknowledged that computer problems had hampered the rollout of the online exchange and reminded consumers that they can also access the marketplace via phone at 1-800-318-2596 and in person at sites in many communities. U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius has been roundly attacked for failing to anticipate or inform the public about problems with the exchange in advance of the rollout. She announced that her department has enlisted Jeff Zients, former Acting Director at the Office of Management and Budget and the nation’s first Chief Performance Officer, to work with experts from industry and government to remedy the problems.
By contrast, states that chose to create their own exchanges report that these are functioning well, with tens of thousands of people having already applied for health coverage. Some of the difficulties at the federal level can be traced to the fact that a majority of states refused to establish their own insurance marketplaces as originally envisioned by the ACA. Subsequently, the federal government moved to vastly expand the scope of the federal exchange.
Another aspect of the exchange that has recently drawn the attention of Obama administration critics is its inclusion of a voter registration site. A spokesperson for the Centers for Medicare and Medicaid Services explained the inclusion to The Washington Post by saying that the National Voter Registration Act of 1993 (the so-called motor voter law) “requires states to offer voter registration [at] all offices that provide ‘public assistance’ (including Medicaid applications). Because people applying at www.healthcare.gov
could be eligible for either Medicaid or Marketplace coverage, [the site] will be providing info on voter registration to people who request it.”