The insurance-buying exchanges created by the 2010 healthcare law stumbled out of the gate Tuesday, or at least their websites did.
In California, online sign-up pages loaded haltingly or not at all throughout the day. The problems weren’t severe enough to stop determined applicants, as long as they didn’t mind having their patience tested. But they were a sign that the system wasn’t ready to handle the volume of inquiries it received on Day One.
Similar problems cropped up around the country as applicants swamped the shopping portals operated by the federal government and individual states. The results were a mixed blessing for supporters of the Affordable Care Act, better known as Obamacare. The success of the exchanges will depend on their ability to attract a broad and deep pool of customers, so the interest shown on opening day belied the polls showing a widespread lack of awareness. But the problems add to the questions about the government’s ability to meet the technological challenges involved in giving people the ability to sign up for subsidized coverage online.
Making matters worse, at least one alternative to the exchanges’ sites -- eHealth’s eHealthInsurance.com -- wasn’t ready to sign customers up for subsidized coverage. The company said Tuesday that it was ready to sign up people for non-subsidized policies in the 34 states with federally operated exchanges, but it didn’t get the information it needed from the feds in time to process applications for subsidies. It hopes to have that capability by Jan. 1, when the coverage actually goes into effect.
(The states operating their own exchanges haven’t yet agreed to let eHealth act as an online insurance broker.)
There was no indication that people trying to sign up by phone or in person encountered similar hurdles. Nevertheless, the inauspicious online launch gave critics of the law -- particularly House Republicans, who are trying to delay the law’s individual mandate to buy insurance for a year -- more ammunition for their argument that Obamacare isn’t ready for primetime.
As it happens, the debate over whether to delay the individual mandate is the centerpiece of the fight over the partial government shutdown that began Tuesday. The less prepared the exchanges seem to be, the more reasonable the House Republicans’ demands will sound to the public -- and by extension, the more pressure the public will put on Senate Democrats to negotiate over that issue.
Then again, seemingly every launch of a hotly anticipated product or service gets off to a rough start. Remember Facebook’s initial public offering? Apple’s introduction of iTunes Match? (I could go on, but you get the point.) It’s hard to predict exactly how heavy the demand will be, and the public has come to expect these sorts of problems.
All that means, though, is that the exchanges aren’t likely to be knocked out by a bad first day. Peter V. Lee, executive director of Covered California, expects people to make multiple visits to the exchange’s website to gather information before they choose a health plan. On the other hand, the people that the exchanges are most eager to sign up -- younger, healthier ones who’ve gone without coverage in the past -- are likely to have less patience for technical problems than the folks most in need of healthcare. So persistent problems on the website could contribute to the sort of adverse risk selection that the exchange really needs to avoid.
As The Times’ editorial board argued Monday, the real test of the exchanges won’t be how well they performed today. It’s where they stand when the open enrollment period ends March 31. And it’s better for them to discover problems now than in late November or December, when people are more likely to be nailing down their insurance plans for the coming year. That’s assuming the problems discovered Tuesday don’t take months or weeks to solve, however.