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  Health website to heal with time, supporters say

Reprinted by permission of The Associated Press

By RICARDO ALONSO-ZALDIVAR
Associated Press

    WASHINGTON (AP)  — It should be working well by the end of November. That’s the Obama administration’s rough timetable for completing a long list of fixes to HealthCare.gov, the new, trouble-plagued website for uninsured Americans to get coverage.
    Summarizing a week’s worth of intensive diagnostics, the administration acknowledged the site has dozens of complex problems and tapped a private company to oversee fixes.
    Jeffrey Zients, a management consultant brought in by the White House to assess the extent of problems, told reporters his review found dozens of issues across the entire system. The site is made up of layers of components that are meant to interact in real time with consumers, government agencies and insurance company computers.
    It will take a lot of work, but ``HealthCare.gov is fixable,’’ Zients declared.
    The vast majority of the issues will be resolved by the end of November, he asserted, and there will be many fewer screen freezes. He stopped short of saying problems will completely vanish.
    The troubles have been nightmarish for the White House, which had promoted enrollment to be as simple as making a purchase on Amazon.com. President Barack Obama declared himself frustrated by the setbacks but is still trumpeting the benefits of the health-care law and encouraging consumers to apply by phone if the website proves a hindrance.
    Obama encouraged the public to call 1 (800) 318-2596 or visit LocalHelp.HealthCare.gov.
    ``We’re only a few weeks into a six-month open enrollment period, and everyone who wants insurance through the marketplace will get it,’’ he said.
    As part of its effort to repair the system, the administration said it is promoting one of the website contractors, a subsidiary of the nation’s largest health insurance company, to take on the role of ``general contractor’’ shepherding the fixes.
    Quality Software Services Inc. —  owned by a unit of UnitedHealth Group — was responsible for two components of the government’s online insurance system. One is the data hub, a linchpin that works relatively well, and the other is an accounts registration feature that initially froze and caused many problems.
    HealthCare.gov was supposed to be the online portal for uninsured Americans to get coverage under Obama’s health care law. Envisioned as the equivalent of Amazon.com for health insurance, it became a huge bottleneck immediately upon launch Oct. 1. The flop turned into an embarrassment for Obama and will likely end up as a case study of how government technology programs can go awry.
    Executives of QSSI and the other major contractor, CGI Federal, told Congress that the government didn’t fully test the system and ordered up last-minute changes that contributed to logjams.
    Health and Human Services Secretary Kathleen Sebelius has said that ``in an ideal world there would have been a lot more testing,’’ but added that her department had little flexibility to postpone the launch against the backdrop of Washington’s unforgiving politics.
    House Republicans trying to defund the nation’s health insurance program precipitated a government shutdown.
    Rep. Fred Upton, R-Michigan, the chairman of the House Energy and Commerce Committee, asked whether the problems evident now foreshadowed future troubles with the health care law.
    ``In a few short months, families across the country will be subject to penalties under the law’s individual mandate,’’ he said. ``How can the administration punish innocent Americans by forcing them to buy a product many cannot afford, from a system that does not work?”
    Administration officials have said it would be middle November before they would release any numbers on how many people have successfully enrolled. Although 700,000 have applied for coverage through the new online markets, it’s believed only a fraction of that number actually managed to sign up. Before the website went live, an administration estimate projected nearly 500,000 people would sign up in October alone.
    The marketplaces are the gateway to obtaining health insurance under the new health care law, which requires most Americans to have coverage by Jan. 1. Middle-class people who don’t have insurance on the job can purchase a private plan with new tax credits to make the premiums more affordable. Low-income people will be steered to an expanded version of Medicaid in states that agree to extend the safety net program.
    The federal government is running the insurance markets or taking the lead in 36 states. The rest were set up by states themselves, including Illinois.
    Consumers have until Dec. 15 to sign up for coverage to take effect Jan. 1. Under the law, pre-existing medical conditions will no longer be a barrier. But the markets also need lots of young, healthy customers to keep premiums affordable. Open enrollment season extends until March 31.
    Zients said almost daily fixes are already having an impact. For example, more than 90 percent of users can now complete one of the first steps, creating an account.
    But the application process, which involves submitting and verifying personal information and income details, remains ``volatile,’’ he said. At one point, as few as one-third of users were getting through that part.
    Zients said there are two big categories of problems. Performance issues involve the speed and reliability of the website. Functional issues are bugs that keep the software from working as intended. Among the high-priority issues is that insurers are getting enrollments with incomplete, incorrect or duplicative information.
    
Republicans seize on issues
    
    Congressional Republicans are waging war against a hapless website and hoping it leads to the destruction of ``Obamacare,’’ the health-care program they loathe so fervently.
    But rather than political or legal arguments determining its fate, it’s likely the health-care overhaul will succeed or fail based on the reaction of millions of Americans in search of coverage.
    ``Let me remind everybody that the Affordable Care Act is not just a website. It’s much more,’’ Obama said recently. He said that because of the law, which has been taking effect in stages for three years, ``preventive care like mammograms and birth control are free through your employers,’’ young people up to age 26 can remain on their parents’ coverage plans and some seniors are paying less for their prescription drugs.
    Republicans skip over any well-received benefits the law might have bestowed. Instead, they speculate that the website is a gateway not to health-care coverage but to bigger and more painful failures in the near future.
    ``Will enrollment glitches become possible provider payment glitches? Will patients show up at their doctor’s offices or hospitals to be told that maybe they aren’t covered or even in the system?’’ Upton, the Michigan House Republican said during a hearing of the House Energy and Commerce Committee.
    Democrats are having none of it, even though they express their own frustration and anger at the debut of the website.
    ``Here we go again, another cynical effort by the Republicans to delay, defund or ultimately repeal the Affordable Care Act,’’ said Rep. Frank Pallone, D-N.J., speaking at the same hearing. ``Their effort, obviously, isn’t to make this better but to use the website and the glitches as an excuse to defund or repeal Obamacare.’’
    Ironically, the roles were reversed a decade ago, when the Bush administration struggled to implement a new prescription drug benefit under Medicare. Many Democrats had voted against the change and harshly criticized it, yet they failed to turn it into a winning issue in 2004.
    At some point, Obama may yet find himself agreeing to major changes in the law.
    There is growing Democratic sentiment inside Congress for a one-year delay in the requirement for individuals to purchase coverage, given the difficulty with the website. Senators on the ballot in 2014 are notably nervous. Support inside both parties is strong for repealing a medical device tax contained in the law.
    For now, though, the focus is the website, a problem the administration insists it can and will fix.
    Republicans’ decision to seize on the flawed roll-out comes as the party tries to shift the public’s attention away from the recent partial government shutdown and the clash over the debt ceiling, and resurrect an issue they hope will benefit them in next year’s elections.
    David Espo, AP special correspondent, contributed to this report