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Published: Monday, 10/21/2013 - Updated: 10 months ago

ONLINE INSURANCE EXCHANGES

Health care fixes could take weeks

Experts: Web site woes go beyond registration

NEW YORK TIMES
Ashley Hentze, left, of Lakeland, Fla., gets help signing up for Affordable Care Act insurance from Kristen Nash, a volunteer with Enroll America in Tampa. Ashley Hentze, left, of Lakeland, Fla., gets help signing up for Affordable Care Act insurance from Kristen Nash, a volunteer with Enroll America in Tampa.
ASSOCIATED PRESS Enlarge

WASHINGTON — Federal contractors have identified most of the main problems crippling the online health insurance marketplace, but the Obama Administration has been slow to issue orders for fixing those flaws and some contractors worry that the system may be weeks away from operating smoothly, people close to the project say.

Administration officials approached the contractors last week to see if they could perform the repairs and reboot the system by Nov. 1.

That goal struck many contractors as unrealistic, at least for major components of the system.

Some specialists working on the project said the online system required such extensive repairs that it might not operate smoothly until after the Dec. 15 deadline for people to sign up for coverage starting in January.

That view is not universally shared.

Experts said the technological problems of the site went far beyond the roadblocks to creating accounts that prevent users from even registering.

Several said the log-in problems, though vexing to consumers, may be the easiest to solve.

One specialist said that as many as 5 million lines of software code may need to be rewritten before the Web site runs properly.

“The account creation and registration problems are masking the problems that will happen later,” said one person involved in the repair effort.

The scrambling underscores the pressures on the administration to fix what is widely viewed as President Obama’s biggest domestic achievement.

Millions of Americans have spent countless hours in frustration trying to use the federal Web site, and its extensive problems have become a political crisis for the administration, providing new opportunities for Republicans who want to roll back the health-care law.

Over the weekend, officials sought to counter pronouncements of failure by announcing that almost half a million people have submitted applications for health insurance through the federal and state marketplaces, about half of them through state exchanges.

But officials declined to say how many have actually enrolled in insurance plans, and executives from insurance companies, which receive the enrollment files from the government, say their numbers have been low.

The enrollment period ends March 31. Those who go without coverage may be subject to fines.

Mr. Obama will host a Rose Garden event today with people who have successfully enrolled in the health-care exchanges.

White House aides said the President will acknowledge that the technical problems are “inexcusable,” but he will point out, as one adviser said, that the health-care law is “more than a Web site.”

“There’s great demand for the affordable health care coverage made available by the ACA,” Jennifer Palmieri, the White House communications director, said Sunday, referring to the Affordable Care Act.

“The challenge for all of us — the state and federal governments and contractors alike — is to make sure the American people can access it simply. We won’t rest until they can,” she said.

Senior officials took to the Sunday talk shows to defend the Affordable Care Act, and Republicans countered them.

Sen. Marco Rubio (R., Fla.) said on Fox News Sunday that the early failures do not bode well for the rest of the health-care law.

“In the 21st century, setting up a Web site where people can go on and buy something is not that complicated,”Mr. Rubio said.

One major problem slowing repairs, people close to the program say, is that the Centers for Medicare and Medicaid Services, the federal agency in charge of the exchange, is responsible for making sure that the separately designed databases and pieces of software from 55 contractors work together.

It is not common for a federal agency to assume that role, and numerous people involved in the project said the agency did not have the expertise to do the job and did not fully understand what it entailed.

The people close to the project spoke on the condition of anonymity.

Administration officials have been debating whether to designate one or more companies as the quarterback for information technology work on the federal exchange, a complex project that has cost more than $400 million.

Communications between the administration and its contractors improved over the weekend as the Centers for Medicare and Medicaid Services began negotiating written agreements with contractors on responsibility and deadlines for the repairs, those people say.

They hope to have a repair plan before a congressional hearing that is scheduled for Thursday.

“The issue right now is between CMS and the White House,” a specialist said Friday before communications improved. “Everybody sits and waits and the meter runs.”

A part of the system, hidden from users, draws data from several federal and state databases to determine if consumers qualify for coverage and then calculates the subsidies for which they may be eligible.

Another part of the system sends enrollment data to insurers.

Several people involved in the project said that problems like those of the last three weeks were not uncommon when software from several companies is combined into a large, complex system.

Insurers have found that the system provides them with incorrect information about some enrollees, repeatedly enrolls and cancels the enrollments of others, and simply loses the enrollments of still others.



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