Obamacare May Be More Than a Website, But It Needs a Website to Function



President Obama will give a White House speech later this morning on the ongoing failure of the health insurance exchanges set up under Obamacare. According to The New York Times, he'll call the snafus "inexcusable" and also argue that the health care law is "more than a website."

That's obviously true in some sense. The law also involves thousands of pages of rules and regulations and more than a trillion dollars of government spending over the next decade.

Regardless of Obamacare's other elements, however, the notion that there's more to the law than the website is not particularly reassuring given how central a smoothly operating online system is to the law's promise of expanding private health coverage to millions of Americans.

The exchange network is the vehicle through which the law's authors envisioned people choosing Obamacare-approved, publicly subsized coverage. If it doesn't work, then that can't really happen—even with manual workarounds like phone or paper applications.

That's because those entries still have to be entered into the online system. As The Washington Post reported earlier this month:

Paper may give people the impression that something is happening when an online system isn't functioning properly. In fact, that's not the case, said Kevin Counihan, executive director of the Connecticut exchange, Access Health CT.

Personnel reviewing paper applications need to manually type data from paper into the same Web-based marketplaces that consumers are using. Reviewers are entering through a different "portal" than one consumers use. But it's the same online system.

"If you don't have a working [online] system, paper doesn't do you any good. It's almost worse because there's this illusion that you've finished something," he said. "When in fact, it's just getting stacked up waiting for the system to work."

The paper process is clunky and prone to errors. And it provides "a substandard user experience," he said.

The same goes for the call centers. Applications taken over the phone still have to be entered online, either at the time of the phone call or sometime later.  And if the system isn't working, that can't be done. 

NEXT: Prosecutors in Cambodia Seeking Life in Prison For Khmer Rouge Leaders

Editor's Note: We invite comments and request that they be civil and on-topic. We do not moderate or assume any responsibility for comments, which are owned by the readers who post them. Comments do not represent the views of Reason.com or Reason Foundation. We reserve the right to delete any comment for any reason at any time. Report abuses.

  1. On the bright side, since Medicaid signups now take place through the portal…

    …Maybe new Medicaid signups will now crash through the floor.

    We might get some deficit reduction out of the ACA after all!

    1. Damn, that is some good news.

      My favorite sub-story is all the people who find out after signing up that they were eligible for Medicare all along. They needed health “care” so desperately that they never checked to see if they qualified for the socialized medicine plan that already in place.

      1. woodwork effect. and it’s going to destroy the budget projections, which were BS anyway.

    2. I want to say that something like half of the people who are eligible for Medicaid never bother to fill out the forms and sign up.

      That doesn’t exactly bode well for a program that is depending on millions of people to sign up for over priced insurance.

      1. Possibly they don’t sign up because they intuitively know that their health outcomes aren’t dependent on Medicaid. Oregon (I think) did a study comparing the outcomes of those on Medicaid to those that would qualify but hadn’t signed up. They found no health benefit to actually being enrolled in Medicaid.

        1. The benefits are low and the time it takes to sign up high. It is just not worth the hassle.

        2. The Oregeon study is great, because it was actually:

          1) State expands Medicaid, but had to hold a lottery for who got into it
          2) Random selection of people in Medicaid/not in it, from the same population
          3) People *felt* healthier as soon as they got notice they were on the Medicaid side, even before benefits started
          4) No actual health benefits, no statistically significant difference in the populations.

          1. Wow. They effectively ran a controlled experiment on the effectiveness of medicare. Of course progs immediately ignored it, because it is all about “science” for them.

          2. “3) People *felt* healthier as soon as they got notice they were on the Medicaid side, even before benefits started”

            How many self-reported signups do we have, not named Chad?

      2. If you sign up for Medicaid, you’re responsible for sending in qualifying documents, keeping social worker appointments, notifying Medicaid of changes in your status, etc…

        It’s much easier to just walk in to an ER with a deactivated Medicaid account (generally deactivated for failure to keep an appointment, failure to recertify eligibility, or previous incarceration) and make the hospital reactivate you on the spot when they provide service.

        Sure, that’s more work for the hospital, but fuck ’em, right?

        1. So we are paying to have a social worker for every medicaide recipient. And we wonder why the program costs a fortune and doesn’t seem to help anyone.

          That is amazing. And it shows how much the progs benefit from the media constantly lying for them. I will bet you 90% of the country has no idea there are social workers paid as a part of medicaide. And if they did know they would be a lot more skeptical about the program. But thanks to the media there is no danger of them realizing it.

      3. “‘

        John|10.21.13 @ 11:11AM|#

        I want to say that something like half of the people who are eligible for Medicaid never bother to fill out the forms and sign up.””

        Which is why we need to EXPAND IT!!/progderp

  2. I love the smell of fuckup in the morning. It smells like … FAILURE.

  3. Still can’t figure subsidiaries until the government releases the info Nov 1st.

    1. You mean subsidies, right?

  4. On Meet The Press, the lisping fetus E. J. Dionne gave the absurd argument that Obamacare is super-popular because 19,000,000 Americans tried to sign up. 19M? Bullshit. Utter fucking bullshit. The website might have had 19M hits, but that’s not discrete attempts to sign up, that’s a million dupes refreshing 19 times on average.

    1. 18 million of those were me.

    2. There is a law that requires them to have health insurance. And 19 million trying to sign up isn’t quite good enough. They have to actually sign up. And if the back log is 19 million, it seems pretty unlikely that they are going to get this done by March. So millions of people are going to be taxed for not buying insurance that was impossible for them to buy. That is one hell of a success all right.

      1. And if the back log is 19 million, it seems pretty unlikely that they are going to get this done by March.

        And to make matters worse, Feb 15th is the deadline to sign up if you don’t want to get penalized. Even if you manage to sign up between then and March 31st, you still get taxed.

        Obama’s caught right now–from a functional standpoint, he can’t stand by and pretend that these are just a few glitches when the problem is clearly architectural and will likely require a ground-up restructuring. But from a political standpoint any delay in the individual mandate validates the Rep insistence on such a delay prior to the shutdown.

        He can’t risk the latter because it has the potential to turn around and bite him and the Dems in the ass–“You refused to negotiate over something that you should have done in the first place?” The media will run interference for him, but he and Jarrett know damn well you can’t predict how public opinion will swing.

        So HHS will flail around for months trying to fix a fundamentally flawed website, and in the meantime all the young people they need to sign up will shrug and move on.

        1. And find their tax returns $95 less than they should have been. Meanwhile, without young people signing up, the insurance companies are going to raise rates and cut services to pretty much everyone else to stay afloat. If the young people won’t pony up and pay for this, the middle class, you have kids and things to lose and are risk adverse and thus are willing and able to pay for insurance even if it is over prices are going to be the ones paying for it.

          Never before has a political party gone directly after the middle class like this. They have done lots of things that hurt the middle class in the past. But they were always done in a way that the cost to the middle class was hidden and the result of a second order effect. It will be interesting to see how that plays out. The middle class vote and have largely either benefited or not been directly hurt by previous prog programs.

          1. I don’t think insurance companies can raise rates for 2014. They have to submit them annually and get approval from the respective states, and that happened over the summer for 2014. I’m wondering whether they cancel policies sold and/or stop selling policies though. If I were an insurance exec, I’d be thinking seriously about doing this to cut my losses.

            1. They already have rewritten their policies making them worse in order to comply with the law. What the companies can do is cut their services and payments to doctors and ration the hell out of care. They don’t need state permission to do that.

              The end result of Obamacare is going to be brutal rationing and a lot of sick people getting less or no care so that a few poor people can overuse the system.

            2. They should have no trouble breaking their interface to the exchange even if they don’t announce that they are stopping sales.

          2. Just a reminder John, anyone who has more than $9500 in taxable income will pay more than $95. My back-of-the-envelope calculations is about $17000 in income for single non-dependents will be the turnover point between $95 and 1% of income. So lots of “poor” people earning $10/hr are going to pay 1% of taxable income.

            1. Of course, it will still probably be 5-7% of income less than their costs through the exchanges, even with subsidies.

          3. And find their tax returns $95 less than they should have been.

            or 1% of taxable income, which for most people is in the hundreds.

        2. So HHS will flail around for months trying to fix a fundamentally flawed website, and in the meantime all the young people they need to sign up will shrug and move on.

          Then it’s time to blame the insurance companies for raising their rates.

          1. Then it’s time to blame the insurance companies for raising their rates.

            They will try that. But it won’t work. Everyone knows what caused this. Even the liberals I know who are getting fucked are not blaming their insurance companies. They will have a better chance blaming it on the tooth fairy. You guys all think that will work. It won’t. The progs spent the last five years claiming this thing was going to bend the cost curve and save money. Most people on the center and left thought this was going to lower their medical costs. No amount of “but the evil corporations!!” is going to deflect the blame here. If people hadn’t been expecting Obamacare to make things cheaper, they might be able to get away with blaming the insurance companies. But since they over sold Obamacare so much, there is no blaming anything but Obamacare when everyone’s insurance rates skyrocket.

            1. You guys all think that will work. It won’t.

              You need to quit repeating this bullshit.

              There is no groupthink on here. That strawman wont burn.

              1. Is the collective “you” beyond your comprehension Rob? Don’t worry Rob, all you have to do is say “I agree, that won’t work” and we will all know you are not part of the collective “you”.

                See, its not too hard.

                1. Is the collective “you” beyond your comprehension Rob?

                  No. When you put the word ALL on the end of it, it includes me.

                  I understand it clearly.

                  Remember rule 2:

                  No two libertarians agree on anything.

                  1. Go fuck yourself Rob. Really? If you have an opinion on this subject state it. If you don’t, stop wasting everyone’s time being pedantic. If you agree with me, that is nice to know. You can kiss my ring later.

                    1. Fuck you John.

                      Stop making universal fucking statements and I will stop being pedantic about universal statements.

                      I keep proving you wrong and you keep repeating your error.

                      I told you in the previous thread days ago that I agreed with you and you keep repeating the same bullshit over and over.

                      And this isnt the first time you’ve done this. You get an idea in your head and you refuse to let go of it.

              2. To be fair, I don’t think John is far off when he claims that many of us are pessimistic about how the Obamacare failure will play out politically.

                I certainly am still in the “They will blame the insurance companies and the media will jam that down the public’s throat until it’s regarded as a truism” camp. I hope I’m wrong and John’s right.

            2. You guys all think that will work.

              I don’t think that.

              It’s a bit different then getting someone to understand that printing money with abandon is a secret tax that funnels money from the middle class to the rich. People will see all on their own that before the law they had cheap, good insurance and that after the law they had expensive, shitty insurance.

        3. …”But from a political standpoint any delay in the individual mandate validates the Rep insistence on such a delay prior to the shutdown.”…
          I wish I were that optimistic.
          Prediction: The national media will blame it on the rethuglican shutdown.

          1. No they won’t. They are not doing that now. The things has been an unfolding disaster for three weeks now. And even the media isn’t blaming the shutdown. Hell, even Obama isn’t doing that. The administration is still clinging to the story this is just a minor glitch.

            The contractors have been paid. Work on the program didn’t stop during the shutdown. They are not going to blame the shutdown. They can’t.

        4. So, Ted Cruz used political jui-jitsu to get the donks to tie themselves to this sinking ship – and expose phant douche-bags.

          Not bad for furren teabagger.

          1. I think he did it by accident. From what I read Cruz is in the “but people will love this and vote Democrat forever” camp.

            1. IOW he’s another over credentialed moron.

        5. He did stand up and say that these are minor glitches. It sounds like he has no idea what’s happening.

    3. 19 million? Doesn’t that mean 300 million American didn’t even bother?

      Wow, ObamaCare must be wildly unpopular if 300 million people haven’t even bothered going to the website.

    4. Lisping Fetus is an awesome hipster band name.

    5. E.J Dionne like many of his background and generation doesn’t know the difference between hits and sign-ups.

      He’s an idjit.

      1. But he’s gone pretty far for a balding 5-year-old suffering from hydrocephalus.

    6. CBOs numbers were based on only 7M sign-ups for 2014, so if 19M actually sign up it’s going to blow the CBO cost estimates out of the water.

    7. “Obamacare is super-popular because 19,000,000 Americans tried to sign up. “


  5. He’s right that ObamaCare is more than a website.

    It’s about a certain idealism Obama has managed to attach to himself in the public’s imagination. We keep hoping that with the next failure du jour that the American people will finally catch on and abandon this freak, but when they’re living in a fantasy world, it’s hard to startle people with facts.

    1. Of course, it’s not just Obama. Intentions trump results all the time.
      The fact that central planning has not worked doesn’t deter people. No new insight here, just pointing out that if not Obama, it would be some other charlatan promising rainbows and unicorns.

      1. True, but Obama is the first to force people to purchase his snake oil.

        1. To be fair to our Dictator, he didn’t do it alone. He had the support of 50% of Congress, and allegedly 50% of the voting public. Not that that makes it any better. If anything, this is worse. This means your neighbor would like to chain you up for sitting orthogonal to his political leanings. Instead of one monster at the top, we are surrounded by the fuckers.

    2. Not only can they not sign up, but also the few who have have been uniformly shocked at the prices and the lousy nature of the policies available. This is one time where the Prog lying and reliance on media deception and low information voters is actually going to come back to bite them.

      The typical low interest, low information, American thought they were going to get cheap or free health insurance out of this. Once they find out they are getting expensive shitty insurance, they are not going to be happy. And no “well its your duty to buy health insurance” or “this just shows how we need single payer” Prog derp is going to make them any happier.

      1. I hoping that the internet can act as a good enough time capsule to remind people how much better it was in the very very very imperfect time before this shit sandwich was force fed to the unborn taxpayers (wait does that mean they shoved this up the collective vagina of ‘Murrica????————-Pron for Warty).

        1. I = I’m…can’t even get out of the gate before fucking up. It’s like I’m Obama or something.

        2. The vast majority of people in the country were happy with their insurance and with their health care. The only reason anyone agreed to this is because they thought they wouldn’t be paying for it. Your typical soft liberal Obama voting surburanite is all for helping the uninsured provided he doesn’t have to pay for it.

      2. it’s derp all the way down.

      3. “This is one time where the Prog lying and reliance on media deception and low information voters is actually going to come back to bite them.”

        Yeah, it was all theoretical in the past. Imagining about unicorns is great–right up until the moment they make you depend on one.

        1. Imagining about unicorns is great–right up until the moment they make you depend on one. that you’re going to be shoveling the shit from someone else’s pony.

  6. Obama might want to think twice about encouraging anyone to dig into all that Obamacare is.

  7. Just got notice that the premiums for my company are going up this year. Probably the first of many notices.

    That jug eared buffoon should be burned in effigy at every one of his softball, horseshit Q&A sessions where he trots out a bunch of schoolkids and old duffers who can’t possibly react violently about the real economic disaster behind his horrible disaster of signature legislation.

    How long til it crashes and/or burns or what possibility is there for another overturn or defeat?

    1. I don’t know a single person in the private sector who is not seeing their health insurance get more expensive and provide worse coverage starting next year. I would like to hear from someone whose plan isn’t changing for the worse because I haven’t met them. I have never seen a government program do so much immediate harm.

      1. Haven’t heard anything yet this year, but my insurance premiums got drastically worse last year. I suspect this was in anticipation of the “Affordable” “Care” Act, so maybe I’m already in the tornado of shit stirred up by this giant cold knife on the economy’s throat.

      2. I’m on my wife’s Kaiser plan. It was basically the same. but it think her employer is eating some higher costs. but they’re an outlier

      3. A couple years ago I switched to a plan with an HSA and a high deductible because the cost of the regular plan had doubled. Now the regular plan is triple what it was three years ago, and the plan I’ve got is being nixed because it isn’t good enough for the ACA.

        So I’ve got to figure out how to live on $600 less a month.

        1. I recommend gun running, pot dealing, or Bitcoin speculating.

        2. You are like the 10th person who has told me that exact story. Maybe it is all anecdotes and I just happen to know a few unlucky people but I doubt it.

          1. Nope, everyone with a cheap HSA is screwed.

            1. That’s a me too.

        3. If I could have gotten a plan like that via work, I would have and it’s been a slight disappointment to me that it isn’t an option. At least Obama has made sure that it’s not a work-specific annoyance anymore!

        4. @sarc

          I too am having my high deductible/catastrophic plan nixed because it doesn’t conform to OC standards. I’m kinda glad because what if I, as a young healthy guy, get pregnant in the next year?

          It’s such fucking horseshit. I keep hearing these chicken little types in the media claiming shit like, that if you have a high deductible plan and get cancer they won’t treat you unless you have a $5k deductible in cash on the ready. As I said, horseshit.

          1. Last year we used up the HSA and ended up with a couple thousand in bills. Surprisingly they allowed my kid into the hospital anyway. Crazy, isn’t it? And at the current rate of $100/month I should have the thing paid off sometime late next year. I must be nuts for preferring to pay $100/month to the hospital than another $600/month to an insurance company.

            1. What’s even crazier is that there are people out there dumb enough to believe that a hospital will pass up $1mil in insurance paid treatment because you don’t have $5k in cash on you. Or that a hospital might want to work with you to pay off the bill within your means.

          2. I’m having my unacceptable “high deductible” plan replaced with an acceptable plan with even higher deductibles!

      4. No change in my plan for this year, but I’m also in MA, where we already had all the crappy effects of this stuff from Romneycare.

        1. If Romney had genuinely cared about the United States govt, he would have stayed the fuck out of the Presidential race.

          Instead he had to deal with his daddy issues…

  8. he’s so goddamn great at everything, I don’t understand why he doesn’t just organize the code himself.

    1. Republican obstructionism. If they would just shut up and do as they are told, he could recode that whole thing in a long weekend.

      1. That and the lazy, unpatriotic young people who refuse to do the right thing and sign up for insurance. The Progs are going to go full “get off my lawn, WTF is wrong with the younger generation” old guy. All of those young, idealistic youth voters that the Progs loves so much when they were turning out for Obama are going to overnight become the new Goldstein. For the first time in my memory at least, the media will find youth culture really distasteful.

        1. Don’t trust anyone over 30.

      2. I heard the Republicans put in a bunch of go tos and globals.

  9. Consumer Reports: How to successfully register for health insurance on HealthCare.gov

    If all this is too much for you to absorb, follow our previous advice: Stay away from Healthcare.gov for at least another month if you can. Hopefully that will be long enough for its software vendors to clean up the mess they’ve made. The coverage available through the marketplaces won’t begin until Jan. 1, 2014, at the earliest, and you have until Dec. 15 to enroll if you need insurance that starts promptly.

    1. Follow Pro Libertate’s previous advice: Stay away from Healthcare.gov for at least another year if you can. Hopefully that will be long enough for you to correct this problem by voting in a veto-proof majority of anti-ACA Republicans or whatever in Nov. 2014.

      1. I thought your advice was to cut spending?

        And see Gravity, which I still haven’t gotten around to.

        1. I was just riffing on their weak suggestions. My advice centers around facilitating fornication through the judicious use of deep, deep reductions in federal outlays.

          1. Ah yes, I had forgotten about that other series of advice. It’s proving slightly more difficult to heed now that I’m single again.

            1. Don’t worry. Obama knows your suffering. Under the Fornication Protection and Affordable Servicing Act, you will receive free contraceptives and massively discounted prostitution services. The latter will be funded by a prostitution mandate, where each American will have to procure prostitution on a monthly basis or pay a penalty to the IRS.

              This is legal, because it’s a tax.

              1. Does a women who likes to have sex with me, but not for money, count as “real” prostitution for the purposes of the penitax?

                1. Look, if you want to violate the law by not paying her for her services, that’s your business, but under Obamawhore, it’s either married sex, mandated prostitution sex, or rape.

                  1. If I like my dumb skank, do I get to keep her?

                    1. Of course! Obama guarantees it. Personally.

                    2. My union provides me whores and Cadillacs to fuck the whores in. Will I be able to keep my Cadillac whore plan?

                    3. Of course. The president has learned from past mistakes and will fully placate and satiate his union friends. And friends of those friends.

    2. If you’re having trouble creating a user name and password, “don’t believe all the status and error messages that you see on the screen,” Simo said. “They may not always match reality.”

      Don’t believe anything it tells you.

      Awesome that Consumer Reports is doing an article a day on Obamacare. Have to figure they have a bunch of them already written, and topics already selected, but it has to get *grim* there when they try to pick other topics.

      1. If you log in to Healthcare.gov and get nothing but a blank page, what’s likely happening, Simo says, is that in your previous visits to Healthcare.gov, your browser got loaded up with lots of cookies, bits of data and code that are implanted for later retrieval and use by Healthcare.gov. The problem is that the cookie files are bigger than what the website can accept back (yes, a design error). Result: a blank page.

        quality programming there, Lou.

        1. I know this is horrible for the country. But there is nothing I personally can do about it. So, I am at least taking solace in watching this. These assholes have lived in a fantasy land of how great and wonderful the world would be if only they were in charge. Watching this thing implode and hearing the screams of horror and shock from these assholes is really priceless.

          1. Schadenfreude would be the source of my solace if I wasn’t feeling the misery of this failure as well as the assholes. Fuckers.

          2. My problem with enjoying it is that it involves real pain. Its why I wanted a balls out, no quarter approach from the GOP House so that this fucker never got implemented in the first place.

      2. I wonder how many of those supposed 19 million hits are caused by people reloading their browser repeatedly, because the damn website doesn’t work.

    3. Hopefully that will be long enough for its software vendors to clean up the mess they’ve made.


  10. Alt, alt text:
    ‘Hey, is this thing on?’

  11. their mistake was hiring a finite number of monkeys.

  12. When Epicac fails… try the new Website’ Government is Good


    A Day in Your Life =

    6:30 a.m. You are awakened by your clock radio. You know it is actually 6:30 because the National Institute of Standards and Technology keeps the official time. And you can listen to your favorite radio station only because the Federal Communications Commission brings organization and coherence to our vast telecommunications system….


    (coming soon in its own Marvel Comic mini-series = The Regulator confronts The Watcher, fines his floating space-dome for failing to meet as-yet-unwritten federal space-dome building codes, sends the EPA after Galactus for creating limitless Space-Waste, and finally catches up with the Silver Surfer to enforce the quadrillion intergalactic speeding-tickets accumulated over millennia…

    1. for fuck’s sake…
      authority cock ain’t gonna suck itself, this crazy bitch is deepthroating the shit out of the .gov

  13. My former business partner has pointed out that fixing things in short order to going to run into the Mythical Man Month problem.

    You cant fix it by throwing tons of IT professionals at the problem.

    Just like you cant get a baby in one month by getting 9 women pregnant.

    1. From wikipedia:

      Brooks’s law is a principle in software development which says that “adding manpower to a late software project makes it later”. It was coined by Fred Brooks in his 1975 book The Mythical Man-Month. The corollary of Brooks’s Law is that there is an incremental person who, when added to a project, makes it take more, not less time. Brooks adds that “Nine women can’t make a baby in one month”.

      1. According to Brooks himself, the law is an “outrageous oversimplification”, but it captures the general rule. Brooks points to two main factors that explain why it works this way:

        1. It takes some time for the people added to a project to become productive. Brooks calls this the “ramp up” time. Software projects are complex engineering endeavors, and new workers on the project must first become educated about the work that has preceded them; this education requires diverting resources already working on the project, temporarily diminishing their productivity while the new workers are not yet contributing meaningfully. Each new worker also needs to integrate with a team composed of multiple engineers who must educate the new worker in their area of expertise in the code base, day by day. In addition to reducing the contribution of experienced workers (because of the need to train), new workers may even have negative contributions ? for example, if they introduce bugs that move the project further from completion.

        2. Communication overheads increase as the number of people increases. The number of different communication channels increases rapidly with the number of people. Everyone working on the same task needs to keep in sync, so as more people are added they spend more time trying to find out what everyone else is doing.

    2. “”Just like you cant get a baby in one month by getting 9 women pregnant””

      Yes, but you still have to try it first *Just to be sure*. Know what i’m sayin’?

Please to post comments

Comments are closed.