Politics

Almost Nothing About Obamacare's Federal Exchange System Works

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Whitehouse.gov

Almost nothing about Obamacare's federal exchange system is working. It's almost impressive how comprehensive the federal system's technical failures are. Just about every part of the system that has been reported on seems to have problems, many of which are quite serious.

  • The account creation system necessary to even start the process of using the exchanges basically didn't work at all when the site launched. Administrators appear to have improved this functionality since launch, but Jeff Zients, who is overseeing the troubleshooting project, says it's still not working for about 10 percent of users.
  • The vast majority of people who can create accounts still can't complete the enrollment process. According to Zients, only about 30 percent of users are able to get through the system.
  • Anyone who successfully logs in gets to the point of shopping for specific plans on the exchanges may see prices displayed incorrectly, as the system has had problems calculating eligibility for public subsidies for insurance. (Subsidy calculation has also proven difficult for several state-run exchanges.) 
  • Anyone who decides to browse for plans without logging in first is also liable to see incorrect prices. The "shop and browse" feature installed to mitigate problems caused by the broken account system often displays the wrong prices, because it lumps together premiums for anyone who is 49 and under, and anyone who is 50 or older. Everyone under 50 is provided prices for a 27-year-old, even though prices for people in their 40s might be quite a bit higher.
  • Several exchanges are having trouble accurately displaying provider and network information for the plans on offer. This is not a big problem for the federal exchanges yet because they are still so dysfunctional, but if the state-run exchanges are any indication, it could eventually create headaches for people who want to know which doctors and hospitals are attached to which plans. 
  • Even with just a trickle of individuals making it all the way through the process, insurers are not getting correct enrollment information from the exchanges. As a result, many are reviewing applications manually. If larger numbers of applications ever make it through the system, that won't be sustainable. And there may be longer term problems as well: If enrollment data is transmitted incorrectly, people could eventually find out they didn't enroll in the plan they selected, or didn't actually enroll at all.
  • The small business exchanges aren't fully up and running either. Enrollment in those exchanges, already delayed once, was delayed again, the administration announced this week.
  • The federal exchanges were supposed to seamlessly interface with multiple state Medicaid programs, but that functionality, originally delayed until November 1, was also further delayed last week. And at this point, federal officials won't say when they expect that functionality will be complete.
  • Security testing for the federal exchange system was never completed. An internal memo warned that too little testing "exposed a level of uncertainty that can be deemed as a high risk." (The temporary security authorization under which the site is operating also appears to violate the administration's own web security guidelines.)
  • The Spanish language version of the website has been delayed indefinitely.
  • The "data hub" that routes information between multiple databases has gone down on multiple occasions due to hosting facility outages.

It's a near-total failure. All the major segments of the system—the user end, the insurer end, the data-routing in the middle, the plan information on display, the connections with state-run legacy systems—are either problem-plagued or broken entirely.