Skip to main content

Obamacare a disaster that needs fixing

By Aaron Carroll, Special to CNN
updated 10:26 AM EDT, Tue October 22, 2013
STORY HIGHLIGHTS
  • Aaron Carroll: Obamacare rollout has been a disaster; there's no excuse for it
  • He says problems at front end of process make it hard to get even through first step
  • He says insurance firms getting garbled date; administration calling in IT experts
  • Carroll: Obamacare needed, but these first days have created problems political and real

Editor's note: Aaron E. Carroll is a professor of pediatrics at the Indiana University School of Medicine and the director of its Center for Health Policy and Professionalism Research. He has supported a single-payer health system during the reform debate. He blogs about health policy at The Incidental Economist and tweets at @aaronecarroll.

(CNN) -- The rollout of the federal Obamacare website has been a disaster, full stop. There can be no excuses, nor will I be making any. It's been clear for years what needed to be done, and failing was not an option. The exchanges, and the website that allowed access to them, had to work, and they just do not.

I wrote a week or two ago that the initial problems with the HealthCare.gov website appeared to be because of volume issues. That could be spun as either a positive or negative thing. But it now seems that the surge was not the cause of the malfunctions. After the first weekend, when the administration added additional capacity to the servers, the issues didn't go away.

What are they? I wish I could say for sure. But some good reports have come out that detail just a few of the problems.

Have you had trouble signing up? Tell us your experience

The first appears to be that the administration decided that people would need to provide a significant amount of personal detail to look at coverage options. I can attest to this first-hand. I have insurance through my work, so I don't need exchange coverage, but I was still interested in looking at what was available.

Obamacare's website woes
Sullivan: Obama should have apologized
Mystery surrounds the 'Obamacare Girl'
Aaron Carroll
Aaron Carroll

I had to provide a lot of information, about my job and family, before I could do so. It's possible that this was because administrators wanted to be able to provide subsidy information to people with the premium costs, so as to soften the blow of how expensive insurance could be, but no one knows for sure. Regardless, this complicated things significantly.

But that's just the front end. The back end is also a real problem.

Insurance companies are reporting that the data they are receiving from the HealthCare.gov website is garbled. This means that automatic processing of the insurance plans being ordered is impossible.

Oddly enough, the problems on the front end are actually helping here. So few orders are actually making it through that insurance companies are able to sort through the bad data by hand to complete enrollment. But if things improve on the front end, then there's no way these companies can do millions of applications without good data.

The administration is bragging that upwards of half a million applications have started. Shockingly few of them have been completed, though.

The front end has a number of steps, including submitting your information, assessing for eligibility and then shopping for insurance. The number being cited by the administration refers only to people who have completed the first step.

Obama: No sugarcoating website issues
Obama details website workarounds
Obamacare: 'The product is good'

There are people who believe that government can never do things as well as the private sector. I'm not one of those people. But in this specific instance, those people have a point.

Evidently, those in charge of the rollout of the exchange website were unprepared. They didn't have the necessary experience to manage the more than 50 different contractors producing software independently that would eventually need to function together as a whole. This is incredibly technical work, and it's not clear that government was in a good position to direct things here.

It appears that the Obama administration has learned its lesson.

Administration officials are now calling in "more computer experts" to try and fix the problem. But this may be too little, too late. Some are saying that even if the administration pours in massive resources, the problems may not be fixed by December 15, the deadline for when insurance needs to be bought for it to be covering people on January 1.

Even if the administration can get this done within a month, some in the insurance industry are concerned that these issues may act as a filter to dissuade healthy people from getting insurance. If it's really, really hard to complete an application, then only truly ill people may have the perseverance to do so.

That could lead to problems in the pool of people signing up for insurance. The administration needs healthy people to buy insurance, too, for the exchanges to function optimally

If we were talking about a company having mismanaged things so badly, you could be sure that heads would roll. Many would be fired, and there would be a change in management. But that may not be possible here.

Were Health and Human Services Secretary Kathleen Sebelius to go, President Barack Obama couldn't get someone else vetted and through the Senate nomination process in an expedient manner. He's likely stuck with his current team, or no team at all.

That doesn't mean Obamacare will fail. It's still possible that this could all be fixed. It's also possible that should significant issues continue, timelines might be adjusted to accommodate implementation issues. But these will cause problems political and real in nature.

Continued failures in the exchange rollout give the President's opponents fuel to attack him and his health care reform. More importantly, they prevent people who really do need insurance, and the care it allows, from getting what they need.

Follow us on Twitter @CNNOpinion.

Join us on Facebook/CNNOpinion.

The opinions expressed in this commentary are solely those of Aaron Carroll.

ADVERTISEMENT
Part of complete coverage on
updated 8:35 AM EDT, Mon July 21, 2014
Frida Ghitis: Anger over MH17 is growing against pro-Russia separatists. It's time for the Dutch government to lead, she writes
updated 8:27 AM EDT, Mon July 21, 2014
Julian Zelizer says President Obama called inequality the "defining challenge" of our time but hasn't followed through.
updated 7:57 AM EDT, Mon July 21, 2014
Gene Seymour says the 'Rockford Files' actor worked the persona of the principled coward, charming audiences on big and small screen for generations
updated 10:17 AM EDT, Mon July 21, 2014
Daniel Treisman says that when the Russian leader tied his fate to the Ukraine separatists, he set the stage for his current risky predicament
updated 12:42 PM EDT, Fri July 18, 2014
Andrew Kuchins says urgent diplomacy -- not sanctions -- is needed to de-escalate the conflict in Ukraine that helped lead to the downing of an airliner there.
updated 9:50 PM EDT, Fri July 18, 2014
Jim Hall and Peter Goelz say there should be an immediate and thorough investigation into what happened to MH17.
updated 11:07 AM EDT, Fri July 18, 2014
Pilot Bill Palmer says main defense commercial jets have against missiles is to avoid flying over conflict areas.
updated 1:55 PM EDT, Sun July 20, 2014
Valerie Jarrett says that working women should not be discriminated against because they are pregnant.
updated 3:53 PM EDT, Mon July 21, 2014
David Wheeler says the next time you get a difficult customer representative, think about recording the call.
updated 3:33 PM EDT, Fri July 18, 2014
Newt Gingrich says the more dangerous the world becomes the more Obama hides in a fantasy world.
updated 6:11 AM EDT, Fri July 18, 2014
Michael Desch: It's hard to see why anyone, including Russia and its local allies, would have intentionally targeted the Malaysian Airlines flight
updated 3:14 PM EDT, Thu July 17, 2014
LZ Granderson says we must remember our visceral horror at the news of children killed in an airstrike on a Gaza beach next time our politicians talk of war
updated 8:06 AM EDT, Thu July 17, 2014
Sally Kohn says now the House GOP wants to sue Obama for not implementing a law fast enough, a law they voted down 50 times, all reason has left the room.
updated 8:14 AM EDT, Thu July 17, 2014
A street sign for Wall Street
Sens. Elizabeth Warren, John McCain and others want to scale back the "too big to fail" banks that put us at risk of another financial collapse.
updated 4:16 PM EDT, Thu July 17, 2014
Newt Gingrich writes an open letter to Robert McDonald, the nominee to head the Veterans Administration.
updated 12:01 PM EDT, Fri July 18, 2014
Paul Begala says Dick Cheney has caused an inordinate amount of damage yet continues in a relentless effort to revise the history of his failures.
updated 10:04 AM EDT, Fri July 18, 2014
Kids who takes cell phones to bed are not sleeping, says Mel Robbins. Make them park their phones with the parents at night.
updated 1:29 PM EDT, Thu July 17, 2014
Buzz Aldrin looked at planet Earth as he stood on talcum-like lunar dust 45 years ago. He thinks the next frontier should be Mars.
updated 2:04 PM EDT, Wed July 16, 2014
Mark Zeller never thought my Afghan translator would save his life by killing two Taliban fighters who were about to kill him. The Taliban retaliated by placing him on the top of its kill list.
updated 11:18 AM EDT, Thu July 17, 2014
Jeff Yang says an all-white cast of Asian characters in cartoonish costumes is racially offensive.
updated 9:24 PM EDT, Wed July 16, 2014
Gary Ginsberg says the late John F. Kennedy Jr.'s reaction to an event in 1995 summed up his character
updated 12:41 PM EDT, Wed July 16, 2014
Meg Urry says most falling space debris lands on the planet harmlessly and with no witnesses.
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT