With the government shutdown over — for now, anyway — the Obama administration must address the stumbling start of its signature program. This is Week No. 4 of the Affordable Care Act's enrollment period, and the federal government's portal is still beset by technical troubles.
"There's no sugarcoating it," President Barack Obama said Monday. "The website is too slow; people have been getting stuck during the application process."
Obamacare, as its commonly known, isn't the first federal program to experience growing pains. An article on Friday's op-ed page described Medicare's messy start in 1965. Four decades later, the rollout of a prescription drug benefit, Medicare's Part D, was accompanied by its own problems. Today, Medicare is widely popular with its senior-citizen beneficiaries, and proposing cuts of any kind is politically risky.
None of that excuses the delays experienced by consumers seeking to purchase health insurance for themselves or their families using healthcare.gov, the website established by the U.S. Department of Health and Human Services.
Public frustration, not the antics of tea party Republicans in Congress and state capitals, is the biggest threat to the Affordable Care Act.
People have until mid-December to enroll for benefits for 2014, and Obama said the administration is relying on "some of the best IT talent in the country" to solve the start-up problems. One place he won't get much help is the states.
It was a different story in 2005 when privacy concerns and systems issues threatened to undercut Medicare Part D, the major health initiative of the George W. Bush administration. A Georgetown University/Robert Wood Johnson Foundation report describes how 37 states set up temporary programs to get people enrolled and ensure that benefits were delivered until the federal government resolved its problems.
With the Affordable Care Act, 34 states declined to set up their own health care marketplaces, leaving the federal exchange as the only access point for their residents — one of the factors pushing the website beyond its capacity.
States with their own exchanges haven't been immune to problems. California, for example, took down its list of health care providers because it had so many inaccuracies. But most problems have been resolved quickly in comparison to the enduring issues with the federal website.
The immediate task is clear: healthcare.gov must be upgraded quickly to meet consumer demand for insurance.
There's also the matter of accountability. Expect congressional committees to ask pointed questions of Health and Human Services Secretary Kathleen Sebelius and other administration officials. They shouldn't overlook CGI, the private company given a $93.7 million contract to set up the website. Reuters reported last week that the cost mushroomed as the demands on the federal government became clear, potentially reaching $292 million.
It took time, but Medicare solved its start-up problems and gained popularity. Obama is confident that his health program will, too — "We know that the demand is there. People are rushing to see what's there." But the clock is running, and fixes are needed quickly.