Is Obamacare turning the corner?

The Washington Post

By Ezra Klein and Evan Soltas, November 26, 2013

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A spin through HealthCare.Gov this morning went smoothly. The site loaded quickly. The process progressed easily. There were no error messages or endless hangs. I didn't complete the final step of purchasing insurance but, until then, the site worked -- or at least appeared to work -- exactly as intended.

My experience isn't rare. There are increasing reports that HealthCare.Gov is working better -- perhaps much better -- for consumers than it was a few short weeks ago. "Consumer advocates say it is becoming easier for people to sign up for coverage," report Sandhya Somashekhar and Amy Goldstein in the Washington Post. "The truth is, the system is getting stronger as it recovers from its disastrous launch," writes Sam Baker in the National Journal. Applying "was no problem at all, with no delays," says Paul Krugman.

Reports from inside the health care bureaucracy are also turning towards optimism. People who knew the Web site was going to be a mess on Oct. 1st are, for the first time, beginning to think HealthCare.Gov might work. Data backs them up: By mid-November, the pace of enrollment in the federal exchanges had doubled from what it was in October.

The Obama administration is certainly acting like they believe the site has turned the corner. Somashekhar and Goldstein report that they're "moving on to the outreach phase, which had taken a back seat as they grappled with the faulty Web site. Next week, the White House will host an insurance-oriented 'youth summit' aimed at people ages 18 to 35, an age group whose participation in the health-care law will be critical to its success."

The White House had held off on this kind of outreach because they believed it would simply drive people to a useless Web site. If they're restarting the outreach, it's because they believe, rightly or wrongly, that HealthCare.Gov will be able to convert the interest into enrollments.

The worry, at this point, is that the site is working in ways that are visible but broken in ways that are harder to see. The Obama administration won't answer direct questions on the percentage of "834s" -- the forms insurers need to sign people up for the correct policies at the correct prices -- that are coming through with errors. Robert Laszewski, a health-industry consultant with deep contacts among the insurers, told the National Journal the problem is getting better, but that his clients are still seeing a five percent error rate. That's still too high.

The systems that determine whether applicants are eligible for insurance are also improving. But inside the administration there's a recognition that it was error-ridden in the first six weeks of Obamacare -- and so the question is how to handle the many people who unknowingly received an eligibility determination that can't be trusted.

Still, it's clear that HealthCare.Gov is improving -- and, at this point, it's improving reasonably quickly. It won't work perfectly by the end of November but it might well work tolerably early in December. A political system that's become overwhelmingly oriented towards pessimism on Obamacare will have to adjust as the system's technological infrastructure improves.

The next challenge for the law, as the White House knows, will be the outreach challenge of signing up enough young-and-healthy people to balance out its risk pools. That's a challenge the White House spent quite a lot of time thinking about before this IT nightmare. The question is whether they still have enough time, and enough clout, to get it right.

http://www.washingtonpost.com/blogs/wonkblog/wp/2013/11/26/wonkbook-is-obamacare-turning-the-corner/?print=1