Obamacare’s Website Gets Its First Performance Metrics. Will They Be Enough?

For
the past few weeks, the Obama administration has been promising
that that the federal health insurance exchange portal run through
HealthCare.gov will work “smoothly” for the “vast majority” of
users by the end of the month. But the administration hasn’t
offered much detail about what that means.

For that, we
turn to The Washington Post, which explains that the
administration is focused internally on getting 80 percent of users
all the way through the enrollment process. In a detail that is
suggestive of the managerial failures that led to the disastrous
rollout of the exchanges, The Post also reports that the goal is
“the first concrete performance standard in the 31/2 years since
the government began to design the health exchange.” Prior to the
launch of the site, the administration had no internal definition
of what constituted a working site. And the contractors who built
the exchange system apparently did not have clear expectations
regarding their work either:

When HHS in 2011 invited contractors to bid on the chance to
build HealthCare.gov, the department’s “statement of work” did not
include requirements typical of many IT contracts in which
interested companies must spell out how the system would perform,
according to an industry representative close to the project, who
was granted anonymity in order to speak frankly. The agreement
that CGI
Federal, the company chosen as the main contractor, signed on
Sept. 30, 2011, also did not contain specific performance criteria,
success measures or response times.

Well, the site certainly behaved like one built without any
performance criteria.

The revelation of this metric leaves us with several big
questions. Is it achievable? And if so, how will we know whether it
has been achieved? An 80 percent success rate leaves room for just
enough failures that it will be hard to independently verify. And
given previous reports by the Post and others that the site is not
likely to improve enough to be working by the White House’s
end-of-month deadline, there’s reason to doubt that the goal can
actually be reached.

Even if it is achieved, will it be enough? The 80 percent target
is simply for users of the exchange to be able to get all the way
through the enrollment process. But it doesn’t say anything about
the accuracy of the enrollment or pricing data that is generated in
the process. That could be a big problem, given that the site has
been sending bad enrollment data to insurers and has also had
trouble with the subsidy calculator that determines premium prices
and subsidy levels.

Indeed, if the website becomes generally usable for those who
want to enroll but continues to generate bad enrollment and pricing
data, we could end up with large numbers of people who think they
are enrolled in one plan, at a particular price, but whose
enrollment information is never properly transmitted, resulting in
mass confusion once new coverage kicks in next year. Hitting this
particular goal, in other words, might not really fix anything, and
could make things even worse.