Obamacare-how caring?

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Some 106,185 people signed up for Obamacare in its first month of operation, a period marred by major technological problems with both the federal and state enrollment websites.

Troubled HealthCare.gov is unlikely to work fully by end of November, says an official with knowledge of the project. According to this source of information, software problems with the federal online health insurance marketplace, especially in handling high volumes, are proving so stubborn that the system is unlikely to work fully by the end of the month as the White House has promised. The insurance exchange is balking when more than 20,000 to 30,000 people attempt to use it at the same time – about half its intended capacity, said the official, who spoke on the condition of anonymity to disclose internal information. And CGI Federal, the main contractor that built the site, has succeeded in repairing only about six of every 10 of the defects it has addressed so far. Government workers and technical contractors racing to repair the Web site have concluded, the official said, that the only way for large numbers of Americans to enroll in the health-care plans soon is by using other means so that the online system isn’t overburdened.

This inside view of the halting nature of HealthCare.gov repairs is emerging as the insurance industry is working behind the scenes on contingency plans, in case the site continues to have problems. And it calls into question the repeated assurances by the White House and other top officials that the insurance exchange will work smoothly for the vast majority of Americans by Nov. 30. Speaking in Dallas a week ago, President Obama said that the “Web site is already better than it was at the beginning of October, and by the end of this month, we anticipate that it is going to be working the way it is supposed to, all right?” Julie Bataille, director of communications at the Centers for Medicare and Medicaid Services (CMS), which is part of the Department of Health and Human Services, said: “We are working 24/7 to make improvements so that by the end of the month the site is working smoothly for the vast majority of users.We are making progress, including fixes to reduce error rates and get the site moving faster. “The challenges we are addressing today,” she added, “are a snapshot of November 12th, not November 30th.” Meanwhile, pressure intensified Tuesday on the Obama administration to address the growing complaints of Americans whose individual insurance policies are being canceled because they do not comply with new government rules for coverage. The online magazine Ozy published a video interview with former president Bill Clinton saying that Obama must “honor the commitment” he made to Americans that they could keep their insurance – even if it requires a change in the law. Fewer than 27,000 Americans selected an insurance plan through the federal healthcare.gov site, which is handling enrollment for 36 states, according to figures released Wednesday by the Obama administration.

The site is still far from fully operational, leaving tech experts racing to get it working by month’s end, as the administration promised. The states running their own exchanges are responsible for the bulk of the sign-ups. Nearly 79,400 people have selected a plan through state-based exchanges, with California leading the way with nearly 35,400 selecting a plan. States have also been battling system errors, with Oregon having yet to accept online applications. Only 11 states reported sign-up figures Wednesday. These figures reflect people who have selected insurance plans through the exchanges, but not necessarily paid for them. Americans have until Dec. 15 to pay if they want coverage to begin on Jan. 1. Open enrollment lasts through March 31. Kansas Insurance Commissioner Sandy Praeger said she and her counterparts in other states have offered suggestions to the White House on how best to address the problem of canceled policies. The most obvious solution, she said, would be to allow customers to renew policies early to let them stay in effect until November 2014. But that would come with a trade-off, she said: Those people would not receive federal subsidies for which they might be eligible if they bought a plan on the exchange. She said that she and other insurance commissioners are trying to address consumers’ desire to use the federal exchange. “Honestly,” she said, “it’s just a big mess right now. .?.?. I don’t know what to tell people.” Debate over how to respond to Americans who are irate about losing their insurance is intensifying on Capitol Hill.

The House plans to vote this week on a bill introduced by Energy and Commerce Committee Chairman Fred Upton (R-Mich.) that would extend this year’s insurance plans for a year. On Tuesday, Sen. Dianne Feinstein (D-Calif.) said she is co-sponsoring a bill with Sen. Mary Landrieu (D-La.) that would require insurers to offer 2013 plans on the individual market indefinitely. The software defects that ware making the Web site unstable with too much volume mean that some people face frozen computer screens when they try to enter information – and then get timeout errors, said the official with knowledge of the project. Call centers have had problems, too. Within the network of 17 federally sponsored call locations staffed by more than 10,000 people, consumers are discovering that telephone representatives lack the authority to correct errors in online applications. And sometimes, consumers with more than routine questions are promised that specialists will call them back, but the calls never come. Insurance companies, which have been pressing the White House for greater ability to sign up customers directly, are stuck at the moment, unable to complete enrollments. That is because they must connect with the federal online system to determine whether customers’ incomes qualify them for tax credits to help pay for their insurance – a part of the system that does not work. According to the official, workers are trying to streamline the computer system so that it can handle outside queries from insurers and the call centers about whether people are eligible for subsidies. Technical workers are striving to have this part of the system working reliably within two to three weeks.In a telephone call with reporters earlier Tuesday, Bataille said that HHS is emailing about 275,000 consumers who have gotten stuck while trying to shop for and buy health plans. The e-mails encourage them to try again. Asked whether the Web site could handle all those consumers if they logged on at once, Bataille replied, “That’s why we are sending this series of e-mails in waves.” The CMS has said it has cut the waiting time for pages on the federal Web site from an average of eight seconds to one second and has reduced errors that have blocked consumers from 6 percent to 2 percent.

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