Problems With Obamacare Exchange Run Deeper Than Admitted

In mid-October, Health & Human Services chief Kathleen Sebelius said it would take “weeks” to fix the federal exchange. We said it would take months.

On October 30 she said we were assured the system would be running smoothly by November 30. Marilyn Tavenner, the official charged with the site’s development, said the same a week later.

But with that date fast approaching, the president in a Update: Dec. 3: The Obama administration says it has met its November 30 deadline, that 50,000 can now access the insurance exchange simultaneously and 800,000 daily. But the "back end" that connects to insurers is causing problems — something akin to what we describe in this article and have been speculating since the system's launch.

news conference just said, “The website will work much better on November 30th….I am confident that by the time we look back on this next year that people are going to say this is working well”. Speaking as the president, the Daily Show’s Jon Stewart said, “Let me be clear. When I said end of November, I did not say which November”.

The administration finally released figures: 106,185 had signed up, but only 26,794 via the federal exchange. Meanwhile, in China 11/11 has become a major shopping day for lonely single men who relate to all those 1s in the date. They splurge on electronic gear, cameras, and so on. Alibaba is China's Amazon. Its website reported successfully handling 402 million unique visitors on that single day. Obamacare claims it can now handle 25,000 at once.

No one has come forward with a technical explanation, and those testifying before Congress as well as the president are technically clueless, so we are left to speculate. But there are hints that our surmise of a few weeks ago may be correct. Why else would the state exchanges, created separately, also be having difficulties “often mirroring the issues plaguing the much larger federal exchange”, says The New York Times. Oregon says their system has problems determining whether people qualify for subsidies or Medicaid. Colorado’s experience is much the same. Others report error message as they wend their way through the system. None of these problems have to do with accessing the system, which was the original calamity; they are problems in the system’s innards.

All exchanges, federal and state, have in common the need to query federal databases — the IRS to corroborate declared income, other agencies to find out if an applicant is enrolled in other assistance programs, etc. — to determine whether the applicant is eligible for subsidies or for Medicaid or to buy on the exchange at all. Our guess, then an now, is that is where the deepest snafus lie. We said this shortly after the exchange debuted:

What undoubtedly makes the system frighteningly complex is not the logic paths that the code must follow to gather its information, but the connections it must make. When the code knows at a certain point to reach out to a particular federal database, it may have found that its target runs on a different and incompatible platform — a stumbling block that the industry calls “interoperability”. As the clock ticked, system designers had to coordinate with that agency or department to find a way into that database, and if lacking, wait for it to be developed. That external data fiefdom will have its own validating ID, password protocols and data format to work through, slowing access. Worst of all, the target system may itself not have been engineered to handle heavy loads; there may be bottlenecks all over the network making sign-up perennially slow and difficult to fix.

The need for such coordination, multiplied times the number of external contact points that could be needed for the universe of applicants, makes for a very tangled web. It is our guess that here lies the deeper problems that could take a very long time to straighten out, which is why we said months, not weeks.

The debacle was so avoidable, starting at the top. Saddled with a Congress that blocks everything he had hoped to do, the President hoped at least to claim the Affordable Care Act as his one crowning achievement. Yet he has more than once said “I was not informed directly” as he did say in the latest press conference. No one in the media, more concerned with preserving access to power, asks the personal question: “Mr. President, why hadn’t you tried to access the system?”. And done so months ago, and each month thereafter, and then weekly as the October 1 deadline grew near? This was his baby and he allowed it to miscarry through utter inattention as to its health. Yet he wasn’t even interested in whether it worked. He could have called for delays months ago, with minor consequences.

And they called George W. Bush the incurious president?