The Deadline for Fixing Obamacare Is Saturday—Here's What to Watch For

By Garance Franke-Ruta
Brian Snyder/Reuters

The deadline on which Barack Obama has staked his presidency is upon us. The president has pledged that Healthcare.gov will be "working for the vast majority of Americans in a smooth, consistent way" by November 30—just four days away.

Already, a CNN/ORC International survey released Monday found that for the first time, a "clear majority" of Americans do not believe Obama is honest and trustworthy. Only four in 10 think he's able to manage the federal government.

Where things stand on Saturday will either reinforce those views or start to repair Americans' trust in their president. Either the site works as promised and Obama escapes from the quicksand of the last few months, or it's not fixed and the administration descends further, with each passing day making it less likely that his administration will ever get back on track.

So we'll find out on Saturday which it is, right? Well, no.

The most likely outcome is that there will be enough legitimate progress for the White House to say Healthcare.gov is (almost) fixed—and also enough problems for opponents to continue to lob criticisms. As such, the day is likely to come and go without much changing public opinion around the Affordable Care Act.

"The system will not work perfectly on December 1, but it will operate much better than it did in October," Julie Bataille, a spokeswoman for the Centers for Medicare and Medicaid Services, predicted in a call with reporters Monday.

One indication of how administration officials feel about the November 30 deadline is that CMS has no plans to hail the date or use it to tout the last month of repair achievements. "You should not anticipate that there will be any call over the weekend," Bataille told reporters, adding that administrators were "mindful that people would like to enjoy their holiday weekend."

The three big problems the Healthcare.gov rescue project set out to fix were "insufficient server capacity, debilitating load times and poorly written code that was prone to error messages," Federal Times noted in mid-November. These problems have by and large been fixed. Here's what we know about improvements to the site, and what to expect this weekend.

Evidence that Healthcare.gov will be (sort of) fixed:

  • A lower error rate. The rate—defined as screens that time out or that serve error messages to consumers—was reduced from 6 percent to less than 1 percent by mid-November.
  • Faster load times. Page load times were reduced from 8 seconds to less than 1 second, also by mid-November.
  • Increased server capacity. The site is now able to handle 20-30,000 people at a time. A push to double that to meet the original goal by Saturday is underway. "By the end of the month HealthCare.gov will be able to operate at the capacity that was originally intended: a rate of approximately 50,000 users on the site at the same time," Bataille said.
  • Hundreds of bugs fixed. There have been more than 300 "software improvements, bug fixes, and hardware upgrades." How many bugs remain is not clear, but CMS officials have emphasized over and over that the work will be ongoing, and that they expect the site to be better each week than it was the last. The bug-fixing does not end Saturday.
  • Easier for navigators. The New York Times reports that navigators working to sign consumers up for insurance in person have started having an easier time with the site, though far from a flawless one.
  • Less dramatic site outages. On the day HHS Secretary Kathleen Sebelius testified before a House committee, Healthcare.gov was down the entire time. Now it's only seeing "intermittent outages," as Bataille described them.

Evidence that it's not going to be fixed:

  • Ongoing insurance-form problems. CMS is still declining to specify the error rate for the forms sent to insurers letting them know who has purchased plans, known as "834s." So long as CMS isn't saying that the problem has been fixed—meaning an error rate of 1 percent or less—it's safe to assume it hasn't been.
  • Ongoing site outages. The site had outages both this week and last week. It turns out that fixing one part of the site can crash other parts of it, and CMS says it expects intermittent site outages to continue in the weeks ahead.
  • Capacity issues. At the height of interest in Healthcare.gov, as many as 250,000 people were on the site at once—five times more than the site is expected to be able to manage on November 30 under the best-case scenario.
  • The return of the dreaded waiting room. "There will be times that volume on HealthCare.gov will exceed ... demand, and we are preparing for that," Bataille said. "If we experience extraordinary demand, consumers may not be immediately able to complete the application. They will be queued, in order to ensure a smoother process, and will experience some wait time." The new online version of "your call will be answered in X minutes" is being touted as better than the last version, an "online waiting room" in which people had no idea how long they'd need to wait.
  • Novel glitches. New bugs will continue to be discovered and need fixing, especially since every new fix risks causing trouble downstream.
  • Many parts still not fully built. The small-business site, the Spanish-language site, and the system for actually transferring those federal subsidies to insurers have yet to come online, and that's not going to magically change on Saturday.

And so on December 1, the day will dawn, people will scrape the last of the stuffing into the microwave for lunch, and Healthcare.gov will be incrementally better than it is today. The improvement may even be "marked and noticeable" compared to October 1, as Obama predicted in mid-November. But as he said at the time, the Affordable Care Act is more than a website. His presidency will rise or fall on the package as a whole—and not just on what happens on Saturday.

This article available online at:

http://www.theatlantic.com/politics/archive/2013/11/the-deadline-for-fixing-obamacare-is-saturday-heres-what-to-watch-for/281832/