Health Care
12:07 pm
Thu October 24, 2013

Obamacare Website Mess: Whose Fault Is It?

Transcript

MICHEL MARTIN, HOST:

I'm Michel Martin and this is TELL ME MORE from NPR News. Coming up, it's no secret that it's getting harder to move on up in this country, to achieve upward mobility that is. Last week, we asked whether the ability of Americans to literally move to different parts of the country is playing a role in this. We heard from so many listeners about this that we decided to dig into the story a bit more, and we'll have that in just a few minutes.

But first, we want to talk about something else that seems stalled this month. That's the government's health exchange rollout. Health Secretary Kathleen Sebelius is feeling the heat after a rocky start to the online exchanges. Here she is speaking to CNN earlier this week.

(SOUNDBITE OF INTERVIEW)

KATHLEEN SEBELIUS: We're not at all satisfied with the workings of the website. We want it to be smooth and easy and let consumers compare plans and choose a plan that's good for themselves and their family, and that's what I'm focused on.

MARTIN: The government says that more than 20 million people have visited the website healthcare.gov so far. Now some have been able to sign up for new health insurance, but many were greeted with slow connections, pages of gibberish, even blank screens. For more on all this and what this could mean, we've called, once again, on Mary Agnes Carey. She's a senior correspondent at Kaiser Health News. That's a news service. It is not affiliated with Kaiser Permanente. Welcome back. Thanks so much for joining us.

MARY ANGES CAREY: Thanks for having me.

MARTIN: So I just want to start with some news that we got yesterday. The White House offered some new guidance about when people need to sign up. What is the news and is this significant?

CAREY: Yes. You have an additional six weeks to sign up for healthcare coverage without facing a penalty. The enrollment period has been through March 31 - and remains through March 31 - and you had a grace period of about 90 days before you faced a penalty. But in order to satisfy that March 31 coverage requirement previously, you would have had to sign up with an insurer by February 15 because most coverage starts on the first of the month. Now the administration's saying you can enroll through March 31 and not face a penalty.

MARTIN: So let's go back to the main problems here. Is this a - I know that you're not an IT expert. You're an expert on sort of the policy here, but what's the main issue? I understand that they've been digging at this for a couple of days now. Is this just that the system just overloaded? What's the problem?

CAREY: It seems to be a variety of things. One decision that was made shortly before the rollout of healthcare.gov was their requirement that individuals create an account before they could see rates. That was credited with lots of the bottleneck of the problems of all the things you mentioned with the healthcare website. Now they've created a work-around where you can go and look at rates and don't have to necessarily create an account.

Some experts say it's volume, some experts say it's the problem with all these different insurers trying to communicate with the federal government website, and something called the data hub that has to verify who you are, how much money you make, are you in the country lawfully and so on. But nonetheless, the administration has come under tremendous criticism from Republicans and some Democrats about the fact that healthcare.gov is not working as envisioned.

MARTIN: Well, I have to give you some examples of this. I'm sure you've been hearing from people. Now we've been talking, as you know, all along with people around the country really for, actually I would say for years now, since the policy's been discussed, to talk to people about what their experience has been with health insurance and why they think they need it and why it's important. And we've been checking back with them to see what their experiences have been. Now Pamela from Indiana tells us she has multiple sclerosis. She says she pays $18,000 for her own health plan. She's got a big deductible as well. She's waiting for the exchanges with the hope that they would provide a more affordable option. And this is what she told us happened to her.

PAMELA: Well, I have tried every day. I get the login screen and then I go, you know, to the authentication screen, which comes up as a big, white blank screen. And it doesn't matter what time of the day or the night I have tried it, 'cause I have been up in the middle of the night trying it. And it still doesn't work. So it's extremely disappointing to me that we get this far and then we can't get a site that works.

MARTIN: Are there any human beings available to help you with this issue? I mean, if, you know, there are certain major banks that you can call up in the middle of the night and some human will answer the phone...

CAREY: Yes, that's...

MARTIN: ...Will a human answer the phone?

CAREY: That is one of the things the administration's been emphasizing. There is an 800 number - it's (800) 318-2596. That's the number that you can call to talk to someone. They had also previously had problems with that. But now they say those wait times have been reduced significantly. That's one option. Also, you can apply through paper - to send a paper application in. That's one way to do it. Another thing is to think about - is there an agent, insurance agent, insurance broker, who you know or trust. Also, the law created navigators and assisters. You can find those on the website. That part of the website works, I've checked it. You type in your ZIP code, they tell you the nearest navigator or assister who could help you. So there are other options.

MARTIN: We heard from Rachel in North Carolina. She wrote in to say, I've attempted to get into the system probably about a dozen times, but I'm willing to wait it out until the system gets corrected. But I hope they start talking about moving some deadlines. And we just heard - heard about that. OK, now here's a question, which may or may not be a political question, which is - there are a number of states in which the leadership is very hostile to this program. Is it harder to get into the system in those states? We understand that this is kind of a global kind of website problem, but are you more or less likely to get any help in those states where the governors or the public officials are not fans of program?

CAREY: If they're hostile to the program, they're probably not running the exchange, which means you're going through healthcare.gov - that means the federal government's running it in those sites. So that remains - that problem would happen whether an administration was friendly or not friendly to it.

MARTIN: If you're just joining us, we're talking about the roll-out of the government's online healthcare exchanges with Mary Agnes Carey of Kaiser Health News. What about the other side of it? If you're in a - in a state where the political leadership is friendly to it, or is amenable to it, in support of it - are you having an easier time? I mean, we understand that, you know, Maryland, for example, that there was still difficulties there and the political leadership there is very supportive of the program.

CAREY: Right. The problems - the glitches, if you will - have occurred also in some of the state-run exchanges, and these are in states where the leadership has embraced creating its own exchange, but they tend to have most of these places - tend to have fixed them. The problems were smaller. Of course, the volume is much smaller than the federal government website. One thing to remember here is the federal government is running the exchanges either totally or in partnership with states in 36 states. It's about 14 states in the District of Columbia running their own exchanges, but they tend to - with a smaller volume, you can tend to get in there and fix those problems faster.

MARTIN: Again, sort of talking a little bit about the politics, there is a growing group on the hill, mainly Republicans, calling for Health Secretary Kathleen Sibelius to resign or to be fired because of this botched rollout. But then, there are supporters of the law who say, well, it's actually the Republicans' fault because they stripped out as much they could strip out. They stripped out money for marketing the program. They stripped out as much as they could strip out. And that that has actually hampered the rollout of the program. Do you have a sense from your own reporting of which of those things is true?

CAREY: It seems to be a combination of things. Obviously, the House of Representatives has voted 40 times - over 40 times - to defund all or part of the health care law. So they're no fans of it, for sure. When the administration asked for additional funding for the rollout, Republicans in the House blocked that. But it's also - you've got to remember, there are some Democrats that have also been critical of the delays. They want an extension of the timeframe for the individual mandate. So the criticism, if you will, is growing a bit. It's far more for Republicans than Democrats. Henry Waxman, who's a Democrat of California, was saying today at a hearing on the hill that most of the law has worked well, but this is a major problem that's getting attention. So it is getting some attention from both parties.

MARTIN: But is the issue here - you know, I'm thinking about a major retailer whose website crashed because a product that they were trying to rollout was so popular that the website crashed. They were - and we don't need to sort of say who. But it was a kind of a lower-priced line of a very expensive kind of a designer - Italian sort of designer. And the website crashed because people were so excited about it. Nobody said, oh, you know what? You shouldn't sell that. It's too popular. You know, so is the issue here that the law is just too complicated and that the administration - the administration of it - the implementation of it can't be fixed? Or is this really a technical meltdown or just a failure of skill?

CAREY: That's probably in the eye of the analyst. But again, thank you for saying at the top of this I'm not an IT expert. But as I understand it, you have a lot of contractors working on the site. You have a lot of insurance companies that are offering coverage. They're all trying to talk to the federal government, including systems within the federal government like Medicare system or the Medicaid system that may be a different computer operating system than healthcare.gov. Now should they have known this all along? Should they have prepared for it? Does all this - do all these - the traffic and the problems that have been exposed, will it lead them to fix them quickly? That's what we don't know.

MARTIN: So what is the administration doing to fix this, because clearly they now understand that they have a lot at stake here?

CAREY: Right. They're bringing in - they say they're bringing in top tech experts. They haven't necessarily said who that is at this point. They're going to provide daily updates - the first one starts today - on the technical problems and how they want to fix it. President Obama has made it very clear he's upset about it, and he kind of joked recently that the fact that he's paying so much attention will guarantee that it gets fixed. So the key will be who are the experts they bring in, what are the problems, how quickly can they fix them and what do consumers do?

Some of the people that have notified - your program have talked about - I'm really frustrated, and I'm going to wait. Will people come back? Will they try again? How long will they wait? There seems to be a fairly narrow window of time that the administration has to get on this and fix it before people simply say, you know, I'm just frustrated. I'm not going to try again. But those are a lot of unknowns. And again, with this extension through March 31 - you can apply without a penalty - that gives the administration a little more breathing room to get in there and fix the problems and get consumers on board.

MARTIN: Now we only have about a minute and a half left. But going back to the politics of it, on the one hand, you can see where conservatives are saying that this is exactly why the government should not be running a program like this because they simply do not have the capacity to run a program this large and this complicated with this many moving parts. On the other hand, you have progressives who are now saying that this is exactly why there needs to be a single-payer system because this is just too complicated. You have too many private entities who are all trying to kind of work together. This is why it needs to be a more unified system under the authority of one central person the way it works in a number of other advanced, you know, economies like ours, mainly in Europe and also sort of in Canada. Do you have any sense of which - from a political standpoint - which of those two points of view has more steam or energy right now, if either?

CAREY: I think that things are more focused on the political reality, which is the Affordable Care Act is the law of the land. It is out there now. It's open for enrollment. The administration's trying to get 7 million people to enroll in 2014. And they're very, very focused on trying to do that. So whether or not they can - whether or not this is a political liability, whether or not it hurts Democrats in the upcoming midterms, in the presidential in 2016 is unclear. But that's kind of where the politics lie, I think.

MARTIN: Mary Agnes Carey is a senior correspondent at Kaiser Health News. I want to emphasize once again she is not affiliated with the insurance company - the health company Kaiser Permanente. She was kind enough to join us once again in our Washington, D.C. studios where she's been joining us to help us understand as much as she can about the Affordable Care Act. Thank you so much for joining us, Mary Agnes.

CAREY: Thanks. Thank you. Transcript provided by NPR, Copyright NPR.