Many will fail using health website

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WASHINGTON -- As many as 1 in 5 Americans who want health care plans through the new federal insurance marketplace may be unable to sign up online even if the Obama administration meets a Nov. 30 deadline for fixing the website, according to government and industry officials familiar with the project.

Under the administration's best-case scenario, many Americans will not succeed in purchasing insurance online, whether because their personal cases are too complicated or simply because the website remains defective, according to an internal target that administration officials have not made public.

The measure, which is the first concrete performance standard since the government began to design the system, was defined by a group of federal health officials and technical experts in late October and is now guiding the work of hundreds of government employees and contractors racing to try to repair the balky website.

The goal is that 80 percent of people going to HealthCare.gov should manage to enroll electronically, but that means many others will be unable to get in.

Whether the government meets the benchmark -- and whether the public regards it as adequate -- will be a central factor in President Barack Obama's efforts to increase support for the controversial health care law and lure customers to the federal insurance marketplace. It puts more pressure on the administration to fix technical problems that have made it difficult for people to sign up for coverage by other routes, including federally sponsored call centers and insurers themselves.

Administration officials acknowledge that until recently, they had no concrete definition for how well HealthCare.gov should work, but they say one would not have made sense before the site went live Oct. 1.

"We are very focused on measuring performance of the site now and moving forward and making sure we have ways to demonstrate progress," said Julie Bataille, communications director for the Center for Medicare and Medicaid Services, a branch of the Department of Health and Human Services with responsibility for the insurance exchange. "That is a focus of the team that is in place now."

The internal 80 percent target is the basis of a promise that has become an administration mantra in recent weeks: HealthCare.gov will "work smoothly for the vast majority of users" by the end of November.

The catchphrase was coined by a former presidential management official, Jeffrey Zients, shortly after the White House assigned him to oversee the website's repairs, according to a government official with knowledge of the project who was granted anonymity to speak about matters that are not public.

To assess progress toward the goal, administration officials have developed two new measurements, appearing in reports generated each morning, that show how long consumers must wait for pages to load on HealthCare.gov and how often they get error messages, government and industry officials said.

The "vast majority" phrase has been invoked repeatedly by Mr. Obama, Mr. Zients and other administration officials, with little explanation of what it means. In a news conference Thursday, while apologizing for the health care law's rollout problems, Mr. Obama omitted the word "vast," saying that "the majority of people who use it will be able to see it operate the way it was supposed to."

Mr. Zients, however, revived the "vast majority" phrase in comments to reporters the next day, adding that "most users will be able to navigate the marketplace from account creation, through the application, all the way to enrollment."

But Mr. Zients also said that "new bugs and other glitches will surface" in December and beyond that and will need to be fixed. Even if the site works well, he said, "that doesn't mean that the site will be sufficient for 100 percent of users or consumers to use for enrollment."

The Washington Post reported last week that the federal exchange is unlikely to be working fully by the end of the month. The uncertainty over the site's future performance stems from the fact that it is currently malfunctioning when more than 20,000 to 30,000 people -- about half the intended capacity -- try to use it at the same time.

According to a government official familiar with the new target, the 20 percent who are unlikely to be able to enroll online are expected to fall into three groups: people whose family circumstances are so complicated that the website cannot determine their eligibility for subsidies to help pay for health plans; people uncomfortable buying insurance on a computer; and people who encounter technical problems on the website.



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