Progress, but still defects in health care website

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WASHINGTON -- As the Obama administration closes in on its self-imposed deadline to fix the troubled online health insurance marketplace, consumer advocates say it is becoming easier for people to sign up for coverage, but insurers warn that critical flaws continue to hinder participating health plans.

Administration officials have promised that will be working smoothly for most people by Saturday, and are citing evidence indicating progress toward that goal. Workers helping people sign up for coverage have noticed that the site has been running better over the past two weeks, with consumers experiencing shorter wait times and fewer crashes.

But the online system is still marred by defects that would create havoc for insurance companies if a significantly larger volume of applicants starts to sign up in coming weeks. Among them are the error-riddled reports that insurers are receiving about who has enrolled, a problem that could be disastrous if not fixed soon.

There is little room for error at this point. People seeking to take advantage of new consumer protections that kick in Jan. 1, or whose health insurance policies are being canceled at the end of the year, have until Dec. 23 to choose a plan and until Dec. 31 to pay their first month's premium. Uneasy Democrats have expressed a willingness to dismantle parts of the law if problems continue.

Administration officials contend that they are on track. By Saturday, they said, they will have doubled capacity to allow at least 800,000 consumer visits per day. They are also working on a new system that gives people alternate ways to sign up for coverage and get government subsidies, including going directly to insurers' corporate websites.

They are also moving on to the outreach phase, which had taken a back seat as they grappled with the faulty website. Next week , the White House will host an insurance-oriented "youth summit" aimed at people ages 18 to 35, an age group whose participation in the health care law will be critical to its success.

White House officials are to hold a meeting today with physicians, nurses and pharmacists about the health care law.

Administration officials have sought to tamp down expectations for the website, noting that improvements will be gradual in coming weeks and months. "The system will not work perfectly on Dec. 1, but it will operate much better than it did in October," Julie Bataille, a spokeswoman for the Centers for Medicare and Medicaid Services, the federal agency in charge of, told reporters Monday.

Even if it does work better for consumers, there are still problems -- particularly scrambled reports insurers are getting about those who have signed up for coverage through Insurers say they are getting duplicate records and reports misstating family relationships, such as listing a child as a spouse.

In some cases, enrollment reports are disappearing. With these "orphan records," insurers would have no way of knowing whether a person is signed up unless a new customer happens to call with questions.

Until such errors stop, "you can't open the floodgates" to large numbers of website enrollees, said an insurance industry official who also asked not to be named to discuss private conversations with administration officials on how to fix the system.

The ripple effects of these flaws affect consumers because the coverage does not begin until customers make their first monthly insurance premium payments. And without accurate data about their new customers, insurers cannot send them correct bills.

Beyond the troubles with enrollment forms, which have been evident since the marketplace opened Oct. 1, insurers are anticipating problems if government and outside contractor IT workers cannot soon build other parts of the online system that are running behind schedule.

For instance, starting in mid-December, the government and each participating insurer is supposed to perform a monthly "reconciliation," to make sure that each side has the same list of new customers, the benefits chosen by consumers and government subsidies for which they qualify. But that feature of the online system has not been built, say people close to the industry and government officials.


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