HealthCare.gov Works Better But Problems Lurk Below The Surface

The administration says Healthcare.gov is now working for the vast majority of users. And as evidence of that improvement, it said that 375,000 visitors used the site on Monday before noon. But that doesn't mean that people who enroll on the site will actually have the insurance coverage they signed up for by Jan. 1. The back end of the system — where the website provides customer and subsidy information to insurers —is still riddled by delays.

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ROBERT SIEGEL, HOST:

From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel. And we begin this hour with our weekly look at technology, All Tech Considered. The Obama administration's self-imposed deadline to fix HealthCare.gov has now passed and the White House says the site is working better. Users have apparently responded. The White House says that just today as of noon, 375,000 visitors had gone to the site.

Well, does that mean that it is fixed? NPR's Elise Hu joins us now. Elise it sounds like the answer the questions about whether the website is working is that it all depends on the meaning of working.

ELISE HU, BYLINE: That's right, Robert. It is much better than where they were at. The administration says the site is now accessible 90 percent of the time, but that's actually not great compared to the standards of major websites. Sites we know like Facebook and Google have uptimes of close to 100 percent. So it is a positive step, but the metrics released yesterday left a lot of open questions.

We still don't know how many people are hitting snags on the way to completing an application, what type of errors they're hitting and how much they're having to wait. Because of that explosive traffic you mentioned, page loads are stressed again today already and lots of consumers are reporting getting stuck in the online waiting room where they're asked to come back later.

SIEGEL: Now, the big question, of course, isn't just whether people can get to the website, but whether consumers are able to sign up for coverage.

HU: That's right. The administration numbers show that about eight out of ten consumers who are trying to enroll are actually making it all the way through to where they can click enroll. In October, that number was closer to 30 percent, so the experience is smoother overall for people who had tried and hit roadblocks earlier.

But we still don't know how the full enrollment picture looks. The administration isn't releasing its next batch of those enrollment figures until probably mid-December. And this actually brings up another issue, Robert, which is the insurance providers are relying on a part of the system you can't see to send them accurate and clear enrollment data. That's called the back end of the system and insurers said they were previously getting blank or duplicate forms, forms with missing information.

So when we talk about healthcare.gov, tech experts are really focused on how well that data transfer there on the back end is working. I talked with Jonathan Wu of the consumer finance site ValuePenguin. Here's what he had to say.

JONATHAN WU: That part is sort of invisible to the consumer. The analogy I would make is kind of the warehouse system that Amazon runs, right? You go and buy stuff on the website, but ultimately there's a system that tracks your packages, tells it where to be delivered and processes that entire piece. HealthCare.gov's got something similar, but what they're doing is kind of enrolling your insurance on the back end.

HU: So those eight out of ten Americans that can get through, that I mentioned earlier, even though they can click the enroll button, we don't know whether insurance providers are getting the information they need to start people's coverage.

SIEGEL: What do we know about how quickly that invisible part of the system is improving?

HU: We don't know much. The data we got on Sunday was all focused on wait times, outages in the front end of the system. The administration hasn't released metrics for the back end that would be helpful, for instance, the full transmission of enrollment data to insurance providers.

SIEGEL: But if the front end is actually working better now, that would mean that people are shopping, possibly purchasing insurance - presumably taxing the back end, no?

HU: That's actually the key concern as we head into these final weeks to get coverage that starts in January. There is an expected rush of enrollments coming and we're already seeing that happen today. But if the data that gets to insurers is incomplete, that means more humans, not computers will have to do the work of resolving it and the clock is ticking for folks who want to get covered.

SIEGEL: That's NPR's Elise Hu. Thank you, Elise.

HU: Thank you.

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