Visualizing the Obamacare Snafu

IT experts say the online marketplace failed due to flawed website architecture. Here’s a chart that puts that in perspective.

National Journal
Brian Resnick
Oct. 7, 2013, 7:53 a.m.

This is what an on­line health care ex­change looks like:

Func­tions

The fed­er­al health-ex­change mar­ket­place, ar­chi­tec­tur­ally, is a mess. That, at least, is the con­sensus of IT ex­perts ex­plain­ing to re­port­ers why so few people were able to sign up on­line for health in­sur­ance last week.

  • In the Wall Street Journ­al: “Such a hast­ily con­struc­ted web­site may not have been able to with­stand the on­line de­mand last week.”

  • On Re­u­ters: “Five out­side tech­no­logy ex­perts in­ter­viewed by Re­u­ters, however, say they be­lieve flaws in sys­tem ar­chi­tec­ture, not traffic alone, con­trib­uted to the prob­lems.”

  • On Wonkblog: “Most of the prob­lems like these are in the soft­ware. Hard­ware is the easy part. You can add more hard­ware and do it eas­ily. Soft­ware takes more time.”

Health and Hu­man Ser­vices of­fi­cials ad­mit­ted to The Wall Street Journ­al that the web­site has cod­ing is­sues, and that they “can do bet­ter and we are work­ing around the clock to do so.”

Na­tion­al Journ­al‘s Mar­got Sanger-Katz pre­dicted this out­come. In Ju­ly, she wrote about the lo­gist­ic­al dif­fi­culties of open­ing the ex­changes, es­pe­cially in cre­at­ing an in­form­a­tion hub that ties dis­par­ate streams of data from vari­ous gov­ern­ment agen­cies. The chart at the top of the page tries to sim­pli­fy what that looks like.

“In an ideal world,” she re­por­ted, “the ex­change web­sites need to be able to talk to sev­er­al fed­er­al agen­cies — IRS to veri­fy an ap­plic­ant’s in­come and em­ploy­ment status, the De­part­ment of Home­land Se­cur­ity to de­term­ine her cit­izen­ship, and the state gov­ern­ment to see if she qual­i­fies for Medi­caid, to name a few — all in real time.”

She con­tin­ued: “It is in­creas­ingly clear that the kind of Amazon.com, one-stop shop­ping that was once de­scribed … will not be avail­able in most parts of the coun­try.”

Well, Amazon it is not. But time might fix the on­line mar­ket­place. Speak­ing to The Switch, an IT ex­pert in­volved with its im­ple­ment­a­tion said the first rocky week may not be in­dic­at­ive of lar­ger Obama­care in­fra­struc­ture prob­lems. But if it is, prob­lems could con­tin­ue to trickle down, for in­stance, when people get the bills for their new in­sur­ance plans.

While the design com­plex­it­ies don’t ab­solve the ad­min­is­tra­tion from blame, they do put the ex­change prob­lem in some per­spect­ive. If and when health­care.gov is up and run­ning smoothly, it will be con­sidered an ac­com­plish­ment of in­form­a­tion tech­no­logy in gov­ern­ment, which tends to lag far be­hind the private sec­tor.

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