This is what an online health care exchange looks like:
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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The nonpartisan Congressional Budget Office has released its score of the House-passed American Health Care Act, which would replace Obamacare. According to the CBO, the bill would reduce the deficit by $119 billion by 2026, while leaving 14 million more Americans uninsured in 2018 than under current law, a number swelling to 23 million by 2026. Further, insurance premiums would balloon 20 percent in 2018 and five percent in 2019 before the waiver provision in the legislation would kick in. The provision allows states to apply for waivers and permit insurers to offer skimpier plans, which would likely entice younger and healthier individuals to buy health insurance while potentially pricing older and less healthy Americans out of insurance plans. House Republicans approved this bill in late April without waiting for the CBO score.
Republican Sen. Lindsey Graham said Wednesday during a Senate Appropriations subcommittee hearing that President Donald Trump's budget is little more than recycling bin material. "The budget proposed by the president doesn't have a snowball's chance in hell of passing," Graham said. Graham had previously opposed the budget over its nearly 30 percent cut to the budget of the State Department. The budget slashes spending on domestic priorities while increasing military spending.
Senate Majority Leader Mitch McConnell said Wednesday that he doesn't yet know the formula towards gaining passage of an Obamacare replacement in the Senate. "I don't know how we get to 50 (votes) at the moment. But that's the goal," McConnell said. The House passed an Obamacare replacement bill which has been widely seen as dead on arrival in the Senate, and McConnell has put together a working group of Republican Senators working towards creating health care legislation which could gain the support of at least 50 Senators.
"Former FBI Director Robert Mueller has been cleared by U.S. Department of Justice ethics experts to oversee an investigation into possible collusion between then-candidate Donald Trump's 2016 election campaign and Russia." Some had speculated that the White House would use "an ethics rule limiting government attorneys from investigating people their former law firm represented" to trip up Mueller's appointment. Jared Kushner is a client of Mueller's firm, WilmerHale. "Although Mueller has now been cleared by the Justice Department, the White House may still use his former law firm's connection to Manafort and Kushner to undermine the findings of his investigation, according to two sources close to the White House."