Government shuts down, health exchanges still very beta

Government shuts down, health exchanges still very beta

At midnight last night, the federal government shutdown following a childish budget battle that continues today. Also at midnight, health insurance exchanges created under federal health care reform came online for the October 1 open enrollment period. While the exchanges came online, their usability is pretty limited, errors defined attempts made by users this morning and many exchanges are offline. Health care reform is the central issue defining this budget debacle, as Republicans seek to roll it back at their own peril, and in the face of discrediting the full faith and credit of the country if this extends to October 17. Where these optics crafted by a novelist, or even Aaron Sorkin, they’d be considered ham handed and absurd, but here we are.

As CivSource reported, many states have plans in the works to roll out their health insurance exchanges with television and direct mail advertising campaigns in an effort to get individuals to sign up. Part of the cost savings mechanism embedded into the online marketplace idea is not only greater price transparency but also to get more healthy people into the insurance pool, thus driving rates down. Both of these goals may face a new hurdle, that has more to do with basic website development than Ted Cruz.

Users that went to healthcare.gov at midnight or this morning may have been able to get as far as their state’s exchange but likely not much more than that. Database errors, account security question errors, and page time outs have taken many state exchanges offline for hours at a time or until later this afternoon. For seasoned website developers, this range of errors typically defines a soft launch into alpha or beta testing not prime time. However, we may be discovering what a 50 state beta test looks like given the overall length of time state IT shops had to get online.

Approximately two years have passed since the first round of matched funding from the federal government was made available to states to start building exchanges. Readers of this website and others may remember that at that time, state legislatures were in a multi-state challenge to stop the bill which ultimately failed in the Supreme Court ruling last year. As such, few states got in on that first round, and by the second application deadline, more states had at least submitted plans to the Department of Health and Human Services, but in the clunky deployment cycle governments use for IT, submitting a plan is often the first year of a multi-year process, not the few months defined by the deployment deadline.

For states that opted out, the federal government was to provide a generic exchange which also coughed up many of the same errors. That exchange opened officially at 8 a.m. Eastern. So, people who tried to sign up before work may have run into errors simply because the site was still publishing. The 8 a.m. launch highlights another disconnect between government deployment and the new reality of being online – unlike the DMV, the internet is always open.

Government IT shops are still at work despite the shutdown, and will likely be working through errors for the remainder of the week. The next challenge will be to get back those users who tried to sign up early today and were unable to. Republicans are still pushing measures today that would put shutter the exchanges for another year, if not entirely. One question that seems to be missing from that gambit is what to do with users who are successful at signing up either later today, or this week. The Senate and President Obama have said they will not negotiate on these points or put off the law any further. Watch this space.

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