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December was, without a doubt, the most positive month for the troubled heathcare.gov and Obamacare in general. As compared to October and November, December saw favorable momentum toward the Affordable Care Act (ACA), aka Obamacare.

From a neutral perspective, there were three major developments that changed the public’s opinion – improved website, relief for canceled policies, and an extension on enrollment period. Let’s dissect these developments in detail.

1) Website Improvements and Technical Fixes – One of the biggest fiascos of the Obamacare implementation was a staggeringly bad rollout of healthcare.gov. What should have been the cornerstone of the entire Obamacare effort turned out to be the weakest link in the chain, riddled with errors, back-end problems, consistent, and at times, constant downtime and a poor user experience. In October and November, fixing the site was the primary aim of the Obama administration. By the end of October, the results of the famous ‘tech surge’ were not good. The website was improving, but it was still too weak to hold the load of interested parties. November saw some improvements in the performance, but the enrollments were still lagging. December saw major results of this tech surge, leading to higher enrollments and a smoother user experience. The site logged over a million visits, which translated into better enrollment numbers for the administration. The proof of the successful effort was the ability of this improved marketplace to sustain the load of newly interested Americans. On December 23, the penultimate day for enrollments, the marketplace handled about 2 million visitors. The enrollment numbers for the month of December were 975,000. To give this some perspective, roughly 137,000 signed up in October and November combined.

2) Canceled Policy Mandate – Amidst the whole mess of poorly performing online marketplaces, the canceled policies created a lot of headaches for many people. Basically, these canceled policies were notices issued by health plans to people with plans that would not be compliant with ACA in 2014 and therefore, as of January 1, 2014 would be canceled. This cancelation was pretty much a slap in the face of the American public as President Obama declared multiple times “if you like your policy, you can keep it.” An initial attempt to allow people to keep canceled policies was met with resistance from health payors and state agencies. In December, the administration stated  that anyone with a canceled health policy could ignore the individual mandate without worrying about tax penalties, and purchase a Catastrophic Plan with a high deductible. This move has relieved people in this situation and allows them enough time to find a health plan that suits them without worrying about the tax penalties in 2014.

3) Enrollment Extension – The enrollment deadline has been extended from December 15 to December 23, 2013. But it shifted one more time when it was pushed to December 24, 2013 to account  for people who were facing any last minute hurdles in getting the insurance they needed. On Christmas Eve, the administration announced a  “special enrollment period,” which will allow for an enrollment extension on a case-by-case review.

Through all these developments and others, the Obama administration made a big impact on the outcome of the health reform in December. As the first quarter of 2014 progresses, there is going to be a lot more activity which will be interesting to watch. The rollercoaster ride isn’t over yet.

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