The Triple Rise and Fall

In the last couple of months, the Obama administration has experienced several ups and downs that have played with its popularity, the nation’s hopes, and the vision of having a fully insured America. While there have been several missteps, the success achieved cannot be undermined. Enrollments are up, the administration’s strategy is gaining steam and the first three months of 2014 should bring major improvements.

As 2013 has come to a close with the final quarter seeing a lot of activity, we would like to rewind the developments of the last three months and present the top 10 highlights of the Obamacare implementation in a two-part series.

1.  Obamacare Launch – The launch heard around the world. On October 1, 2013,  State-based exchanges and the Federally Facilitated Marketplace went live to a nation full of expectations. Unfortunately, the FFM launch was a universal nightmare. The site was riddled with bugs and errors that prevented anyone from enrolling without spending a good chunk of time dealing with site availability, processing time and then finally turning to call centers to enroll. Naturally, the administration took some hits for launching a marketplace that was not ready for mass usage. However, there were some bright spots. Some state-based exchanges performed well, such as Kentucky, New York and California.

2. Technical Failures and Bugs – A slew of technical bugs and system outages made the operation of the federal marketplace nearly impossible. The website was way too unstable initially, and most people couldn’t enroll. And for people who luckily made it through the gauntlet were not guaranteed actual enrollment, courtesy of the 834 transaction error.

3. A Slow Trickle of Enrollments – Amidst all the confusion, technical errors, opposition lobbying, and mass protests, the federal marketplace showed a slow trickle of enrollments. However, it did appear that America was ready to shop for health insurance online. The traffic statistics and movement over the website showed that people were spending time on the website, comparing options and setting up accounts. The health insurance benefits marketplaces were popular, the bugs weren’t. These enrollments, however were way off target at only a few hundred thousand as opposed to the initial aim of couple of millions.

4. Paper Applications – Although the onus was on the online marketplace to get enrollment numbers, paper applications turned out to be a real winner. Ironically, this was exactly the cumbersome and tedious process that the administration wanted to remove. Around the country, exchange navigators were utilizing paper applications for a number of their customers. Fortunately, the paper applications did not suffer from the new age problems of technical bugs and errors, thus assisting in increasing the enrollment numbers. Surprisingly, these paper applications worked out to be a star of the enrollment process, functioning as a reliable medium for exchange navigators and consumers.

5. Back-end problems – Probably the most painful of all of the site challenges, the back-end problems continued to make matters worse. These back-end issues ranged from 834 transaction errors to incorrect subsidy calculations and subsidy blockages. There have been cases where people haven’t been given the subsidies for which they are eligible, even though the system shows they are receiving a subsidized insurance plan. What made matters worse was a lack of technical understanding of the problems that were causing these back-end errors at the initial stage. However, this has been reduced with 10 percent of enrollees experiencing these problems. Ten percent is still too high of a number but improvements are being shown.

These top five highlights of Obamacare influenced the first couple of months of the ACA launch. Stay tuned to learn more about the highlights that had a major impact on the progress of ACA in the second half of November and throughout December in our second part of the series.

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