In it, but not of it. TPM DC

The Next 5 Fixes That Obamacare Needs

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AP Photo / Susan Walsh

Fix The Back-End Of HealthCare.gov

The fixes that the administration touted Sunday were largely focused on the consumer experience of the site. Those are important because that's how the average American, the people who the law needs to win over and enroll, interact with HealthCare.gov.

But the site's infrastructure seems still riddled with problems. The New York Times reported Monday that insurers were continuing to receive bad data or no data at all from the site. The Wall Street Journal reported that some states wanted to break out on their own rather than rely on the federal database that verifies information people enter on the federal and state sites. A federal official admitted last month that the website's payment functions and other back-end features still needed to be built.

These could be big problems if they persist, leaving people thinking they've enrolled in coverage when they haven't. As a spokesman for America's Health Insurance Plans, the industry's top lobbying group, told the Times: “Health plans can’t process enrollments they don’t receive."

Roll Out The Spanish-Language Version

As TPM reported last week, enrollment on CiudadoDeSalud.gov is expected to start at any time. That's a big step for the administration after some major Latino advocacy groups had started to express frustration with the delay. The rollout is significant for both practical and political reasons. With the former, Latinos make up a significant portion of the country's uninsured (the administration estimates that more than 10 million will qualify for financial help). On the latter, they are among the President's most dedicated demographic groups.

How easy that will be isn't clear. The administration is planning a soft launch, targeting some key advocacy groups to test the site and make sure it's working properly. The longer that lasts, the less amount of time will be available for an all-out enrollment push before the Dec. 23 deadline to enroll people in coverage that starts on Jan. 1, 2014.

Get The Small-Business Marketplace Ready For 2015

Even as the White House boasted about its progress in fixing HealthCare.gov, one of the site's key features was being delayed. Small businesses were supposed to be able to get their employees signed up for coverage through the website like individual consumers. But the administration announced last week that those businesses would have to enroll outside of the website until 2015, while it worked to create a "smoothly functioning online experience."

According to the Small Business Majority, a pro-Obamacare group, more than 20 million uninsured people are part of the small business community. That's a lot of people who aren't being served by the law as they were supposed to be.

Prepare To Enforce The Employer Mandate In 2015

This delay was an administrative, rather than technical, failure. According to Bloomberg, the postponement of the law's requirement that companies with more than 50 employees provide health insurance resulted from complaints from the business community that the reporting requirements were onerous. White House officials said they would work to simplify the process before implementing the provision in 2015.

That postponement came at a cost: According to the Congressional Budget Office, a million fewer people will be covered through their employer because of the delay and the government will lose $12 million in revenue, mostly because it won't be collecting a penalty from companies that don't comply.

Start Getting The Word Out

The administration might argue otherwise, but the public relations side of Obamacare has been notably muted since the disastrous Oct. 1 launch. The President himself acknowledged that it was hard to encourage people to go sign up for coverage when the website wasn't working. Enrollment in October was low, to say the least, leaving a lot of ground to make up in subsequent months. Some experts think that the surprisingly small proportion of enrollees thus far who qualify for financial help suggests that many people who will benefit from the law don't know it yet.

Perhaps in recognition of this, the administration has given itself some extra cushion by extending the deadline to sign up for coverage that starts in January from Dec. 15 to Dec. 23. Groups like Enroll America have pledged to ramp up their enrollment efforts this month, and insurance companies are planning an ad blitz that will begin this month, according to the Washington Post. But because of the website's trouble, they're working on a shorter time table than expected.

About The Author

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Dylan Scott is a reporter for Talking Points Memo. He previously reported for Governing magazine in Washington, D.C., and the Las Vegas Sun. His work has been recognized with a 2013 American Society of Business Publication Editors award for Best Feature Series and a 2010 Associated Press Society of Ohio award for Best Investigative Reporting. He can be reached at dylan@talkingpointsmemo.com.