Why The Administration Isn’t Sweating Obamacare’s Ugly First Week

Read the headlines, and the first week of Obamacare’s health insurance marketplaces has been hugely problematic, bordering on disastrous.

Long wait times on the Obamacare websites and crashing web pages. A dearth of consumers who have actually purchased insurance — at least those who can be found by reporters. It’s frankly hard to imagine a worse rollout for the law, from a public relations standpoint.

But the administration isn’t sweating things yet. Neither is a veteran of health reform in Massachusetts, the only truly comparable experience to what Obamacare is going through this week.

“It is way too early. We didn’t really start cranking until the individual mandate was real” a year after the Massachusetts marketplace went live, said Jonathan Gruber, a MIT professor who was on the ground in Massachusetts and advised the Obama administration while Obamacare was being drafted in 2009 and 2010.

“Really six weeks from now” is when the marketplaces need to be functioning properly, Gruber told TPM in an email. Dec. 15 is the last date that people can sign up for coverage and still have it start on Jan. 1, 2014. “The key enrollment starts in late November,” Gruber said.

So the problems need to get fixed and soon, but an ugly first week probably isn’t the end of the world.

From the White House’s perspective, officials always downplayed the importance of Obamacare’s opening week. In a briefing prior to the launch, senior administration officials showed reporters a line graph of Massachusetts enrollment numbers. The story was that enrollment peaked as the enrollment period came to a close, similar to what Gruber told TPM. Dec. 15 is the first big date then, and people can still enroll until the open enrollment period closes at the end of March 2014.

Health and Human Services Kathleen Sebelius told reporters the day before the marketplaces went live that the administration viewed Oct. 1 as the start of an outreach campaign, not the end of one.

“What you’ll notice starting (Tuesday) is a turning up the volume on our educational efforts since now people finally have something to do,” Sebelius said. “(Tuesday) is the beginning of a sustained six-month conversation that we are going to continue to ramp up,” an HHS official added.

That’s why the administration has been mostly pushing the news of unexpectedly high interest in the marketplace. Seven million people visited HHS’s Obamacare website in the first 48 hours, though the White House isn’t saying how many actually signed up for coverage. Those big traffic numbers are a primary cause of the website’s troubles (though, as Ezra Klein pointed out Friday, there are also fundamental design flaws to consider, too).

According to HHS, they’ve been adding servers to drive down wait times and putting engineers to work to fix problems with the system. Wait times are down by one-third on the website, according to HHS. HHS officials assured TPM that the reduction in wait times and glitches had led to people actually enrolling in coverage, but declined to provide enrollment numbers.

“Experts are working around the clock and were able to expand system capacity somewhat overnight,” HHS spokeswoman Joanne Peters said Thursday. “Work on the site continues today to meet the demand and excitement generated in just the first 48 hours of our open enrollment.”

“The volume is driving the slower consumer experience. That is a high-class problem to have,” a White House official told TPM. “That is our central issue. There are massive amounts of people at the site.”

There are legitimate concerns, though, about how a poor launch could affect the law’s long-term outlook. If people come to the site and can’t even get through to look at their coverage options, that could discourage them from coming back in the future. In general, bad press for a law that isn’t exactly beloved by the American public can’t be encouraging for the administration.

So the White House should do everything in its power to smooth things out for the consumers, said Joel Ario, a private consultant who worked at HHS in the early days of the law’s implementation. Ario suggested, for example, eliminating a glitchy security question page so that people can look at their coverage options without creating an account on the website.

“I do think this question of being shop and browse is important, as soon as possible,” Ario said. “We know most people don’t want to just go in and go straight to the purchase. They want to be able to see their options, think about it, talk to their friends.”

“It’s all about expectations. I think what the exchange should do is go out of their way to underpromise and overdeliver,” Ario said. “To the extent they know they’re not going to be ready with certain things, as long as the consumer’s told that something’s not quite ready, I think people will accept that.”