Washington Health Policy Week in Review Archive

Washington Health Policy Week in Review is a weekly newsletter that offers selected stories from the daily newsletter CQ HealthBeat.

  • June 23, 2014 Issue
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Simpler Enrollment Application Planned for Fall Health Law Sign-Up

By Rebecca Adams, CQ HealthBeat Associate Editor

June 17, 2014 -- Federal officials and software engineers are working on a simplified application to install on the federal insurance website healthcare.gov during the upcoming enrollment period. The goal is to make things easier both for consumers and the website, which collapsed under the pressure of high volume during the first days of last fall's sign-up window.

Application 2.0 will be "for people who don't have complicated financial assistance needs, so we think it could be a high percentage of people who are signing up," said Paul Smith, a software engineer who was part of the technical rescue team that helped Obama administration officials patch healthcare.gov in the months after its disastrous launch on Oct. 1.

Smith continues to advise federal officials as they prepare for the second sign-up period, which will run from Nov. 15 through Feb. 15. He spoke at a conference organized by Enroll America, the organization that led efforts to mobilize uninsured people to sign up for coverage.

The simplified application could be likened to a 1040-EZ form for taxpayers with uncomplicated situations and will ask fewer questions.

"I think there will be a few other things like that, that will provide better user experience and at the same time take the heavyweight transactions off of the main system," said Smith.

However, Smith said that there is limited time to add new functions to healthcare.gov. Federal officials and contractors are still working on back-end issues that had been expected to be finished months ago, such as an electronic system to pay insurers. In the meantime, insurance companies are invoicing federal officials to get subsidies for consumers covered by their plans.

Besides adding the simpler application, fixing the back-end problems and bringing a portal for small businesses online, the federal website consumers use in November will look much the same. Consumers can still use healthcare.gov now to sign up if they are eligible for special enrollment periods.

"That's not a long runway to do a lot of big changes, so the system that crossed the finish line in April is largely the one that will start the starting line on November 15," said Smith.

On an earlier panel, former Health and Human Services Secretary Kathleen Sebelius said the "most terrifying days" in the federal government's efforts to fix the flawed enrollment website were at the end of November.

Federal officials had promised that the website would work well for the "vast majority" of consumers by the end of the month. During those final days, Sebelius recalled thinking, "I really hope this is going to work."

She said she felt "great validation" on Dec. 1, when the website performed much better than in previous weeks.

When open enrollment started on Oct. 1, the federal website was so flawed that only six people in the entire country were able to enroll on the first day. Later that month, federal officials and contractors were able to start making fixes that would result in improvements each week.

Sebelius said that she's seen a lot of political campaigns, but that Enroll America's work to sign people up for coverage was "the most amazing effort I've ever seen in my life."

She added that the Obama administration's outreach effort before the open enrollment period started was outspent by negative publicity from critics by 4 to 1. Federal officials faced attacks from right-wing media, opponents among the leadership in Congress, shadow political organizations and hostile governors, she said.

Sebelius spoke on a panel with Kentucky Gov. Steve Beshears, Kaiser Family Foundation President Drew Altman, and Independence Blue Cross President and CEO Daniel Hilferty.

Beshears called Sebelius a "hero," adding he "never saw anybody take so much abuse, undeserved abuse" during the troubled launch of the new marketplaces under the law (PL 111-148, PL 111-152).

Altman noted that the remarkable thing about the polls his nonpartisan foundation produces is that they have changed so little over time. No matter what happens with the health care law, the public's views are distributed almost perfectly along partisan lines.

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