Obamacare Technical Glitches Are a Big Deal

Health and Human Services Secretary Kathleen Sebelius discusses the Affordable Care Act at Miami Dade College on Sept. 17, 2013, in Miami.

Photo by Joe Raedle/Getty Images

I’m bullish on Obamacare: “Obamacare’s Going to Be Great” is how I put it. But over the past week or so, I’ve had my first sign of something that I think could be a real problem for the program. Not the regulations or the taxes or the subsidies, but the computer programs. For the exchanges to work, as a literal matter of techology, websites need to be operating where people can go put in their information and find out about their options. And there are a lot of signs recently that the process of building these systems out isn’t going so well.

Jon Cohn offered a good summary of these issues recently, paired with an admonition not to freak out

I’m a little more freaked out than he is. The fact of the matter is that these kind of complicated technical projects usually don’t go off without a hitch. (Here at Slate, we launched a redesign last night, and even though the dev team has been working superhard on it for a long time, we’re still experiencing various glitches and problems today.) But launching a glitchy program into an uncertain political environment could be an unusually severe issue. Think about something like SimCity 5 that garnered rave reviews from critics but then proved extremely glitchy when it launched to the general public. Those glitches are fixed today, and the game is a joy to play. But the impact of the glitches was that during the game’s first week of availability—the one time that the general public was likely to be reading information about SimCity 5—the coverage was overwhelmingly negative. 

That’s what makes me worried about this Obamacare situation. The exchanges will launch in October, but coverage under new plans won’t kick in until January. That’s ample time to iron out problems and get everything working. There’s a reason why the exchanges open months before the new year, after all. But given the amount of fear, uncertainty, and doubt that Republicans have been raising about the entire project, it’s going to make a strong impression in people’s minds if the first two weeks of exchange availability are plagued by technical problems. It’ll hardly be a disaster that it’s impossible to recover from, but it will be a very real problem.

The Affordable Care Act has been very extensively covered in the elite press, and wonky types know a lot about it. But the evidence is overwhelming that the general public still has a very low level of awareness of the Affordable Care Act or what exactly it says or does. Launch week is sure to involve a lot of high-profile coverage, not just in political publications but in the kinds of places (e.g., local TV news) where normal people get their information. If that coverage is dominated by technical problems, it may be very difficult to come back for a second bite of the apple.

People are scrambling to try to fix the situation as best they can over the next week, which is great. But the relative inattention to this brass tacks aspect of implementation is, I think, the only really big mistake I’ve seen in the law’s rollout. It’s easy to say there’s going to be a website that does this and that, but actually making one that does it is hard.