A design critique of HealthCare.Gov

October 6, 2013

The Web site for the Affordable Care Act has had myriad technical problems. But even when it is working, the design, though impressive in some respects, has been a source of confusion and frustration for applicants. Here, Joey Marburger, the Post's director of digital products and design, and Sarah Sampsel, our digital strategy director, offer some thoughts on what went wrong, and how it could be improved. 

1. What am I doing here again? Help!

Most people don’t understand the Affordable Care Act. According to this Washington Post-ABC News poll from September, 62 percent of adults do not feel they have enough information to understand what changes will occur as the new health care law takes effect. Today, when arriving to the site, there is no clear description of what the Affordable Care Act is or why it’s necessary to enroll.

Depending on your state, you either continue the enrollment process within the healthcare.gov site or you are sent to an external site, for example, D.C. residents are sent to D.C. Health Link, which has different messaging and looks completely different.

As healthcare.gov users sought help, their options were somewhat limited. They were directed to call 800-318-2596 to speak with an agent, but those who called the first few days experienced a 30-plus minute wait. Online help alternatives were also problematic. Just as people had trouble loading the Web site, they had difficulty getting responses on the live chat (not to mention that tech support can't do much to help when the underlying tech keeps crashing).

2. Should I click ‘Apply Now’ or ‘Start Here’?

Action design is important. Because of the complexity of enrolling millions of people in many different locations who speak a number of different languages, healthcare.gov is complicated and because of this, messaging must be clear. Instead, the wording throughout the site is often inconsistent or redundant.

3. What is this carousel doing here?

Some of the most upfront information is located in this text carousel that splits the page and is somewhat hard to read. The first option, “Get covered: A one-page guide” sounds useful. Maybe a carousel isn’t the best option.

We also wonder what the difference is between the navigation at the top, this carousel of information and all the rest of the links throughout the page.

4. Maybe I’ll check the Sitemap … No.

The vast and complex sitemap looks like a test in information architecture. Most users don’t typically know how to navigate such things and they tend to feel overwhelmed if they just have a simple question. The site also provides a glossary of terms that seems useful if you’re looking for something in particular, but it’s an overwhelming amount of information provided out of context. The terms don’t provide any insight unless you click in and go down the rabbit hole once again.

5. Forms

We wanted to assess the process of creating a marketplace account (By the way, what is a marketplace account? Should I know that by now?) to begin enrollment into the program. After waiting patiently for about 30 minutes, we were finally able to access the form.  Success is ours!

The steps to fill out the form were straightforward and pretty easy to do (even using keyboard shortcuts). But after diligently filling out each field and hitting the button to create an account, we were greeted with this:

...frustrating. Like many others, we will have to try again later.

6. Clear messaging about tech issues

It’s no secret that the site has been experiencing a barrage of users trying to sign up, which is resulting in page errors with little or no explanation. So why not tell users the problems up front? Perhaps a simple message on the home page, “We are experiencing technical difficulties so you may want to come back later.” Once users waste their time, frustration inevitably sets in.

What could have been done differently to simplify this process?

Aside from optimizing the site to handle volumes of people, one option we discussed was to make the entire site a questionnaire. Why just use that tactic when people are seeking help, especially since this is a brand new experience for all users? The homepage could be a simple screen that welcomes people to the site and asks whether they are an individual & family or a small business, then we go from there. We establish who we’re dealing with, ask if they have the information they need to proceed with enrollment and either direct them to more details or send them to the form.

The design doesn’t need all that navigation across the top, the carousel with additional information or the redundant list of links below if the information is prioritized and the interface focuses on the number one goal for the user -- to enroll in the program. The design should help people understand what they don’t know and guide them through the process, not be a barrier to entry.

It sounds simple, we know. It’s always easy to critique a site from the sidelines without understanding all the nuances and complexities behind the scenes (heck, we know washingtonpost.com has its fair share of these issues and we’re hard at work fixing them). We know there were several hurdles for the design and development teams to overcome, but the first impression shouldn’t highlight those complexities and internal debates and compromises. It should be focused on the user coming to the site to enroll. The rest really doesn’t matter.

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