November 30, 2013

TODAY, THE Obama administration’s message is that HealthCare.gov is a lot better than it was on its disastrous inauguration two months ago.

Well, sure: Using HealthCare.gov is a more pleasant experience than it used to be. Registering is much easier. The site doesn’t freeze repeatedly. But it still is not where it should have been on Oct. 1 — and the early success of the policy still hangs in the balance.

Leading up to its weekend deadline to get the site working, Obama administration officials assured the public that the “vast majority of users” would be able to use it. To them, “vast majority” means 80 percent of users — which is still too low. Officials boast the site is able to handle 50,000 simultaneous users. Yet that was the goal for Oct. 1, a day on which five times that many tried to access the site at once.

Then there are less-visible issues. Officials admit they are still having trouble with the files that transfer enrollment information to insurers. Other parts of the site’s back end still aren’t built. It was right — but not encouraging — that the Obama administration extended the date by which people have to apply to get coverage that starts on Jan. 1. Even that, though, is risky: Insurers will have only eight days to work out the logistics of enrolling those signing up late this month.

Timing has become the most urgent implementation issue. Late last monththe Commonwealth Fund estimated that the country is roughly 3 percent of the way to its goal of enrolling 7 million people through new marketplaces by the end of March, when 2014’s enrollment period ends for good. The program must reach people who are very far from policy debates; a recent Kaiser Family Foundation poll found that 38 percent of the uninsured had heard “nothing at all about” the new health-insurance marketplaces the law is setting up for them.

The challenge is evident even in states where implementation is going well. California, which set up its own health-care marketplace site, led the nation with 80,000 enrollments in private insurance plans as of late last month. The profile of those signing up also appeared balanced between young and old, a balance the policy needs to work. Yet the task is still huge: The Golden State has only four more months to sign up the remaining 500,000 to 700,000 people it expects to enroll and obtain subsidies through its marketplace by March 31.

Numbers everywhere will pick up as deadlines approach. The extent to which they do, however, depends on, among other things, the length and quality of the delayed enrollment campaign, and the extent to which people respond to the threat of charges from the Internal Revenue Service — assuming that understaffed agency can pull off its part of the rollout.

In Washington, where short-term thinking is the only type, it’s easy to look at the many challenges that remain, condemn the whole reform as unworkable and propose some counter-productive “solution.” That would be a terrible mistake. Though elements of the rollout have flopped, the policy itself has not proven a disaster. It is still one President Obama, nervous Democrats, uncooperative Republicans, and others at all levels of government can get to work. It’s about time they all tried their hardest.