3. The White House's confidence is apparent in their efforts to drive traffic to the Web site. As of a few weeks ago they were emphasizing analogue options, like signing up over the telephone or in-person with an Obamacare "navigator," because they wanted to keep people off the Web site.
4. The White House has three very good reasons to keep people off the site until it actually works. 1) More people on the Web site makes the site likelier to crash. 2) People who get through the front door only to have a lengthy, frustrating experience that ends in failure might never come back. 3) Those who seemingly get through the process successfully might be getting incorrect subsidy information or the insurer might be getting a corrupted file creating huge problems later.
The fact that the Obama administration is driving people to the Web site now means they think the Web site is, for most people, able to successfully transform interest into enrollment.
5. It will be almost impossible to know if the Web site really is working smoothly for 80 percent of users on Sunday. There's no solid polling in the field. Journalists don't have access to HealthCare.Gov's back-end dashboard. And there's no way to judge the representativeness of anecdotes. It'll be easy to see if the Web site is crashing across-the-board. It'll be virtually impossible to separate a Web site that's working for 67 percent of applicants from one working for 83 percent.
6. Don't forget the denominator. Whether the site is working for 80 percent of users has a lot to do with how many users there actually are. The Obama administration wants the site to be functional for 50,000 people at a time. If they succeed, then it will be easy for them to hit their goal if only 30,000 people are using it at any given moment. It'll be impossible if demand reaches the levels it did in the early days of the launch, when more than 250,000 people were on it at any given time.
7. A big question mark is whether the less-visible parts of the experience will work smoothly. It's possible for a consumer to believe everything went well but for their eligibility determination to be wrong and for the 834 form that's sent to the insurer to be corrupted. Of late, I've been hearing from industry and staff sources that there's real improvement in both the eligibility and 834 functions. But, again, it's hard to know for sure.
8. Dec.1 — Vast Majority Sunday — is a political deadline, not a policy deadline. No one really knows the policy deadline for getting the 2014 risk pool right. Perhaps it already passed, and so many young people were turned off by the bad press and the awful sign-up experience that there's simply no way for the administration to get them back this year. Or perhaps young people wouldn't have signed up till the last-minute anyway — that's what happened in Massachusetts, and that's also what happened with not-so-young people in Medicare Part D — and so the site is fine so long as it's working reasonably well reasonably soon.
9. Where the Dec. 1 deadline really matters is for people who've already had their plans canceled and who need to be able to sign up for a new one in time for it to start on Jan. 1. If the Web site isn't working smoothly for these people in the next week or so it'll be an utter disaster when 2014 comes and many of these people find themselves uninsured and some get sick.
10. Even if the Web site does work for 80 percent of applicants, that's not 100 percent. The Obama administration needs a strategy for those who lost their insurance and still couldn't or didn't get a replacement in times. "There is a 100 percent chance that this will happen to a nontrivial number of people," says Mark McClellan, who led the implementation for Medicare Part D. "So the Obama administration needs some kind of plan in place for resolving those cases as rapidly as possible and making sure they get the care they need."
11. Obamacare's problems don't end once the Web site works. Come January people need to be able to use the insurance they purchased. In many cases, that will go smoothly. But there will be some cases — particularly for people who signed up when the Web site was buggier — where information was lost, corrupted, or otherwise ruined during the transaction even though the customer thought it went fine. That said, a world in which hundreds of thousands or even millions of recently uninsured people are using insurance they got through Obamacare is a world the Obama administration will be happy to reach. That's a world in which, at last, Obamacare's winners are also visible.