IT IS a fitting, if unwelcome, coda to the Affordable Care Act’s opening act. On Wednesday, the Obama administration announced that this Monday’s hard deadline for people to enroll in health-care insurance plans will be a little softer than advertised. If people encounter problems completing applications over the next few days, they will be able to claim some extra time to apply next month, officials said. The reason: The administration isn’t sure its Web site can handle a last-minute explosion in enrollment.
There are some good reasons for the move. It’s better to make clear contingency plans, which the administration failed to do when HealthCare.gov launched last October, than to not. If people get trapped in a technological purgatory during a final enrollment surge, it’s only fair to offer them a limited amount of leeway. And we mean limited: The administration needs a better answer for how it will combat fraudulent requests for more time, and it needs to make clear any opening it offers will be short.
But the announcement points to at least two significant problems. It suggests that HealthCare.gov still isn’t as capable as it should be. The administration boasts that the site can handle 100,000 concurrent users. That’s a huge number, but the site logged 250,000 concurrent users when it launched, disastrously, in October. The administration also has better ways of managing users who can’t access the application process: Those locked out can enter the line in a virtual waiting room, or they can send along their contact information and get a call back. The administration is beefing up its enrollment call centers, too. That’s all good — but a Web site that can handle truly massive volumes would be better, and it’s not too much to expect — nor was it last October.
The second problem is that the rollout of the Affordable Care Act has been very confusing. Some confusion was unavoidable; the law is new and complex. But the administration’s many policy shifts haven’t helped. Can people stay on their old insurance or not? Various phase-in deadlines have moved around; when do people really need to sign up? Health policy wonks following the administration closely can answer these questions, but a new poll from the Kaiser Family Foundation finds that three-fourths of the uninsured are bewildered even about when this year’s enrollment period will end.
The government’s effort to extend health-care coverage to nearly all Americans is just beginning. The Congressional Budget Office projects that more people will sign up for private individual insurance under the Affordable Care Act next year than this year. To make good on that projection, the administration must improve HealthCare.gov further, avoid setting expectations that all deadlines are flexible and demystify the system for people who aren’t paid to follow the policy. Otherwise, fewer people will seek coverage, when the point was to expand the number of Americans with insurance. And those who do sign up will disproportionately be the most motivated of customers — generally, the sicker, costlier ones.