For more than 100 days we counted down to the opening of state and federally run health exchanges as mandated by the Patient Protection and Affordable Care Act, which you probably know better as Obamacare. And for the past 26 days, the vast majority of Americans has been adding up the number of days they've tried to access the health exchange in their state without any luck.
With the exception of close to a dozen state-run health exchanges that have seen decent enrollment figures despite minor traffic overload and technical issues, the rollout has been marred by innumerable glitches on the federal exchange, which have appeared as everything from incomplete insurance applications sent in to insurers to faulty prices being offered to consumers. Other users can't even get past the personal identification stage of the process. In short, things haven't run nearly as smoothly as the Department of Health and Human Services anticipated.
Setting the record straight
What we haven't had during this process from regulators was any clarity as to when these problems would be fixed and exactly how severe the problems were in the first place. We did hear rumors from USA Today earlier in the week that Verizon (NYSE: VZ ) was likely to be hired to utilize its networking expertise to diagnose the federally run health exchange, Healthcare.gov, which covers 36 separate states. Whether that comes to fruition and is officially announced remains to be seen, but Verizon alone is unlikely to be able to fix the enormity of problems seemingly apparent with the exchange.
Yesterday, though, finally brought some concrete answers from the White House. We learned from White House Healthcare.gov spokesperson Jeffery Zients that UnitedHealth Group (NYSE: UNH ) subsidiary Quality Software Services, or QSSI, is now going to be the responsible contracting party overseeing the technological progress and fixes of Healthcare.gov. Previously the Centers for Medicare and Medicaid Services was in control, but critics of Obamacare had questioned its role as technical director of the website with such little previous experience in leading such a complex rollout.
The other long-awaited concrete answer we received is the timeframe as to when Healthcare.gov would be working smoothly. According to Zients, the website isn't a lost cause as some people had suggested and placed an end-of-November target, 35 days from now, on getting everything working smoothly for a majority of Americans. Zients also noted that through three and a half weeks, approximately 700,000 applications between state and federal exchanges have been filled out across the country. This doesn't exactly tell us how many of those people were able to enroll, but it still leaves the daunting target of 7 million enrollees many miles away.
While I'm certainly glad that regulators have finally come clean about Healthcare.gov's problems and put a company clearly in charge of Healthcare.gov's technical aspects in UnitedHealth Group's QSSI, I'm somewhat torn about the prospect of regulators placing a 35-day countdown on fixing Healthcare.gov.
Why a 35-day countdown is great news
On one hand, setting a definitive date could be viewed as a positive for a number of reasons. To begin with, it provides accountability when previously there had been no measure of accountability. We clearly know QSSI is in charge of technical operations and there's a good likelihood that other contractors could be brought in to help diagnose some of the technical problems. Trust is going to be a key factor of luring in uninsured Americans, and this increased transparency via visible goals could go a long way to establishing that trust.
Another point of contention is that a visible countdown improves American's awareness of the new health reform law. Regardless of whether it's good or bad press, simply having the PPACA in the news on a daily basis is raising awareness of a law that roughly two-thirds of Americans had little to no knowledge of just weeks ago. The ability to make informed decisions utilizing transparent pricing on state and federal health exchanges is one of the primary reasons Obamacare was developed. If people don't understand the law, they can't make informed decisions.
Why setting a deadline is also silly
Then again, setting a concrete countdown to a "fixed by" date seems equally meaningless for its own set of reasons.
For one, we already know that the majority of people are going to wait to the very last moment possible to sign up for health insurance. We live in a land of procrastinators (I should know -- I'm one!), and it's really difficult to get someone to sign up for insurance now when they aren't going to be billed for or receive the benefits of a product for two months and a few days from right now. Even more so, with the cutoff date looming at the end of March, many of those individuals who would prefer not to have health insurance in the first place, but will purchase it anyway because of the individual mandate, will wait until the very last minute to make their purchase, thus avoiding three months of premium at the beginning of the year. In other words, this is going to be a very back-loaded sign-up period and I wouldn't expect enrollment to exactly soar even if the website were running smoothly come Dec. 1.
Also, while transparency is a great thing, as is accountability, what sort of consequences will there be if Healthcare.gov isn't ready to go by Zients' end-of-November proclamation? Obviously, regulators can install a new contractor to oversee Healthcare.gov, but there aren't any real consequences to these existing contractors or involved parties should the deadline be missed. Really, the only thing at stake here is another public shaming of Healthcare.gov, the HHS, and the Obama administration should the website fail to be ready on time.
What does this all mean?
Ultimately, it's looking as if enrollment is going to be pushed out as long as possible for many Americans. The real challenge for regulators is going to be whether they can lure young, healthy adults into signing up, especially given the numerous technical glitches that tend to drive the younger and more technically savvy generation away.
The story for your investments, though, hasn't changed much. Insurers such as Aetna (NYSE: AET ) are still going to be looking at disappointing enrollment figures for the first couple of quarters as Americans wait until the last couple of days before the end of the coverage cutoff to sign up for health insurance. While this really doesn't affect insurers over the long haul, expectations for rapid gains out of the gate have been baked in for some time. For Aetna, its strong ties to federally run states could put an extra damper on its results over the near-term.
Not all insurers are in bad shape over the near-term, though. eHealth (NASDAQ: EHTH ) rocketed higher yesterday after reporting what looked like a ho-hum third-quarter report. The real boost came from its 24% membership growth, which could accelerate even faster given the problems with Healthcare.gov. eHealth has years of experience operating private platform health insurance marketplaces for individuals, families, and small businesses, and it could continue to thrive as long as Healthcare.gov struggles.
For CGI Group (NYSE: GIB ) , QSSI's appointment to head the technical aspects of Healthcare.gov might be the best thing to happen to it in weeks. The success or failure of Healthcare.gov is now squarely on QSSi's shoulders, allowing CGI Group to possibly back away from this PR nightmare. In addition, QSSI's open commentary about last-moment changes to the system and the government's lack of testing is helping to take some of the heat off of Healthcare.gov architect CGI Group. I'm still concerned that CGI could face long-term headwinds from this debacle that could cost it future orders, but it remains to be seen if that will come to fruition.
For now, the clock is ticking; now let's see whether regulators can deliver on their 35-day window!
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