The big question that everyone was waiting for has been decisively answered: "Will Obamacare's health exchanges work from the get-go?" The answer was a resounding "No."
President Barack Obama and the man tasked with managing the fix of the federally run health exchange, former acting Office of Management and Budget chief Jeffrey Zients, have spent the past two months handling damage control and reassuring the public that top tech experts were on the job. The revamped Healthcare.gov was recently relaunched and is now functional for a majority of the public in the 36 states it covers, meeting the government-imposed deadline of fixing the website by the end of November.
Despite the fix and the expectation that things will now go according to plan, there are still three questions I have about Obamacare that are left to be answered.
Source: White House on Flickr.
1. Why didn't the so-called top tech experts build Healthcare.gov in the first place?
If there has been one frustrating aspect of Obamacare's website glitches that's stood head and shoulders above the rest, it was the announcement from White House officials that a "tech surge" would bring in the top experts within the information technology industry to help fix Healthcare.gov.
This aid came in the form or middleware specialists Red Hat and Oracle (ORCL 0.73%) which were critical in diagnosing why data wasn't getting from the user to the data center and then to the insurance company for processing, and Google (GOOGL 1.55%) whose global source code network expertise helped decipher a good chunk of what was wrong with potentially millions of lines of code in Healthcare.gov.
Although things are fixed now after a two-month wait, I have to wonder why the government didn't choose these top tech experts to build Healthcare.gov in the first place. Instead, the government contracted out the website's development to Canada's CGI Group (GIB 0.07%) which lost a large contract in its home country in 2012 and has repeatedly struggled to meet deadlines.
The concern here would be that if the government failed to take the time to research this critical aspect of the development process, what other corners may have been cut that may rear their head down the road?
2. Are young adults signing up for health insurance?
In mid-November, we received our first taste of what the early stage registrations for Obamacare looked like, with 106,185 people between state and federally run health exchanges completely enrolling for health insurance and another 975,407 making it through the application and identification process but having yet to pick a plan. Of these applicants, 396,261 have been determined eligible for government-sponsored Medicaid or the Children's Health Insurance Program.
By all accounts full enrollments over the first 33 days were much weaker than anticipated, but with nearly 1 million people completing the application process (and trust me from firsthand experience, it's not a quick process) the expectation is that these individuals will soon select insurance coverage.
There haven't been any breakdowns of the age groups comprising the current enrollees and applicants. As I've stated before, enrolling young adults into Obamacare will truly be the standard by which Obamacare's success is measured. As it stands, a small portion of the sick and elderly (about 5%) make up about half of our annual health care expenditures in this country. In order to counteract these costs we need healthier young adults to sign up and pay into the system.
While getting fresh data from the Department of Health and Human Services is helpful, it's not nearly as helpful as finding out whether young adults are signing up for insurance. Until we have this data, the success of Obamacare will remain a gigantic question mark in my book.
3. Can our health-care system and doctors handle this surge of newly insured people?
One often overlooked aspect of bringing a targeted 7 million newly insured people into the health-care system is whether our infrastructure can handle it. Growth in the number of doctors in this country has been in the very low single-digits at best for years, and some doctors are simply choosing to opt out of accepting insurance obtained through Obamacare's health exchanges. Without adequate access to physicians, having health insurance won't do a lot of good when it comes to getting preventive care.
Another factor of concern would simply be the number of insurers operating in each state. Earlier this year we saw UnitedHealth Group (UNH -0.35%) and Aetna (AET) both pull out of what appears to be a lucrative, but crowded, California individual insurance market. Having big insurers like UnitedHealth and Aetna avoid many state exchanges could lead to cancellation notices being sent out to members in states where those insurers choose to no longer operate, further altering Americans' access to health care.
Simply put, it remains to be seen if our health care infrastructure can withstand the expected surge in preventive care and medical treatments.
