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HealthCare.gov Take health care into your own hands

About

Healthcare.gov[1] is the online marketplace where U.S. citizens can enroll in a range of healthcare insurance plans in accordance with the U.S. Healthcare Reform. Since its official launch in October 2013, the website has drawn criticisms for frequent downtimes as a result of high traffic volume and critical bugs in the software.

History

One of the provisions in the Patient Protection and Affordable Care Act[2] of 2010 called for an online health insurance exchange with a marketplace where individuals could buy their own health insurance that would launch on October 1st, 2013. In April 2013, a finalized version of the health care application[4] went live online, in preparation for those planning to make a purchase in October. By September, news sites like the International Business Times[3] posted articles on how to navigate the site and what documents shoppers would need to have handy in order to make a purchase. Healthcare.gov (shown below) launched on October 1st, 2013, despite the government shutdown that also began the same day.

How the Marketplace works 2 4 JAN HELLO My name is $含 Pick a plan Next you'll see all the plans and Enroll Choose a plan that meets your needs and enroll! Coverage starts as soon as January 1, 2014. Apply Create an account First provide some basic information. Then choose a user name, password, and security questions for added protection. Next you'll enter information about you and your family, including your programs you're eligible for and income, household size, other coverage you're eligible for, andv more. compare them side-by-side. You'll also find out if you can get lower costs on monthly premiums and out-of-pocket costs. Use this checklist now to help you gather the information you'll need.

Controversies

Launch Failure

Its first day online, Healthcare.gov crashed (shown below) after receiving more than 1 million visitors[7] in less than 24 hours, with the marketplaces for residents of Maryland[5] and California[6], among others, becoming completely unusable.

HealthCare.gov Learn Get Insurance Individuals & Families Small Businesses All Topics Search SEARCH Health Insurance Marketplace: Please wait We have a lot of visitors on our site right now and we're working to make your experience here better. Please wait here until we send you to the login page. Thanks for your patience! Search HealthCare.gov Search HealthCare.gov SEARCH Open Coverage Can Begin 31 Closes JAN Open DAYS LEFT TO ENROLL 1 Enrollment Began Health Insurance Marketplace

That same day, Redditors from /r/WebDev[11] began picking apart the code, finding a number of spelling errors and other issues. By the following afternoon, Healthcare.gov attracted 6.1 million unique visitors.[8] Site issues continued to persist, and on October 5th, the Washington Post[9] interviewed application management expert Jyoti Bansal, who theorized that the site's problems were actually glitches in untested code and not solely due to traffic problems. Flaws in the design were acknowledged on the 6th by Joanne Peters[10], a spokeswoman from the Department of Health and Human Services, who also reported the site had seen more than 9 million customers, but actual purchases were in the low thousands. On October 8th, Slate[12] broke down a number of the site's problems, noting an error message containing a phone number to call for help had been hidden in an HTML comment tag in the site's source code, making it so it would not display anywhere on the page.

HealthCare.gov Get Insurance Learn Log in Español Individuals & Families Small Businesses All Topics Search SEARCH The System is down at the moment. We're working to resolve the issue as soon as possible. Please try again later. Please include the reference ID below if you wish to contact us at 1-800-318-2596 for support Error from: https%3A//ww w.healthcare.gov/ marketplace/global/en_US/registration%23 sign UpStepone Reference ID: 0.cdd74f17.1380634949.2f9c301c Open Enrollment Began Coverage Can Begin Open Enrollment Closes OCT JAN MAR 181 DAYSLELFT T1Eiopelment Health Insurance Marketplace ENROLL 31 Live Chat"

Obama's Response

On October 21st, 2013, President Barack Obama held a press conference (shown below) to discuss the Healthcare.gov glitches and downtime, during which he said there is no excuse for the flaws in the system and that no plan would not sell out and will be available throughout the enrollment period.[13] Later that week, the President asserted that the site would work more smoothly by November 30th.[14]

Congressional Hearing

On October 24th, a hearing was held in Congress in which representatives from the contracted companies that built the site, CGI Federal and Quality Software Systems Inc., gave testimony as to what would have caused the issues.[15] Both representatives claimed that their half of the software worked, blaming the federal government for the problems.[16] Slate[17] suggested that the representatives did not know that some bugs were unacceptable and were too optimistic about a program that did not fully work.

As Cpbeil Mr. Slavit Ms. Spellecy Mr. Lau

Marilyn Tavenner's Apology

On October 29th, chief of Centers for Medicare and Medicaid Services Marilyn Tavenner (shown below) issued a formal apology for the website as part of the Congressional hearing. She was the first member of the Obama administration to testify at the hearing, stating that the site did not live up to the government's expectations. She also noted that more than 700,000 people have successfully submitted coverage applications, but did not specify how many of those people actually were enrolled in benefit coverage.[18] The same day, many news sites including CNBC[19] and Bloomberg[20] reported that hundreds of thousands of current health insurance plans were being cancelled for not covering minimum policies under the Affordable Care Act, including more than 300,000 in Florida and 280,000 in California.

[This video has been removed]

Highlights

Obamacare Girl

As malfunctions and glitches continued through the latter half of October, an image of a smiling woman prominently displayed on the homepage soon became the scapegoat of the launch failure, inspiring a slew of late-night talk show satires as well as online mockeries.

HealthCare.gov Learn Get Insurance Log in Esp Individuals & Families Small Businesses All Topics Search SERR The Health Insurance Marketplace is Open! Find new health care options that meet your needs and fit your budget. Apply for coverage that can begin as soon as January 1. APPLY ONLINE APPLY BY PHONE SEE PLANS AND PRICES IN YOUR AREA SEE PLANS NOW

On October 21st, The Onion highlighted the woman in an article titled "People In Healthcare.gov Stock Photos Now Visibly Panicking,"[24] featuring a photoshopped image of the woman with a frightened facial expression (shown below). In the following days, the mysterious woman became dubbed the "Mona Lisa of Health Care" in the political blogosphere and news media, as well as drawing attention from online discussion forums, before it was replaced with another image on October 27th.

People In Healthcare.gov Stock Photos Now Visibly Panicking NEWS IN PHOTOS Government . Healthcare. News ISSUE 49.43 Oct 22, 2013 7.5K 653 160 HealthCare.gov Log in Learn Get Insurance Individuals & Families Small Businesses All Topicsv The Health Insurance Marketplace is Open! Find new health care options that meet your needs and fit your budget. Apply for coverage that can begin as soon as January 1. APPLY ONLINE APPLY BY PHONE SEE PLANS AND PRICES IN YOUR AREA SEE PLANS NOW Get covered: A one-page guide Find out if you qualify for lower costs See 4 ways you can apply for coverage Get in-person help in your community Call 1-800-318-2596 for information y Cover age ROper Heath nsurance Marketploce 160 DAYG LITTOin Lneolment1 1 Degan Can Begin 31 Enrolment CONNECT WITH US OP CONTENT 4 ways to apply for coverage Get an estimace of costs and savings 21 ocr Were listening-and improving every day Share Your Story 21 4 ways to apply for coverage in the

On November 13th, the woman in the photograph appeared in an exclusive interview with ABC News Good Morning America[25] to discuss the ordeals of her newfound fame as the face of Healthcare.gov. The woman, who only wishes to be identified by her first name "Adriana," also asserted that she has become a victim of cyberbullying as a result of the unwanted association with the website.

"The saga of the photo started innocuously enough. Seeking free family photographs, Adriana emailed a contact at the Center for Medicare and Medicaid Services, the agency responsible for the Affordable Care Act's rollout, about having photos of her and her family taken in exchange for allowing the photos to be used to market the new health care law. She was never paid."

Traffic

On October 1st, Healthcare.gov saw 2.5 million unique visitors, but that number steadily dropped, hitting 500,000 on October 10th and continuing to trend downward.[21] Despite the traffic drop, the percentage of visitors that actually completed an application increased from 0.3% to 5.7% between October 1st and October 24th (shown below). Though Healthcare.gov's Quantcast[22] statistics are hidden, the site has an Alexa[23] score of 238 in the United States.

Percentage of Healthcare.gov Visitors Who Converted at Various Stages of the Process by Week Source: comScore Custom Analytics, U.S., Sep-Oct 2013 Week 1 (Week Ending October 6th) 5.31 million Healthcare.gov Week 2 (Week Ending October 13th) 2.39 million Week 3 (Week Ending October 20th) 1.58 million Enrollment Funnel Unique Visitors # who clicked "Get Insurance" from the home page 2.73 million 1.21 million 618,000 who attempted to register or login # who reached the final account creation step # who successfully logged-in # who verified identity before the application process # who initiated an application # who completed an application and compared plans 2.17 million 1.12 million 653,000 273,000 498,000 171,000 126,000 424,000 353,000 115,000 287,000 155,000 84,000 200,000 232,000 14,000 45,000 90,000

Search Interest

External References

[1] Healthcare.gov – Home

[2] Wikipedia – Patient Protection and Affordable Care Act

[3] International Business Times – ‘Obamacare’ Open Enrollment Begins Oct. 1: How To Apply To The ACA Health Insurance Exchange

[4] Washington Post – Affordable Care Act application just got a whole lot simpler

[5] Washington Post – Rush of interest continues on insurance Web sites

[6] Forbes – Healthcare.gov Crashes During First Day, Why Massachusetts Never Had This Problem

[7] Politico – Traffic causing HealthCare.gov problems

[8] New York Times – As Demand Stays High, Officials Try to Address Problems in Exchanges

[9] Washington Post – A techie walks us through healthcare.gov’s two big problems

[10] The Wall Street Journal – Software, Design Defects Cripple Health-Care Website

[11] Reddit – /r/webdev: i guess a couple of are trying to sign up for healthcare…(a minor bug on the new healthcare website)

[12] Slate – Err Engine Down

[13] The White House – Remarks by the President on the Affordable Care Act

[14] Al Jazeera America – Obama promises end to health care website glitches

[15] Al Jazeera America – Creators of buggy HealthCare.gov face Congress

[16] Washington Post – In hearing, a startling agreement on who to blame for HealthCare.Gov

[17] Slate – Debugging the Healthcare.gov Hearings

[18] CBS News – Medicare chief apologizes for HealthCare.gov problems

[19] CNBC – White House knew millions could not keep plans under Obamacare

[20] Bloomberg – Health Policies Canceled in Latest Hurdle for Obamacare

[21] ComScore – Following Initial Fiasco, Healthcare.gov Website Conversions Jump as Traffic Surge Subsides

[22] Quantcast – Statistics for healthcare.gov

[23] Alexa – Statistics for healthcare.gov

[24] Democratic Underground – Adriana, I love you. Please let me in….

[25] The Onion – People In Healthcare.gov Stock Photos Now Visibly Panicking

[26] Fox News – Who is that girl? The mysterious face of Healthcare.gov
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[27] Mediate – The ‘Mystery,’ ‘Search,’ and ‘Hunt’ for the Mysterious Obamacare Website Girl Is On!

[28] BuzzFeed – The Search For The Mysterious Obamacare Website Girl

[29] Good Morning America – Exclusive: Obamacare's Mystery Woman Says She Fell Victim to Cyberbullies

[30] Twitter – @ObamaCareGirl's Account



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