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CHOUGULE: Obamacare dysfunction isn’t just its website

An overabundance of sick enrollees could bankrupt the system

- - Monday, May 12, 2014

By now, the federal government's ineptitude in rolling out the Healthcare.gov website has been well-documented. As President Obama's health care act exchanges launched in October, the federal marketplace website promptly fell flat on its face.

Despite having had three years and more than $600 million to work with (more than it cost Apple to develop the iPhone) the federal government and its chosen contractor, where Michelle Obama's Princeton classmate happened to be an executive, could not build a functional website.

The flubbed launch added to America's Obamacare dismay, but supporters were quick to claim that the faulty website said nothing about Obamacare itself, and that the law would ultimately work properly. However, a recent Friday evening news dump cited by Politico explained that two may not be mutually exclusive. The back end of the website remains dysfunctional, which could both refute the much celebrated 8 million sign-ups claim, and lead to either higher insurance premiums or greater taxpayer costs.

The website was originally intended to function automatically, calculating premium subsidies, making government payments, and tracking enrollment information that would affect future costs, but the accuracy of all of the above has now been called into question. The longer the issues persist, the more problematic and error-prone the data becomes as it shuffles around applicants' personal information and billions of taxpayer dollars.

The interim system currently in place, which Politico's Kyle Cheney described as "pretty much a spreadsheet and some informed estimates," prevents the government from knowing exactly how many people have actually paid a premium and how sick or healthy the enrollees are. Thus, once the automatic system goes live (whenever that may be), taxpayers could be on the hook for significantly higher costs, and the idea that 8 million people "signed up" for Obamacare could be dispelled completely. Mr. Obama has paraded enrollment numbers as vindication of the law, but those claims are largely meaningless without the missing data specifics to back them up.

Worse, if an insurance company's consumers are less healthy than expected, premiums will rise beyond the previously predicted increases. Outgoing Health and Human Services Kathleen Sebelius acknowledged that many people will see premium increases, but these new revelations about the website add another twist for average Americans to worry about as premiums are announced.

The entire website was supposed to be functional by October, but obviously that was not the case. The government then focused on fixing the front end for consumers, perhaps to create the Potemkin Village-style illusion that the site worked. As a result, though, they left the back end in disarray. The deadline to have the back end ready was pushed from October to January, to March and now to some unnamed point this summer. Even that aim could be overly ambitious.

Government officials acknowledge problems, but refuse to provide details about the issues, their progress or an exact deadline. Politico reported that previously, the government warned that if the system was not in place by March, "the entire health care reform program is jeopardized." They explained that the government could be making "erroneous payments to providers and insurers," but would not give a more exact deadline for full correction beyond sometime "over the summer."

Industry experts and insurance companies share concerns about the volatility of Obamacare and its numerous technical and inherent problems. They worry that the Obama administration is using faulty estimates to calculate Obamacare's financial impact. Worse, flawed enrollment numbers, higher costs and general frustration could compel insurers to leave the exchanges, which would send premiums through the roof.

The countless delays, millions of canceled plans and lost doctors aside, the federal government has repeatedly demonstrated its inability to run the nation's health care system. It's not just the website that doesn't work — it's the whole law. Healthcare.gov may still not work correctly, but Obamacare still managed to cancel more than 6 million health plans. Yet Mr. Obama still insists his signature law is going swimmingly.

As Dan Schuyler, director of exchange technology at Leavitt Partners, told Politico, "I think there comes a point when it becomes unmanageable." It would appear that point came and went a long time ago.

Akash Chougule is a policy analyst at Americans for Prosperity.