THE BLOG
12/30/2013 05:19 pm ET Updated Mar 01, 2014

An Obamacare Checkup

It's time for a regularly scheduled checkup (to use a medical metaphor) on how Obamacare's doing. Three months in, things do seem to be improving. So much so, in fact, that January will (one way or another) see a shift in the political discussion to other aspects of the health reform law than just the HealthCare.gov website. Whatever way the story gets spun next month, it will be different than the prevailing storyline up to this point. But before we get to that, let's take a look at the progress made in the past month.

December was pretty crucial for the website. After the interminable wait in October and November, this was pretty much the last chance for the federal insurance exchange site. But now that the numbers are starting to leak out, it looks like the website performed not just competently, but downright admirably once all the fixes were in.

December was always going to be a "spike" month for the program, due to the deadlines built in to the system. This was exacerbated by the pent-up demand from October and November (all those people who had waited until the website was pronounced fixed before trying to access it). But even under this heavy load, the website held up. Rather than freezing up or giving error messages, there was a newly-added safety valve built in, and it seems to be working as designed. On the website's biggest traffic day (last week), even with over a million people accessing the website on the same day, the wait times were reported as only seven minutes, after the safety valve ("take a number, leave your email, and we'll contact you when you can log on") was turned on. That's a pretty acceptable wait time for such a high-volume day.

Also encouraging on this front was the reported fact that the safety valve was dynamic -- the website operators could adjust when it kicked in, to deal with whatever load problems developed. On the first day of December, there was an initial rush (after the White House proclaimed the site up and ready) and the "take a number" feature was set to kick in when the system got over 30,000 users simultaneously. The specification for the system had initially been 50,000 simultaneous users. But by the biggest spike at the end of the month, the system was successfully handling something like 80,000 users at once, before the safety valve was turned on. That is huge progress, and bodes well for the final projected big spike (at the end of March). So my initial fears of the newly-fixed website being overwhelmed by a December spike were not realized, thankfully. Whoever programmed (or came up with the idea of) the safety valve feature deserves a fat raise, that's all I can say.

The White House has been controlling the data flow about the website with considerable political finesse. They initially announced that they'd only release numbers once a month, but this still leaves them free to leak numbers whenever they wish (whenever the numbers look particularly good, to put this another way). We've just had such an "authorized leak," so let's take a look at what's being reported.

In December, it looks like the number of people who successfully signed up for private insurance on the federal Obamacare website (this doesn't count people who signed up for Medicare or Medicaid, in other words) was over a million. The other figure I've heard batted around is that when you add in everyone who has signed up since the October launch -- including those who have signed up through state exchanges -- that a total of around two million people have now successfully signed up.

The last time I looked at the numbers was in November, when the official pre-leak for that month happened. The final numbers were pretty close to the initial numbers, and what they showed was that around 500,000 people had signed up in October and November (on both the federal and state exchanges). But the target that had been set was to sign up at least seven million by the end of March. Two months into a six-month window (one-third of the period), they had only hit one-fourteenth of the target. Which was pretty worrisome.

Now, however, the numbers look a whole lot better. If the leak proves true, it would mean that approximately 1.5 million people signed up in December. Now, December was a "spike" month, and this number will likely go down in January and February, but then will reach what will possibly be an even-larger spike when the final deadline nears. So while it's tricky to use averages in this case, doing so nevertheless shows that Obamacare could come very close indeed to the initial estimate. If the next three months are as successful as December was, that would mean an additional 4.5 million people signed up. For a grand total of 6.5 million -- pretty close to the initial target set. So, even with the inaccuracies inherent in this sort of averaging, it's at least within the realm of possibility that Obamacare's numbers will look pretty good by the end of March. Which is, significantly, the first time that claim could ever realistically be made.

With the website largely fixed and the deadlines passed for insurance policy cancellations, the stories in the media are going to shift. What they shift to remains to be seen. Both Democrats and Republicans will be trying to influence this storyline, meaning we're in for a month of fierce political spin, folks.

Republicans will be scouring the land for personal stories of any failure in the new system. While the error rates are way down (below one percent), there will undoubtedly be stories of people who thought they were insured and who went to a doctor, only to find out that the insurance company doesn't have them on the rolls yet. Perhaps there will be people who "can't find a doctor" on their new plans. I'm sure Republicans will be diligent in digging out such stories.

Democrats will be pushing more positive storylines, of course. The best ones will be "I visited a doctor for the first time in years, and can now get my medical problems treated without entering bankruptcy." This, after all, was the whole point of the Obamacare program. A video of some poor soul weeping tears of joy after receiving their first cancer treatment will be a good example of this.

The real question is which one the media will run with. Perhaps at the start, the two storylines will be balanced. But after a few weeks, the problems of "not having my insurance card when I thought I was insured" will likely fade, as the insurance companies fix individual problems. The official release of the website numbers for December will come mid-month, which could also bolster the positive storyline. Of course, problems with insurance companies didn't begin when Obamacare was passed (they were, in fact, the reason for passing Obamacare in the first place), and they're not all magically going to end overnight either. So there will always be stories of people seriously annoyed at health insurance companies for one reason or another.

Democrats are finally going to be given a chance to argue Obamacare on its merits. They really didn't do so very well when it passed (from Obama on down), and they really couldn't very well do so while the website was limping along. Which cleared the field for scaremongering, of course. Democrats would do good right now, though, to do a little opposition research -- go back and mine all the quotes you can find from Republicans from the past three years or so. Find every single example of some Republican saying "Obamacare will mean that X is going to happen," and then highlight them prominently to remind the public "Obamacare is now up and running, and X did not happen." Start with Sarah Palin's "death panels" and work your way forward, right up to the present. Find every laughable prediction you can, and start debunking them all in the media right now.

Republicans are not being shy about letting it be known that their entire 2014 congressional campaign will not just revolve around or be centered on, but indeed will consist solely of attacking Obamacare. For Democrats, it's not just about making the argument in January to win some sort of media war over the issue. This is going to be the whole 2014 campaign to Republicans, and Democrats had better be ready to fight back on this battlefield if they have any hope of doing well in the upcoming midterm election.

 

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