Obama Gets A Second Shot At Getting Health Care Reform Right

Obama Has A Second Shot At Getting Health Care Right, And Here's How He's Going To Do It
President Barack Obama walks from Marine One to Air Force One as he leaves Los Angeles International Airport Tuesday, Nov 26, 2013, returning to Washington after a three-day multi-city political and fundraising trip on the West coast. (AP Photo/Nick Ut)
President Barack Obama walks from Marine One to Air Force One as he leaves Los Angeles International Airport Tuesday, Nov 26, 2013, returning to Washington after a three-day multi-city political and fundraising trip on the West coast. (AP Photo/Nick Ut)

WASHINGTON -- Contrary to the cliché, there are second acts in politics. They just don’t usually come two months after the first.

On Nov. 30, the Obama administration will have a second chance to showcase its capacity to administer a website and oversee health care reform. Senior officials in the administration are quick to insist that the date is merely a point on a calendar, not a moment when a switch is suddenly flipped and all the problems surrounding Obamacare disappear.

But as a political matter, they also understand the scrutiny that comes after Nov. 30 will be heightened, and the stakes a bit higher. More than one administration official over the course of reporting this article said they fully expect that the first time a consumer encounters an error message on the website on Dec. 1, it will be used as a cudgel by the critics. Senate aides, meanwhile, say it's unclear how long a leash up-for-reelection Democrats would give the president should problems persist. Senate Majority Leader Harry Reid (D-Nev.) may not be able to keep legislation reforming the Affordable Care Act off the floor absent major, tangible improvements.

And so, as they enter , White House aides and ideological allies are taking steps to avoid repeating the disastrous first one.

"We are better prepared because the site is a better site," said one senior administration official, speaking on condition of anonymity to discuss post-Nov. 30 plans. "We have visibility into the site, what’s happening with it, how many consumers are coming. It is vastly improved. It will allow us to adapt our tactics and tools to reach consumers in real time. And now, people all across the country have enrolled and we will continue to make sure their stories are told. It is different when you have lots of people enrolled as opposed to day one, when you had some people trying to enroll and who were stuck."

On a technological level, the administration is far ahead of where it stood on Oct. 1 -- an important but hardly remarkable feat considering how bad things were two months ago. Medicare spokeswoman Julie Bataille said that as of the end of November, approximately 50,000 users will be able to use HealthCare.gov concurrently, which will be the equivalent of more than 800,000 during a day.

If user interest exceeds those numbers, the administration has set up “a customer-friendly queuing system which would notify you when to come back to the site and sort of be first in line,” Jeff Zients, President Barack Obama’s point man for rebuilding the website, told reporters in a Tuesday roundtable.

The White House also hired a general contractor to set up a command center in Columbia, Md., that functions as a 24/7 monitoring and incident response team. The center, which is staffed by 25 people with different areas of expertise in web technology, will work with the White House to troubleshoot and react to incidents that may occur on healthcare.gov, in real-time.

The better the website works, the logic goes, the easier it will be to manage the politics. But even so, the White House is also making administrative adjustments to HealthCare.gov in order to avoid a repeat the agony of those early October days.

One (perhaps the only) unforeseen benefit of the website's disastrous rollout was that interest didn't wane as much as expected over the course of October. In addition to the stream of consumers looking to buy insurance, people wanted to see what the fuss was about -- like drivers who can't help looking at the car wreck across the freeway. So the administrators of the site got a healthy sense of when traffic peaks (around lunchtime) and when it lulls (the weekend). Looking forward, that data will allow them to help keep the number of visits to the site relatively steady.

Hoping to manage Nov. 30th expectations, the administration has already told private insurers to hold back on advertising the exchanges, worrying that heavy traffic could overwhelm the servers. Allies in the progressive community, meanwhile, say they've been told to wait for word from the administration before sending out sign-up alerts to their email lists.

Already, there has been evidence of some success in micromanaging the traffic flow. According to a 39-page “recess toolkit” put together by the White House for Democrats on the Hill, which was shared by an aide with The Huffington Post, the Center for Medicaid and Medicare Services was able to invite back, in clusters, nearly 275,000 consumers who had problems during the account creation process in early October. Of those who returned to the site, 92 percent successfully created an account on HealthCare.gov.

Another Democratic Hill aide said the White House is expected to step up its consumer education and outreach in early December, particularly focusing on the 18-to-35-year-old demographic. Next week, for instance, the White House is planning a youth summit to ensure that young leaders understand the benefits of the health care law and help get the word out among their peers. That comes on top of the administration’s ongoing efforts to enlist athletes and celebrities to engage with youth on the law’s benefits.

The White House is also trying to make it easier for Democratic lawmakers to go on offense this time around. In addition to the sending them home for the Thanksgiving recess with a 54-page packet of Affordable Care Act sign-up “success stories,” broken down by all 50 states, administration officials are encouraging Democrats to talk about a new report released by the White House Council of Economic Advisors showing how Obamacare is helping to slow health care costs, in turn helping the economy.

Despite these steps, Democrats in and out of office have a hard time evincing much confidence that the political troubles caused by health care reform will dissipate quickly. Some are hopeful but not yet sold that the administration can successfully manage the next few months after being stunned by the ineptitude they exhibited around the website's launch.

"The website is getting better but it's not fixed," said one Democratic lawmaker. "Don't even get me started on talking points. They should use the time they spend writing useless talking points fixing the website."

Even the administration acknowledges that success on Dec. 1 means that the website will function for some 80 percent of users. And with 20 percent still in the dark, critical focus will continue -- a scary proposition for many Democrats. One party operative who works on health care reform said that it remains a mystery as to how to respond to accusations that the president misled the public when he pledged that people could keep their insurance plans if they liked them.

"If there are good talking points around that, I haven't heard them," the operative said.

Several other operatives, when interviewed for this piece, marveled at how the administration "lost" traditional media allies during the October rollout.

Winning them back has proven difficult, though the White House is far better prepared for the media wars now than it was on Oct. 1. A Democratic aide familiar with White House strategy said the administration has given assurances that it will have a beefed-up, rapid-response operation to address new attacks or incorrect stories. They certainly have more manpower.

"You have to remember what happened on Oct. 1," said the health care reform operative. "There was a government shutdown. All the people who would have been part of the rapid response team were furloughed. That lasted for 16 days."

During the early weeks of October, nearly all the White House staffers chiefly responsible for pushing back against bad press and spreading good health care news were off the job. Eric Schultz, a White press official who worked during the shutdown and has health care reform under his portfolio, was so preoccupied with the shutdown that he was seen running the president's remarks to the podium -- a task usually reserved for a junior staffer.

"The shutdown wasn’t the root cause of the problem," commented one administration official, "but it sure as hell didn’t help."

HuffPost readers: Do you plan to try HealthCare.gov or a state-run health insurance exchange website in December? Tell us about your experience -- email jeffrey.young@huffingtonpost.com. Please include your phone number if you're willing to be interviewed.

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