The Affordable Care Act has been under intense scrutiny in recent months for a number of issues ranging from website difficulties to enrollment numbers. Since the failed rollout of the healthcare law, there has been a scramble to determine how to address its problems. Many people are criticizing the website glitches and lower than expected enrollment as a sign of the problems yet to come with Obamacare. Despite these exchanges, what many don’t realize is the complexity of new technologies and how it takes time to discover glitches and for the market to adjust to new things. As economist Brian Arthur puts it, technology is dynamic, it will evolve and adapt to issues and changes that arise (Arthur 2009).
Even though website building is a common activity today, this healthcare law and conjoined website were new ideas, so naturally, there would be a learning curve and a need for improvements following its rollout. The Office of Health and Human Services explained that following the glitches, they replaced the original database with a much more efficient and effective one (Fox 2013). The standard engineering behind the website is what was lacking; the focus was primarily on the rules and policies, not necessarily the design and construction of the website (Arthur 2009; Goldstein 2013). CGI Federal, the company tasked with building the website, was under scrutiny for several reasons, including shoddily putting together code and having a lack of sufficient funding. Similarly, the website was only tested during a two-week period before the launch, when many claim a longer window of a few months would have been preferred (Fox 2013).
Despite the finger pointing, according to Steve Weber, a professor at the University of California, Berkeley and author of The Success of Open Source, “the more users…actively engage in using a piece of software, the more likely that any particular bug will surface in someone’s experience.” The initial problems that were discovered by users following the rollout, in the end, make the website better down the road (Weber 2004). As more and more users are on the healthcare site and these glitches come to the surface, the higher the standards to which which the website will be held. The architecture that is being created will determine the interactions and transactions that take place for the Affordable Care Act down the line (Garcia 2013).
The website glitches and negative press have played an obvious role in the current enrollment numbers. Some are claiming that the “low enrollment signals the failure of the health care reform.” However, the administration noted that they expected the initial enrollment to be small, especially given the window of time in which people can enroll (Cohen 2013). As more people sign up, the desirability of healthcare will increase to other potential users, increasing the law’s power (Grewal 2008). However, as the enrollment deadline of March 31, 2014 approaches, it is clear that the enrollment goal of seven million Americans will not be reached, as expressed by Vice President Biden. Despite not reaching their goal, Health and Human Services officials are happy with the current results given the controversy of the bill (Condon 2014).
What I find most intriguing about the enrollment is the large disparity across states. States like California, Kentucky, North Carolina and Idaho have all done extremely well in reaching their projected numbers. In contrast, states like Maryland, Massachusetts and Minnesota are as low at 17 percent of their projected enrollment (Howell 2014). Economist Brian Arthur and author of The Nature of Technology discusses how it takes time for a technology to diffuse into an economy; the economy needs time to adjust to the new technology (Arthur 2009). The discrepancy between state and federal markets appears to be playing a key role in the enrollment numbers. As March 31, 2014 approaches, time will tell if these disparities will even out and we will see if enrollment numbers soar in the final weeks (Howell 2014).
Cohen, Tom. “Obamacare Website Official: Sorry for Problems, but System Working.” CNN. Cable News Network, 01 Jan. 1970. Web. 03 Mar. 2014. <http://www.cnn.com/2013/10/29/politics/obamacare-hearing/>.
Condon, Stephanie. “Biden: We May Not Meet Obamacare Marketplace Goals.” CBSNews. CBS Interactive, 20 Feb. 2014. Web. 03 Mar. 2014. <http://www.cbsnews.com/news/biden-we-may-not-meet-obamacare-marketplace-goals/>.
Fox, Maggie. “We’re Sorry and We’re Fixing Website, Health Officials Say.” NBC News. N.p., 29 Oct. 2013. Web. 03 Mar. 2014. <http://www.nbcnews.com/health/hill-panel-grills-top-obama-insurance-site-executive-8C11487718>.
Goldstein, Amy, and Juliet Eilperin. “HealthCare.gov: How Political Fear Was Pitted against Technical Needs.” Washington Post. The Washington Post, 2 Nov. 2013. Web. 03 Mar. 2014. <http://www.washingtonpost.com/politics/challenges-have-dogged-obamas-health-plan-since-2010/2013/11/02/453fba42-426b-11e3-a624-41d661b0bb78_story.html>.
Howell, Tom, Jr. “New Obamacare Enrollment Map Reveals Surprises, Uneven Progress across U.S.” Washington Times. The Washington Times, 13 Feb. 2014. Web. 03 Mar. 2014. <http://www.washingtontimes.com/news/2014/feb/13/new-obamacare-enrollment-map-reveals-surprises/>.