A Look Back at Healthcare.gov

The period of time during which individuals are able to take part in the open enrollment end March 31, 2014. The amount of publicity Healthcare.gov received in October last year drew in numerous discussions. The situation has settled down and now we can look back with a clearer picture.

Complex System

Healthcare.gov was more than just a website. It’s a front-end for an entire set of systems interconnected to exchange data. The system has to make requests to a handful of other agencies checking for citizenship, financial eligibility, IRS, Homeland Security, SSA, etc. Because of the multiple layers Healthcare.gov needed such as:

  • Bank level authentication and encryption.
  • Verification of identity and identity.
  • Granting insurance companies access to advertise plans.
  • Calculation of federal subsidy.
  • Managing and storing all the application data.

These were just some of the situations that made the back-end component of Healthcare.gov struggle. In addition, political interest required the site to do the enrollment upfront in order to show the subsidized price to reduce the sticker shock to the American public.

Lack of Proper Testing

Initially the contractor’s built their system to handle 50,000 people using it at the same time. The number was based on the roll out of the Massachusetts version of the site a number of years ago. When launching a new online system, the peak load will often happen on the first day of launch. Without proper stress testing, many systems will drop dead due to the flood of traffic. For examples of this, Intechnica wrote a blog listing 15 examples of high profiled companies having their website crash due to lack of testing. The lack of QA and proper testing before the live launch of Healthcare.gov was a nightmare for user experience. The multi-hour wait times, blank menus, and so called “prison glitches” which stopped a user from moving forward until they specified how long they had been incarcerated, despite never being incarcerated. The administration expected more states to make their own exchanges to reduce workload on the federal system. The exact opposite happened. Over 60% of the country is coming to the federal exchange instead of a state-run one.

Project Management & Communication Problems

Another failure was also lack of communication. The front end of Healthcare.gov was made by one company, and the back end made by another. They did not adequately communicate with one another during development, so issues have arisen based on the poor communication between the two parts.
The projection of the project was beyond optimistic. A web application of this scale being rolled out for the whole nation isn’t going to be finished. The term finished doesn’t fit too well with software development these days. The publicity to urge millions of Americans to sign up the first day was a standard that was unrealistic especially when the contract expected Healthcare.gov to be flawless on October 1.

Patching and Fixing

Since the launch of Healthcare.gov, the level of pressure to improve the web application has been significant. There is still work being done to improve the system and enhance user experience. The new management system has improved the site stability by lowering the error rate below 1% and allowing a capacity of 50,000 concurrent users.Below are charts and graphs to see the progress of Healthcare.gov after the first month of launch.
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