What does the healthcare.gov web site do?


The Obamacare exchange, healthcare.gov, web site has been in the news lately. It supposedly cost a lot of money to build and doesn’t work very well, but none of the news articles seem to explain what it does.

For example, does a consumer actually complete a transaction on the healthcare.gov web site? Or does the site simply allow a consumer to fill out a form that gets forwarded to an insurance company where coverage will be established?

And what did it cost to build? It seems safe to assume that it was more than the $25 million in funding that sufficed for Google’s expansion for the first six years. (Wikipedia) Was it more than the $327 million that California spent on their state exchange? (see this earlier posting)

15 thoughts on “What does the healthcare.gov web site do?

  1. Good questions!

    But to imply that Google “cost” $25 million for the first 6 years is ridiculous. The company didn’t take more funding because it was profitable. But the costs, just for employee salaries, over the first 6 years was at least ten times the $25 million figure; that’s not counting the cost of stock options, nor the considerable capital costs of data centers.

  2. I used it to make an account yesterday, intriguing to me, it was clearly very different code from three weeks ago….

    I wasn’t able to get past account creation, profile creation, and “applying”, but that’s because there are some issues that it said I needed to wait on in ways which didn’t seem to be its fault and more the fault of the idiot state I live in.

    But in those steps it seemed pretty straightforward. I will say the defintion of applying seems backwards because the workflow is you apply which I think determines financial needs and support and then after the application you begin to figure out which insurance you want.

    What does it do? It’s a damn good question.

    My total speculation is that it has to interact with 50 states, pulling in qualified insurers in those states, and pulling in information about state medicaid, and state insurance markets.

    And then it has to for each insurer, bundle up the person’s profile and interoperate.

    But beats me how reporters or so called experts claim there are 5 millions lines of code that need to be *rewritten* or one reporter that wrote it had 500 millions lines of code.

    Having been on other gov’t programs, I can well believe the feds took over a year to get specs out, and specs that were just terrible. And I’ve personally seen gov’t software programs “delivered” in a complete unusable and broken state in order to fulfill some contract, get paid, and satisfy some management bullshit, with promixed fixes to make it working in the next release months down the road.

    I should hope any audit will answer the questions: what does this thing to, and also answer why didn’t testing catch these problems months earlier.

    Whoever is Obama’s IT advisor needs to resign, this sort of peak achievement, eponymous achievement of Obama’s presidency should never have been rolled out the way it was, and it should have been obvious to everyone months earlier.

    And frankly whoever rolled it out the way it was and his superiors probably could use a good going over by a US Attorney.

  3. http://www.ibtimes.com/obamacares-website-recipe-disaster-500-million-lines-code-shoestring-budget-political-pressure
    This article suggests that $1 billion (which they refer to as “only” a billion dollars and “a small budget”) was allocated to setup the federal health exchange (of which some amount is presumably the call centre, and not merely the web site).

    This article suggests that part of the dizzying complexity is due to an attempt to integrate a lot of data from a lot of government agencies that are probably not known for data standardisation, in an effort to check (at sign-up time) that people are actually eligible for various subsidies.

    And let’s not forget that instead of allowing a market in insurance to function, insurance is segregated not just on a state-by-state, but even county-by-county, basis. So they have to integrate all of the various insurers and plans and costs and exclusions of 36 states and their counties.

    It’s a wonder that it works at all.

  4. Commenters so far… You guys are proving my point that nobody knows what the site is supposed to do. Can anyone answer the simple questions, e.g., does the site take credit cards and charge people for insurance? Or are the transactions completed by the insurance companies once a user ends up on an insurance company’s site?

    Separately, I’m not sure why this site would be more complex than Progressive.com, which quotes and then sells auto insurance in multiple states. The rate for car insurance varies depending on the specific town (and maybe neighborhood?) in which one lives, the age and number of drivers in the household, the kind of car, the previous loss and traffic ticket history (may require integration with other insurance companies and state DMV systems), etc.

  5. Thanks for bringing this up on your blog. I’ve done a little reading this morning, here’s what I’ve learned so far:

    Obama’s current CTO, Mr Todd Park, is an economics major from Harvard.


    It’s a little frustrating to see that a president who has encouraged young Americans to study science and engineering picked a harvard econ major as his CTO, but Mr. Park is a smart and accomplished man, and no less a voice than Tim O’Reilly thinks his econ background is a real asset.


    Mr Park is now being called upon to help fix the healthcare site.


    Here’s a bit about what the site is supposed to do (from the link above):

    “Today, more and more individuals are successfully creating accounts, logging in, and moving on to apply for coverage and shop for plans,” [HHS] said. “We’re proud of these quick improvements, but we know there’s still more work to be done.”

    I’m confused about why Mr Park wasn’t more involved throughout the project, but maybe he figured they just needed someone to code it up.

  6. Basically, legacy system integration is what is causing the headaches.

    “A review of internal architectural diagrams obtained by the AP revealed the system’s complexity. Insurance applicants have a host of personal information verified, including income and immigration status. The system connects to other federal computer networks, including ones at the Social Security Administration, IRS, Veterans Administration, Office of Personnel Management and the Peace Corps”


  7. What exactly does Healthcare.gov do?

    That’d be a hell of zinger question for an Obama press conference!

  8. What does it do? It captures all your personal+income+contact info, show you prices, then if you opt not to buy, a few days later it sends you threatening emails telling you how much you will be fined if you dont buy insurance.

  9. The Washington Post represents the purpose of healthcare.gov is to generate batch-processed EDI Form 834’s for submission to the Insurance Provider, which are then reviewed manually.

    “The FFE will send the first 834 transaction to a QHP Issuer(s) with enrollment information,” the manual says. “This exchange contains the Initial Enrollment Notification transaction(s). This transaction is created after an application has been determined eligible and a Qualified Health Plan (QHP) selected.”

    To translate that into non-insurance speak: The 834 transmission is the one form, in the giant machinery of HealthCare.gov, that lets insurance companies know who signed up for their product. It is the electronic file that lets them get to work printing member cards, mailing them out and, eventually, paying claims.


  10. I just tried the web site using Tor and received this.

    Access Denied
    You don’t have permission to access “http://www.healthcare.gov/” on this server.

    Reference #18.cdd27a5c.1382732582.1357a9b6

  11. Hey Phil.

    My understanding is that what Healthcare.gov tried to do was provide a public, secure, online federal marketplace for individuals to research, compare and ultimately purchase subsidized health insurance products following verification of eligibility.

    The October roll out of healthcare.gov is encumbered not only by a lack of consumer input and testing, but also by the layers of health care privacy law and the significant complexity (some argue fraud) innate to our fee for service health care system. Fred Trotter points to other encumbrances in Wonkblog: http://www.washingtonpost.com/blogs/wonkblog/wp/2013/10/25/wonkbook-how-healthcare-gov-looks-to-a-health-it-pioneer/.

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