I'll confess that I was pretty surprised about the difficulties Healthcare.gov has been having. After all, despite all the complexities of creating this system, it wasn't exactly hard to foresee that the workability of the exchange website would be a very big deal. So you'd think that once a day or so for the last six months, the President would be calling the Secretary of Health and Human Services and saying, "This is going to go smooth as silk, right? Don't let me down, Kathleen." And she'd light a fire under everybody reporting to her to make damn well sure it did, so they wouldn't have to scramble like mad to fix a hundred problems once it had already launched. While the different things the site has to do certainly present technical challenges, they're hardly insurmountable.
Now, you might just put it down to the fact that the whole thing was outsourced to private corporations, and we all know you can't trust the private sector to do anything without screwing it up (ha!). But while there's no doubt the Obama administration deserves plenty of criticism for the difficulties, ask yourself this: Ten years from now, will the workability of Healthcare.gov be something we as a nation are going to be spending a lot of time talking about?
Of course not. That isn't to excuse the problem, but unlike some problems—global poverty, say, or keeping Pakistan's nuclear arsenal secure indefinitely—this is a problem that can and will be solved before long. Maybe it'll take a few weeks, or maybe a few months, but it will be solved. Many of the state-exchange websites are working just fine. The long-term success of the ACA is something we'll be judging over a period of many years, based on how many poor people got Medicaid, whether the individual mandate solved the adverse selection problem, what effect the payment reforms had on health-care spending, and a dozen other things. It will not hinge on whether there were website crashes in the first couple of weeks.
It does warm the heart to see Republicans so concerned about solving this problem. Rather than mounting distributed denial of service (DDoS) attacks on Healthcare.gov or trying to make sure that the contractors are rewarded for their mistakes, they're going to hold hearings to get to the bottom of the problems. Some are so disturbed by anything less than a perfect rollout of the ACA that they've demanded that Kathleen Sebelius be fired! Maybe they've gotten the message that though many Americans dislike the law, not only does a majority either support it or think it should have gone farther, but even many of those who dislike it would still like to see it work. Now that the GOP is unified in its commitment to seeing that ACA implementation proceed effectively, we should see some real progress.
Sarcasm aside, I actually don't think it's a bad thing for the Republicans to hold hearings on the website problems. First, it actually will put them in the position of pretending to want the site to work, and that means tacitly accepting that a functioning ACA is a worthwhile thing. As Alec MacGillis said, "Administration officials will come in for questioning and Republicans will demand to know: How many people are signing up for coverage? When will the site be working better? What are you doing to fix it? Unspoken in all of those questions is something that Republicans have simply shut out of their assault on Obamacare until now: That there are people out there, millions of them, who do not have coverage and will be helped by the law if it can be made to function properly."
But more importantly, some extra political pressure on the administration to get things fixed quickly couldn't hurt. The more it's in the news, the more everyone, from the White House to HHS to the contractors, will care about solving the problem, and fast. But that doesn't change the fact that this is an issue with a very short half-life.
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