3 questions the Obama administration won't answer about Obamacare

CNN
Wednesday, December 4, 2013 - 11:22am

WASHINGTON (CNN) -- Donald Rumsfeld's most famous quote has to do with whether there were weapons of mass destruction in Iraq.

But he might as well have been a reporter talking about Obamacare.

"There are known unknowns," said Rumsfeld back in February of 2002. "That is to say we know there are some things we do not know. But there are also unknown unknowns, the ones we don't know we don't know."

When it comes to Obamacare and the frantic White House effort to right the listing website meant to bring private health insurance to the uninsured, there's a lot more we know we don't know than hard information we can point to.

Here, in order from least to most alarming, is a look at three of the things we're pretty sure the Obama administration knows about the health law and is choosing not to share:

1. How many people are on the website?

In fixing the healthcare.gov website, the head of the company tasked with cleaning up the mess touted the real-time information pored over by a large team of contractors and web programmers holed up in the D.C. exurb of Columbia, Maryland.

"Outside on the walls we have a band of about 15 different large screens or monitors," QSSI CEO Bikram Baskshi told reporters on a video conference November 29. "And what they tell us at any given point in time on multiple data points -- and these data points could range from what's the current traffic on the site, how many people are trying to access what part of the application. They also show us exactly (inaudible) the various components of the healthcare.gov system as a whole."

He and others went on to detail a menu of off-the-shelf computer programs and services that provide a remarkable level of detail to the people monitoring the website. It was monitoring that data that led site administrators to periodically employ a "queuing system." That means administrators thought the level of traffic was high enough that it might crash the site -- 50,000 concurrent users is supposed to be their max -- that it could again crash the site. So they shut the front door at times and essentially asked people to take a number before they could get to the portion where you apply for coverage.

On Monday, CMS spokeswoman Julie Bataille said more than 1 million people visited the site. She said 13,000 went into that online waiting room. But that was about it. We don't know how many people went on to apply for health insurance or even how many created accounts.

That 1 million figure includes window shoppers, too -- people who went on for what Bataille called "educational" reasons.

The metrics are important to grade not only whether the health site is working, but also how many people are actually moving toward getting insured.

2. How many people are signing up?

Among those website metrics that enable site administrators to know how many people are visiting at any given time is a program that allows them to know how far people are getting on the site and how many are actually applying for insurance.

But don't look for any of that data from the White House, HHS or CMS. They've said they will only release data on a monthly basis.

The first disappointing enrollment numbers were rolled out November 15, six weeks after the website's troubled launch. The second set of enrollment figures are expected December 15, eight days before the deadline to sign up for a plan and be insured by January 1, when new insurance plans go online.

The administration must have some grasp on the data. On Monday, for instance, CMS announced that 1.46 million people have been determined to be newly eligible for Medicaid since the October 1 open enrollment period began. But when Bataille was asked on a conference call for reporters to give updated enrollment numbers, she demurred, arguing the administration wanted to wait for accurate data.

There is data available, just not for states serviced by HealthCare.gov. Fourteen states and the District of Columbia have their own state-based insurance exchanges. Many of those have provided much more frequent updates on enrollment. CNN has an ongoing count for each sates.

One government agency projected 7 million Americans would seek private health insurance via Obamacare during 2014. The open enrollment period lasts until March 14, so there is time.

And there has been a pickup. After just more than 26,000 enrollments on the federal site, an administration official told CNN's Jim Acosta approximately that 100,000 had enrolled in November. That's an improvement, but far short of the 800,000 enrollments goal that had been set internally by the administration.

3. How broken is the back end?

If the front end of the website is the part seen by people who want to get insurance, the back end is the part seen by insurance companies who want to sell it to them. There are increasing reports that the back end of the system is just as glitchy now as the front end was back in October. Insurance company executives and industry spokespeople have raised increasingly frantic alarm bells that the information they are receiving from the website is at times faulty and duplicative. That's when they receive information at all. There are reports from some insurers that they have tested the website with John Doe applications and not received them through the back end.

That's led to concerns that there are people who think they've signed up for health insurance but who might not be on the radar of any insurance company.

But while Bataille said Monday a new fix would address 80% of these errors, she wouldn't say how many errors there are. She declined to answer that question again on Tuesday.

As a result, Bataille said people getting insurance need to be dogged in following up and making sure they make a premium payment before January 1. She would not guarantee there are people who think they're getting health insurance after navigating the HealthCare.gov site, but who might not actually have it from an insurance company.

"It's important to remember there are some steps that consumers need to take in order for their coverage to be effective," said Bataille on Tuesday. "That certainly involves paying their first month's premium and then being in touch with their plan to confirm that their enrollment has in fact taken place. Consumers can call the issuer of their choice -- the person they have selected -- to confirm their coverage. They can also call our call center and we will work with them if there is any issue they are worried about."

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