Sticker Shock and the Obamacare Website

By Grace-Marie Turner

The Obama administration appears to be caught in yet another bind over the HealthCare.gov website. One of the site’s functions that actually worked well in testing was shut down days before the October 1 launch. CNN reports on internal administration e-mails:

When the troubled federal health care website came online, the key “Anonymous Shopper” function was nowhere to be found — even though it passed a key test almost two weeks before HealthCare.gov launched.

That successful test, noted in documents obtained by CNN and confirmed by a source close to the project, contradicts testimony from an Obama administration official overseeing HealthCare.gov, who told lawmakers earlier this month the function was scrapped because it “failed miserably” before the October 1 launch.

Like much of the HealthCare.gov rollout, the subject has become political fodder for Republicans, who claim the decision to nix the anonymous shopper was made by administration officials worried it would produce rate estimates so high they would deter potential enrollees.

Someone made a decision in mid-September to block the “shopper” feature on the website, a decision that likely contributed to the launch problems. Anyone visiting the site had to first enter a battery of personal information to determine whether and how much of a subsidy they might be eligible to receive. Then they would see only the subsidized price, not the full sticker price.

Avik Roy of the Manhattan Institute and I wrote here and here about the growing evidence that the administration feared having millions of people see the full sticker price of the health policies available in the exchanges. That meant that everyone visiting the site, even out of curiosity, had to enter a battery of personal information first. The system was not set up to handle such massive traffic and crashed.

CNN says that the window-shopping feature, which required visitors to enter only minimal data, “was turned off before HealthCare.gov launched and is still unavailable to users.”

Henry Chao, the top technology officer for the Centers for Medicare and Medicaid Services, said in congressional testimony that he and his colleagues decided to block the feature because it “failed so miserably that we could not conscionably let people use it.”

Yet a CMS document made public by the same committee last week tells a different story. The agency and one of its subsidiaries, the Center for Consumer Information and Insurance Oversight, was working with government contractors on the website. It determined the Anonymous Shopper feature “tested successfully,” revealed “no high severity defects open” and that “remaining lower severity defects will not degrade consumer experience.”

CMS raised questions about the “tested successfully” denotation for the feature in a statement.

In it, a spokeswoman writes: “CMS believes that the ‘yes’ that is written on the document in question is likely an error, because the same document also lists a number of ongoing defects and problems with the tool. Additional defects were communicated and discussed in other settings.”

The source close to the project, however, said the anonymous shopper function did pass testing conducted in the weeks ahead of the HealthCare.gov launch.

The shopping feature was successfully tested on September 17, with only minor glitches that developers said could easily have been repaired, according to the documents obtained by CNN. Yet the following day, another memo shows CMS pulled the plug on the shopper function, saying it “isn’t needed and thus should be removed.”

One of the world’s leading design firms, IDEO, created the prototype, Enroll UX 2014, as a model of world class health insurance shopping experience.

IDEO’s team for the $3 million project included the designer who created shoe and apparel giant Zappos.com and currently directs design at the popular online restaurant reservation site, OpenTable.com.

After a year of work, they presented their Anonymous Shopper template to state and federal officials in June 2012. CMS endorsed the prototype and encouraged states to adopt it, according to a letter the agency wrote to states, which CNN obtained. Many of those states, including California, Colorado and New York, are using the feature designed by IDEO effectively.

House Oversight and Government Reform Committee chairman Darrell Issa is determined to get to the bottom of this dispute.

While the website has many more and much deeper problems than the “anonymous shopper” problem, it is important for citizens to ask why the CMS made the decision to turn off a feature that is so common to other consumer-focused websites. Was it fear of sticker shock?

Posted on National Review Online November 22, 2013

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