Uncertainty persists on eve of HealthCare.gov deadline

In late October, after it became clear that HealthCare.gov’s problems went far beyond heavy traffic, the administration’s freshly-appointed Obamacare website czar Jeff Zients promised, "By the end of November, HealthCare.gov will work smoothly for the vast majority of users.”

On the eve of its self-imposed deadline, the Obama administration has made significant progress on the dysfunctional website, which serves as a portal to the new Obamacare marketplaces for 36 states -- perhaps enough progress to meet its own vague standard of functionality for the “vast majority” of users. Even so, significant portions of HealthCare.gov have yet to be finished, and uncertainty in the new marketplaces persists.

After HealthCare.gov’s disastrous Oct. 1 launch, the administration turned its focus to improving the user experience on the website. By December, HealthCare.gov should be able to handle as many as 50,000 users at a time and more than 800,000 visits a day, administration officials said Monday. There may still be some outages, but the administration promised a smooth experience for most users. If more than 50,000 visitors crowd onto the site at once, some should be placed in a user-friendly queuing system.

“We are definitely on track to a have a significantly different user experience by the end of this month,” Health and Human Services Secretary Kathleen Sebelius told state and local officials on Tuesday.

“We’re seeing more and more enrollments each and every day,” Sebelius added, noting that the administration has made hardware and software improvements to the website. “I would urge you and your folks on the ground to not hesitate to recommend people go to HealthCare.gov and get people signed up.”

While the administration has, for the most part, been reticent to define what the “vast majority” of users means, it acknowledged last week that it expects around 80 percent of HealthCare.gov visitors to make it through the enrollment process. White House spokesman Jay Carney said that the other 20 percent may experience website glitches -- or they may find it preferable to finish the enrollment process offline for other reasons. For instance, a person with complex health issues may find it easier to enroll with assistance over the phone.

An 80 percent success rate is a reasonable goal, Larry Levitt, a senior vice president at the Kaiser Family Foundation, said to CBSNews.com.

“I don’t think it’s unreasonable to expect that a minority of people will need some help,” he said. “If you look at the experience in states where the process is working pretty well, there’s still a significant number of people who need help with the application.”

That’s particularly true given that millions of Americans are being dropped from plans on the individual market that no longer meet existing Obamacare standards.

For instance, California’s new marketplace, Covered California, already has more than 360,000 people enrolled and has been touted as a success

“As a country we’re now poised to gain health coverage for millions of Americans January 1, and that includes 350,000 right here in California who have already signed up,” President Obama said in Glendale, Calif. on Tuesday. But with as many as 900,000 Californians expected to lose their coverage, Covered California this week opened a hotline with 25 dedicated representatives to help guide people through the transition to Obamacare.

The number of Americans losing insurance -- and the evolving policy surrounding the problem -- are adding to the uncertainty the new marketplaces fact. In fact, some states with more stable Obamacare marketplaces, like California, are rejecting Mr. Obama’s administrative policy solution, which allows insurers to extend existing plans for another year. The president’s solution, some insurers and state regulators argue, would leave only the sickest customers with incentive to sign up for Obamacare in its first year, consequently destabilizing the new market.

This market upheaval would make it difficult to build up the new marketplace, even if HealthCare.gov were running smoothly. The impact of these challenges will be more clear in mid-December when the administration releases national enrollment figures for the second month of open enrollment. In mid-November, the administration reported that in the first month, only 106,185 people had successfully chosen health insurance plans from the new Obamacare marketplaces -- far fewer than the nearly 500,000 the administration anticipated. By the end of the six-month open enrollment period in March, the administration initially anticipated having seven million enrollees.

Sebelius on Tuesday stressed that there’s plenty of time left for people to sign up. “We are eight weeks into a 26-week open enrollment period,” she noted.

Still, public confidence in the Affordable Care Act has suffered a serious blow in the wake of all of the health law’s problems. A CBS News poll released last week showed that approval of the law has dropped to 31 percent - the lowest number yet recorded in CBS News polls, and a drop of 12 points since just last month. Additionally, just 32 percent approve of how Mr. Obama is handling the issue of health care, down eight points from September.

Even if the user experience on HealthCare.gov improves and consumers return to it with restored confidence, the administration has significant work to do on the back end of the website. Last week, Obama administration officials acknowledged that it still has to build elements of the website, such as financial management systems to transfer tax credits to insurers. The administration said those systems are not essential until 2014.