Congress: HealthCare.gov Technical Problems May Impact Enrollment

November 25, 2019 - Democrats from both the House of Representatives and the Senate sent a letter to HHS Secretary Alex Azar and CMS Administrator Seema about reported technical problems that may have prevented 100,000 Americans from accessing health insurance through HealthCare.gov on the first day of Open Enrollment this year.

“Families across the country rely on this website to search for and enroll in quality, affordable health coverage, and they need to know they won’t be stopped by unaddressed technical issues,” the letter reminded.

According to the letter, some potential enrollees faced error messages when they attempted to enroll in the federal health insurance marketplace.

AP News originally broke the story in an article which revealed that the administration was working to repair glitches after the first day of open enrollment.

While CMS has assured the public that the issues were resolved and the site was in working order the weekend following the first day of open enrollment, some policymakers fear that the problem could recur.

The letter asks CMS six questions:

• Has CMS conducted an investigation into the user difficulties and, if so, what was the source and was it related to high traffic?
• How many enrollees were affected?
• What is CMS doing to fix the issue?
• How is CMS addressing the enrollees who were affected and how will it ensure that all consumers can successfully enroll?
• Can CMS give assurances that the agency fixed the issue?
• Should enrollees and Congress expect any future disruptions in the enrollment process before the end of open enrollment?

The Congressional representatives expect a response from CMS by December 2, 2019.

Enrollment has been notably lower this year than in previous years.

A Kaiser Family Foundation marketplace tracker shows the trajectory nationwide and state-by-state of enrollment from 2014 when the Affordable Care Act went into effect until 2019.

Enrollment seemed to hit a peak in 2016 of approximately 12.6 million. It has since sloped downward. The 2019 open enrollment season ended 1.2 million below the final count for 2016.

Comparing numbers from last year’s second week of open enrollment to this year’s shows that the trend may persist into 2020.

From November 1, 2018 to November 17, 2018, almost 2 million people (1,924,476) had newly enrolled on HealthCare.gov.

From November 1, 2019 to November 16, 2019, the number of new enrollees currently stands at 1,669,401.

The numbers show a nearly 200,000-person gap between 2018 week one new enrollee numbers and 2019 week one, and a 238,000-person gap between 2018 week two cumulative new enrollee numbers and 2019 week two of open enrollment.

“We are very concerned these errors may have prevented some consumers from completing their enrollments as intended during an already abbreviated Open Enrollment Period and created further barriers for people to access health coverage,” the letter explained.

This is not the first time that HealthCare.gov has encountered technical problems during open enrollment season.

Last year, a data breach exposed 75,000 enrollees’ sensitive information including names, birthdates, home addresses, and parts of enrollees’ social security numbers. Before that, the site crashed in 2014 during the ACA Exchange’s first open enrollment period.

Since its initial disruptive start, CMS has permitted enhanced direct enrollment (EDE) vendors to provide alternative platforms for enrollees to use and ideally deflect some of the high volume that causes the site to crash. This year, CMS increased the number of EDEs to improve the open enrollment process. There are now five EDEs for enrollees to choose from, each closely audited for security.

In addition to more EDEs, CMS opened a “waiting room” to help regulate traffic on the site. Unfortunately, neither of these enhancements was sufficient to prevent the crash that occurred in the first week. However, CMS has promised that it has the situation under control.