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Healthcare.gov's next hurdle: Fixing the part you don't see

This December 2, 2013 photo shows a woman reading the HealthCare.gov insurance marketplace internet site in Washington, DC. The troubleshooter appointed by President Barack Obama to overhaul a bungled health care website rollout said Sunday that improvements had made a 'night and day' difference in handling online traffic. 

By midday Monday,  roughly 375,000 people had logged onto healthcare.gov. But an "Open for Business" sign may still be a long distance from a health insurance policy that works at the doctor's office. There are a lot of steps between signing up for health insurance and actually getting that insurance card.

Just think about all the folks-and computers- that need to talk to each other.

“Between the enrollee, the IRS, Homeland Security, and healthcare.gov,”  says Robert Town, a professor of health care management at the University of Pennsylvania's Wharton School, there is a whole lot of verifying that that needs to happen.

“I'm sure there will be SNAFU's in the process," he says, "because it’s a pretty complex set of connections that have to be made.”

“It is puzzling why the government decided to fix the front door without having a reliable back door,” says Robert Laszewski, an insurance industry consultant. He says health insurance companies are getting all sorts of funky data from the government,  about who is trying to sign up. Right now, Laszewski says,  sorting things out is doable because the numbers are manageable. But, he says,  “If we do start getting tens of thousands, or hundreds of thousands enrolling during the month of December and we have a high error rate, we haven't accomplished a lot.”

And the government says people are coming. The site could get more than 800,000 visitors today.

For its part, the Obama Administration says  it's working on fixing the back-end of the system.

But, says Peter Van Loon, COO of Connecticut’s health insurance exchange, making a fix, “it's not inconsequential to do, as we found out, when we built our system to make sure the carriers got the information they need.” His exchange is state run. People there don't have to rely on healthcare.gov. 

But, states and the fed are still under the same pressure -- to get everyone who signs up that insurance card. 

About the author

Adriene Hill is the senior multimedia reporter for LearningCurve.

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