ACA: They should have segregated the 'shoppers' from the 'buyers'

[B2G]

They should have implemented separate sites/servers for those wanting to shop for plans and rates from those individuals wanting to actively enroll.

That would have eliminated these access headaches and the complaints that people need to give out very personal information just in order to see what their options are.

I have no idea why they didn't take that approach.

[snooper2]

1. Kind of like two ebays, or two craigslists, or two Apple stores

[B2G]

2. Exactly like Amazon. You have a shopping cart

You browse for what you want and when you're ready to check out, it takes you to a secure server to collect your payment information and finalize your transaction.

Novel concept, I know...

[JoePhilly]

3. Probably because of all the state variances, and a fixed "go live" date.

You really can't have a single calculator because some states have their own exchanges, some will use the federal one, some states won't take the federal medicare funds, and then different companies are in different states.

So my bet is that, at least initially, you'll have to go to the actual sign-up site because that (ability to sign up) was required for any of this to start up by today.

The individuals state calculators, while a great thing to have for sure, were not an "application defining feature" at this point for the program to "go live" today. You could "go live" without it.

I'd expect those to be coming over time, perhaps even in these first 6 months of sign-up.

Bottom line, this is sufficient for some one who knows they want to sign up to be able to do so right away. And that was the most critical feature at this point.

[enlightenment]

4. You don't need to calculator to see the plans.

People want to know what their premium is going to buy them and that is what a lot of this traffic is about. Not people whipping out their checkbooks - just people whipping out their readers to see the fine print (which, interestingly, is still largely unavailable).

[JoePhilly]

5. That's going to vary by state. The plans in the exchanges are not uniform across the country.

Nor are the premiums.

[B2G]

6. Isn't that why you select your state up front?

I'm not sure I understand your point.

[JoePhilly]

9. My point is mainly about how decisions are made in software (web) development

as to which features appear in the 1st version of any new application.

In this case, the most critical thing is that you can actually sign up people across the country, and calculate and compare what their costs will be for a wide array of HC plans, which vary not only on number and kind, but also in terms of subsidies based on state decisions about medicare.

The site did not need an "open calculator" to go live. That's a nice feature, but you did not need it to "go live".

To go live, you needed a basic website, the ability to navigate to a particular state's page, and then the ability to create an account and sign up. And you have to test all of that and make sure it all works. Everything past that is extra stuff that puts the schedule at risk.

I suspect that much of the infrastructure to provide a more "shopping-like" experience exist under the current UI, and that those features will surface over the next 6 months, as the testing of it all completes ... those will also probably evolve based on state level priorities. Some states are very serious about this, some moving more slowly.

The current UI is pretty rudimentary. I'm guessing that its the initial veneer. Sitting on top of the most basic of the "go live" required capabilities.

Web applications are, in many ways, easy to update and evolve, assuming that the infrastructure beneath is fairly well designed.

[Roland99]

10. Part of the problem is 36 states all use healthcare.gov

they don't have their own exchanges.

[Yo_Mama]

8. Yes, but what many people want is just to see the list of exchange plans and premiums

and deductibles and so forth for their state.

[enlightenment]

11. Doesn't matter.

If it's the federal exchange, I presume you choose your state before anything else.
If it's a state exchange, all you're going to see are the plans approved by the state.

The premiums are not the issue at the moment - yes, they vary and the subsidies will modify the amount. People want to see the plans - what the deductibles are, the co-pays, the co-insurance. What is covered, what is not. They want to compare the plans.

Once they have an idea of what they are being offered, they can make a more informed decision about the value of the product. Do you honestly think people are just going by the weird "metal" coding . . . "Hi, my name is Fred. I'm single, 27, non-smoker, no dependents. I make $30000 annually and I'd like a Bronze plan, please."

My state only has four insurers in its exchange - each insurer has multiple plans in each "metal" tier. Each one is slightly different. People want to know what those differences are and how they compare. Once they know that, they can look at the premiums and sign up to determine their subsidy, if any.

[B2G]

12. And they DON'T want to divulge so much personal info to make that decision

I cannot believe, after all of the NSA flap, that anyone could have possibly though that was a good idea.

Unless they want that information up front. For whatever purposes.

[JoePhilly]

13. You seem confused about my point.

I agree that it would be very nice to have the items you describe available on the web site from day 1.

But those features, are not, and were not required, for the site to GO LIVE.

You are describing a feature you would LIKE ... the government, initially in setting up this site, had to focus on the REQUIRED elements so that, as of Oct 1st, people could actually sign up. Everything past that is gravy. But if people can't sign up, and pick a plan, the entire thing is a failure.

The number of variables involved in this are so numerous, and have been varying for so long, that trying to get all the way to the point where one gets to have a shopping style experience like you describe was determined to be a RISK to getting the REQUIRED elements ready by OCT 1st. That does not mean such features are not valuable, or even planned, it just means they were not "release defining", they were not "critical" for going live.

Every additional feature in a SW development project is a risk to the scheduled release date.

Now, for some software projects, you just move the dates to accommodate new features that you'd LIKE to include. Some times you can get away with that. In this case, there was NO moving the "go live" date. That date was fixed.

The questions was "why didn't the government do it like this?" ... with "this" being a more shopping like experience. The reason was because that shopping experience, while nice to have (and I'd bet its coming pretty soon) was not required to "go live".

[enlightenment]

14. The point is that

people aren't going to sign up for something that they haven't checked out. If the government is stupid enough (which I firmly believe they are capable of being) to believe that Jack and Jill Citizen are going to buy a health insurance policy without seeing what that policy provides them, then the government needs to get their collective head screwed on straight.

All this talk of "going live" is great - I agree, they had a mandate to make it happen by 1 October. But their failure to anticipate that people would want to see what they are being told to buy is most certainly not a bell and whistle. It is a fundamental part of the process.

What you're saying is that the government - despite have a LOT of time to design this system - failed to create a workable tool. With that I agree.

[Yo_Mama]

7. tons

Also many people with small businesses, who have received notices of rises in rates and are trying to figure out if it would be better for their employees to just bag the company coverage and go on the exchanges (esp. because of the dependents loophole).

Also there are many who are trying to figure out whether it would be better to go on their spouse's coverage or buy ins separately and so forth.

At this point, a lot of traffic is just people trying to see what their options are.