Fixing Healthcare.gov

healthcare.gov sign in page

On my way into work today I heard various pretty intelligent critiques of healthcare.gov and realized that the fix is easier (and the existing site stupider) than I ever expected.

The key points are:

  • The IRS provides a service for verifying a person’s income to mortgage vendors.
  • The actual signup for a plan is (I assume) in fact a transaction between a person and a private company that presumably has a website (or phone number) for signing you up, handling security, etc.
  • So the only job healthcare.gov has to do is tell you what products are available to you and how much they cost. And, modulo disclaimers, it probably doesn’t even have to be right.

As someone on NPR pointed out, the job is very similar to selling mortgages through a site like Lending Tree or Quicken Loans. You enter the value of your house, the amount you owe, and your credit score, and you get given an estimate whose accuracy depends on the accuracy of what you put in. If you close the deal, the figures you enter are verified by the actual lender.

So, healthcare.gov basically needs to know the price structure of the plans it is dealing with (this presumably is quite complicated, but not hideously so), and the location of the applicant. It can work with guesstimates of everything else (but there’s an existing IRS service to provide exact figures if needed). So you need a couple of simple web pages that ask the following questions:

  1. Where do you live?
  2. How much do you (and your spouse) make?
  3. How many people do you want to cover?
  4. Do you get health insurance through your employer?
  5. Based on the answers, here’s a list of available plans and their prices.
  6. Click on a button to apply for a specific plan (handed off to vendor website).

This is a little oversimplified, but only a little. (I’ve implemented life insurance application processes — and most of the things that feed into those calculations are expressly not factored into Obamacare health plans — Life Insurance is all about discriminating on the basis of pre-existing conditions.) Without income verification, this could all run client-side from static HTML. It would be technically simpler than the sign-in page shown above. Fixing this fiasco in a few weeks with a team of a dozen people is actually perfectly realistic. Fixing it with hundreds of the “best and brightest”, however, suggests that the wrong approach is being taken to the wrong problem.