Some major health insurers are so worried about the Obama administration’s ability to fix its troubled health care website that they are pushing the government to create a shortcut that would allow them to enroll people entitled to subsidies directly rather than through the federal system.
The idea is only one of several being discussed in a frantic effort to find a way around the technological problems that teams of experts are urgently trying to resolve.
So far, the administration has resisted the idea, partly because of concerns about giving insurance companies access to personal data. People familiar with the matter said no such modifications are planned, and even some insurers are not holding out much hope.
But senior White House officials said the administration was open to ways in which insurers could handle more enrollments and had stepped up efforts to make that possible because of the technical problems with the site.
“It was something we were always doing,” one official said, but it is “of additional value now.”
In a statement, Chris Jennings, a senior health care adviser to President Obama, said the administration was “continuing to pursue additional avenues by which people can enroll, such as direct enrollment through insurance companies, that will help meet pent-up demand.”
In proposing the idea, the insurers said a bypass giving them direct access to the federal platform that determines a consumer’s eligibility for a subsidy would alleviate the traffic on the website, healthcare.gov, and provide more breathing room to fix complicated technical problems that threaten to persist beyond a crucial, self-imposed Dec. 1 deadline.
But even if such a shortcut could be designed, federal officials are concerned about protecting personal data, such as confidential financial and tax information and immigration status. The security and privacy issues are likely to overshadow any possible compromise, according to people briefed on the discussions.
A more likely solution is for consumers to be able to work directly with an insurer to estimate their qualifications for a subsidy, leaving federal verification to a later date, some insurers said. Insurance executives declined to speak on the record because of company policies and concerns about alienating political officials.
Time is running out. Kathleen Sebelius, the secretary of Health and Human Services, has promised to have the website’s technical problems largely solved by the end of the month. But inside the White House, there is increasing anxiety that the troubled rollout of the health care site could imperil the remainder of Mr. Obama’s presidency.
Aside from the direct enrollment option, insurers and federal officials are examining other ways in the coming weeks to sign up the millions of Americans looking for health insurance. However, none of the options represent a quick fix. One idea being considered would allow people to enroll before the paperwork is completed. At the extreme, despite strong resistance from the insurance industry, there is even talk of extending the deadline for obtaining insurance on the exchanges by months.
Consumers must now enroll by Dec. 15 for insurance coverage that would begin Jan. 1. The open enrollment period is to end on March 31. The main stumbling block for some consumers is the need to determine their eligibility for subsidies, and the amount. Insurance companies can now only estimate the amount for them. It is up the government to verify eligibility, using personal financial information from tax returns and the like.
“The question is, can they create a separate direct pathway so consumers can get that information on their subsidies?” asked one industry official. “If they don’t have Healthcare?.gov up and running by the end of the month, direct enrollment is critical.”
The other option, allowing consumers to obtain their own estimates, seems more palatable. It is unclear whether that proposal is possible. Insurers are worried that they will have offered coverage to individuals whose actual subsidies are less than they have estimated, potentially leaving the insurers or the people themselves financially exposed.
“I think there are potential work-arounds,” said an executive of a major insurer. “I think we have some leeway here so long as people are not in a situation where individuals have to pay significantly more than expected or plans end up in a position with cash-flow issues.”
Insurers are opposed to the idea of extending the enrollment period. They say it encourages people to wait to sign up, particularly the young and the healthy, an age group that insurers need to balance the cost of insuring people with expensive health conditions. They are also worried about the effect of the delay on their ability to price plans for 2015.
By all accounts, the administration is making an enormous effort to rescue the website. The appointment of Quality Software Services late last month as the project’s general contractor has established a sense of order amid chaos. Henry Chao, the technology official from the Centers for Medicaid and Medicare Services, who had managed the project since its infancy, has been sidelined, people involved in the effort said.
Specialists say software engineers now have a clear set of priorities and are steadily crossing items off a three-tier list for repairs. On Friday, Jeffrey D. Zients, the administration’s point man on fixing Healthcare.gov, said “a couple dozen” high-priority fixes would be made over the weekend. He repeatedly declined to say how many critical fixes had been identified, saying the list continually changes.
“We are making progress across those priority items, and the site is getting better each week, and will be at the standard that we set for the end of the month,” Mr. Zients said.
Specialists said that most of the effort so far had been focused on eliminating the delays and timeouts that have so frustrated consumers trying to shop for and enroll in plans. More challenging, one person said, are the repairs to the more complex, invisible part of the system that draws information from various federal and state databases into a central base to determine eligibility and subsidies and confirms enrollment data.
The technological effort cited by the White House, that person said, is actually a swell of software engineers. Red Hat, which makes Linux operating systems, and the database giant Oracle, already had sent specialists to help out.
Quality Software has assigned one senior engineer, from Google, to edit website software fixes, he said.
Some software engineers on the job have been replaced simply because they were too burned out to continue the late-night schedule. “A lot of the stuff people are doing now is going through the checklists they should have gone through before Oct. 1,” one specialist said.
On the two floors at an office building in suburban Virginia, visible evidence of President Obama’s promised new “tech surge” is slight. About 350 employees are hunkered over their computers — roughly 70 more than last month — trying to repair Healthcare.gov.
Several White House technology fellows, young enough to be mistaken by some as students, have taken over one office. Another change, said one person closely involved in the repair effort: “A lot of suits are walking around.”
The scene at the office building, for one of the two main contractors that built the troubled website, illustrates the bind in which the Obama administration now finds itself. Despite the White House’s suggestions that a cavalry from the Silicon Valley has arrived to save the day, specialists say that the online system cannot be fixed by adding manpower. Some experts argue that an influx of software engineers at this stage would slow down, not speed up, the repair effort.
“If you have got nine women that doesn’t mean you can have a baby in a month,” said Frederick P. Brooks, a computer science professor at the University of North Carolina, Chapel Hill, and one of the world’s leading authorities on software development. Rather, he and others said, fixing the system involves a painstaking slog through line after line of software code.
No one at this point can be certain how many fixes need to be made, specialists said, because some fixes expose new problems.