Less than 1 Percent of HealthCare.gov Visitors Successfully Enrolled in an Insurance Plan

Less than 1 percent of visitors to the federal website that connects uninsured people with coverage through President Obama’s landmark healthcare reform law successfully used the site to enroll in an insurance plan during its first week online, according to an independent study released on Tuesday.

While nearly 9.5 million people visited HealthCare.gov during its first week, just 0.04 percent of them actually enrolled in a health plan through the site, the non-partisan market research company Millward Brown Digital reported.

That figure does not include people who started at HealthCare.gov but were directed to a state-run insurance exchange, Millward Brown Vice President and report author Matt Pace said.

Only about 10 percent of unique HealthCare.gov visitors were able to successfully register on the site, the study found. Enrolling in an insurance plan is the final phase of a lengthy process for Healthcare.gov visitors that includes registering with the site, logging back into the site after receiving a confirmation email, entering information and choosing between numerous insurance plans.

Software failures have plagued HealthCare.gov since it's launch. The system also suffered from insufficient server capacity during it's first days, according to U.S. Chief Technology Officer Todd Park.

Those glitches have also frustrated visitors to individual state’s online exchanges, which rely on data provided by the federal site. The federal government is running exchanges for 36 states, while 14 states and the District of Columbia have launched their own exchanges.

Critics of the HealthCare.gov launch have expressed concern that there may be even more software troubles that haven’t yet been uncovered because most people so far have been halted at the sign-up phase.

Developers built HealthCare.gov to handle about 60,000 simultaneous users, U.S. Chief Technology Officer Todd Park told USA Today after the site’s rocky first week. The decision to build the site to manage that capacity was based, in part, on peak visitors to the site’s nearest analogue in government, which is Medicare.gov.

But officials wildly underestimated public interest in using the website. During its first day online, 9.47 million visitors -- nearly 1 percent of all online Americans -- navigated to Healthcare.gov, according to figures from Millward Brown. That’s the equivalent of daily visitors to major e-commerce sites such as Target.com, the company said.

Many of those visitors were shuttled to state exchanges. Only about 1 million visitors were able to create accounts on HealthCare.gov and roughly one-fourth of those were able to successfully log back into the site after receiving a verifying email. Just 36,000 visitors enrolled in a health insurance plan through the site.

Millward Brown’s study was based on a sample of 2 million users that allowed their online lives to be anonymously tracked, Pace said. Researchers then tweaked that list to be demographically representative of the whole U.S. population, he said. Millward Brown is confident the study is representative of the full U.S. population but doesn’t calculate a specific margin of error, he said.

A spokeswoman for the Health and Human Services Department told Nextgov the site had received 14.6 million unique visits during its first 10 days online but did not comment further.

While irritation with HealthCare.gov’s failures is running high, the true test of the site will be whether, once all the software is repaired, people choose to return to the site and sign up for coverage rather than pay a penalty the healthcare law imposes on those who do not buy insurance or receive it through an employer, Brookings Institution Visiting Fellow Lawrence Kocot, said.

Kocot was formerly senior advisor to the administrator of the Centers for Medicare and Medicaid Services and helped launch an online Drug Plan Finder application for Medicare Part D, the Medicare prescription drug benefit. That site suffered from some glitches in its early days, including missing data and not having enough server capacity. Those hiccups are almost entirely forgotten now, he said, because the site -- and the program -- proved successful in the long run.

Pace warned against making long-term presumptions about the Affordable Care Act's success because of early problems with HealthCare.gov, noting that heavy traffic during the site’s first days shows strong public interest in buying insurance through the site. It’s also difficult to measure consumer confidence in the site, he said, because unlike a corporate e-commerce site, people can’t simply go to a competitor’s site.

Some of the drop off between people who successfully logged on to HealthCare.gov and those who enrolled in an insurance plan may have had less to do with technical problems than with people realizing they had to do more research first, Pace said.  

“A lot of people may have realized this was less like signing up for a cable TV package and more like taking out a mortgage,” he said. 

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