Houston   Reading the papers about the efforts to enroll the uninsured in Obamacare, two directly contradictory themes emerge these days.   First, it is clear that there is consensus that the website, www.healthcare.gov is working much, much better, even if not perfectly.   Secondly, it also is clear that there continues to be wildly competing direction at work on how to achieve maximum eligible participation forcing almost daily, game day modifications in enrollment strategies.

Clearly, the website’s earlier problems have depressed the enrollment figures from the government’s original estimates.   Been there, done that, and let’s go forward.

The government seems to have understood during the website crisis that written applications were important and encouraged the various health centers, assistors, and navigators to move people into paper applications.   Navigators are reporting to the Associated Press that paper applicants have not received enrollment follow-up, even while the government is saying that all paper applications have been processed.   What are the facts, Jack?

Meanwhile the government has discontinued printing paper applications, even in Spanish despite the fact that there is no Spanish language access to the online enrollment process, in order to encourage full utilization of the website.  Some of this is situational since there is virtually no way that a paper app could be processed completely in a two-week period before Christmas in order to ensure coverage by the first of the year.   Meanwhile the problem of the digital divide and the language gap is unresolved for the coming year’s enrollment, so we can almost predict different public guidance will be coming, hopefully after the first of the year.

Reports in the Times discussed something that the government is informally calling “orphan” enrollments, which is very disconcerting news.  The so-called “orphans” are enrollees who believe that they have successfully completed all steps of the process and are now good to go, but in fact are in a limbo-land where even though they have been fully processed a glitch in the system may have not gotten their information fully to the insurance company, therefore leaving them still without insurance, even though they think they are ready to roll.   The same article indicated that 25% of all enrollments may have errors sufficient to block enrollment.  The government reports that it is solving this, so we can hope this is a tree falling in the health care forest that we wish we hadn’t even heard about.

Another rumor I could have lived without are unconfirmed reports that there may be rightwing and Republican hacking at the healthcare.gov site contributing to the problems.   I honestly doubt this is happening, but the strength of the rumor alone could dissuade people already tentative and uncertain in dealing with the website to approach it even more gingerly, if at all.

We’re dealing everywhere with voter suppression.  It seems right now we need to deal with Obamacare suppression even more aggressively.