Having been involved in the content side of software development, it is not surprising the ACA website is fraught with problems. Problems with various EHR solutions are well-documented.
The bottom-line: They are not written from the point of view of the end-user and try to solve many problems with a click of a mouse!
A successful website or software product should be designed with the end-product concept developed first- What is the end goal? Then, develop the code to create the product.
A final common pathway has to be created with a creative design team that has to interface with the programmers. What works for programmers does not necessarily or automatically work for normal end-users.
The ACA website has taken on the overwhelming task of integrating the needs of the IRS, insurance companies, state to state variation, and finally the consumer. Creating a rules engine to encompass the endless number of scenarios would probably be a nightmare.
The ability of the various consumers with different levels of computer expertise has to be factored into the development process- obvious prompts, reminders, and potential suggestions. The fact is even a "young computer geek" may not know the difference between a co-pay, deductible, coinsurance, or total maximal annual out-of-pocket expenses. The site has to show the products in such a manner that is intuitive, so a selection is made according to your lifestyle, income, and pre-existent conditions. There has to be instant access to ACA calculators to get a ball park figure based on your personal data prior to choosing a policy.
The insurance sites have to be transparent in regards to participating providers, clinics and hospitals. This "shoe" is 1-2 years from becoming a huge problem with access issues.
How does this site with multiple moving parts keep all the data confidential and does not release the information about what providers the consumer was looking at? This might lead to HIPPA Part 2, with all the burdens associated with HIPPA. The IRS involvement becomes a HUGE issue we will leave for another day.
Conclusion, the website needed a proactive, experienced leadership team that could grasp all these moving parts and create an interface that with time would work. This is very reminiscent of EHR usability and efficiency problems...
http://online.wsj.com/news/articles/SB10001424052702304441404579119740283413018
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