Sorry, says Sebelius
 
“HOLD me accountable for the debacle,” Kathleen Sebelius told Congress on October 30th. “I am responsible.” Mrs Sebelius, Barack Obama’s health secretary, has the unenviable job of implementing the Affordable Care Act, better known as Obamacare. It has not gone well. Healthcare.gov, the insurance shopping site for individuals in 36 states, has had repeated problems, including an outage just before Mrs Sebelius’s testimony.

Congress is trying to find out why the launch of Obamacare on October 1st was botched. There was not so much a chain of command as a tangle. Contractors are blaming officials, who are blaming contractors. On October 24th healthcare.gov’s main contractors confirmed that the health department did not fully test the site until late September.

Mrs Sebelius told Congress it was Marilyn Tavenner, one of her deputies, who made a fateful decision to force shoppers to create accounts before they could see health plans. That trapped visitors in an interminable registration process. Mrs Sebelius said she knew there might be problems, but that no one knew they would be so bad. Asked by Mike Rogers, a Republican from Michigan, about security, Mrs Sebelius said the site was safe. But Mr Rogers cited a leaked memo suggesting that its safeguards were not properly tested.

“You deserve better,” Mrs Sebelius told Americans. Yet she insisted that healthcare.gov is fixable. The health department has hired QSSI, already one of the exchange’s main contractors, to oversee repairs. Mrs Sebelius is encouraging shoppers to buy coverage by phone, in person or by post. By the end of November, Mrs Sebelius says, the website will work for the “vast majority” of visitors. Individuals can shop for insurance until the end of March. Those who want coverage to begin in January, however, must sign up by December 15th. Millions of the uninsured are eager to sign up and frustrated that they cannot.

Perhaps even angrier are those who already have coverage they like but will be forced to change it. This is due not to glitches, but Obamacare itself. Mr Obama repeatedly assured voters that those who have insurance would be able to keep it. This was untrue. Americans currently insured through their employers may largely carry on as before, but many who bought plans on the individual market will be obliged to buy different ones.

Obamacare requires insurance to cover many services. Health plans in place before it became law in 2010 are exempt, unless they are revised in some way. However, even small changes count, so a lot of people are affected. For example, Independence Blue Cross, an insurer in Philadelphia, has 24,000 customers in plans that do not meet Obamacare’s standard; Florida Blue has 300,000.

Health wonks have long known this was coming. Indeed, the Obama administration itself quietly estimated that 40%-67% of individual policies would have to change. But ordinary Americans were taken by surprise. Many who are healthy and too well-off to qualify for subsidies are suddenly facing higher premiums, and are irked.

Insurers maintain that the transition to new coverage will be as painless as possible. Independence sent its customers letters in October; it will phone them in November to discuss new options. Florida Blue has set up retail centres so that patients can ask about the changes in person.

Democrats say the old insurance policies will be replaced by better ones, which will offer more benefits and be barred from charging more to the sick. Republicans retort that customers should not be forced to buy costlier insurance than they want. “Some people like to drive a Ford, not a Ferrari,” quipped Marsha Blackburn, a congresswoman from Tennessee.

Mr Obama, speaking in Boston later that day, insisted that most Americans would see their premiums fall. He reminded voters that Mr Romney’s health reform in Massachusetts got off to a slow start, too. “We are going to see this through,” he promised. His deputies are “working overtime to improve it every day”, he said. They had better hurry.