‘Dead on Arrival’, ‘digital Hindenburg’ and ‘a failure of catastrophic proportions’ were some phrases used to describe ObamaCare’s health insurance marketplace as it hit the world wide web in October 2013.
Nine years ago in October 2013, the Affordable Care Act manifested in the form of HealthCare.gov—soon to become one of America’s landmark studies in UX disasters for all of the time.
At the time of the launch, HealthCare.gov suffered a fatal flaw—it was untested for its usability, and therefore disconnected from the needs of the 7 million Americans who would be compelled to register with the federal insurance provider.
The purpose of the website was simple—to provide a platform for residents to survey, compare and enroll in a healthcare plan that matched their needs. The Affordable Care Act allowed for individual states to either administer their healthcare exchange platform or opt-in to the one purveyed by the federal government.
On October 1, 2013, the website rolled out to 36 states that had opted-in to the healthcare exchange platform provided by the federal government.
It took two hours for the national healthcare exchange platform to succumb to the traffic of 250,000 users accessing the website from across America.
In retrospect, it was evident that the technological infrastructure was under equipped to handle the traffic at launch—however, even if the issues surrounding the IT infrastructure were magically fixed at the time of launch—the website would still be largely unusable—thanks to its dysfunctional, user-hostile design.
The select few who were able to access the website at the time of the launch reported witnessing incomplete dropdown menus, glitches, sluggish operation and long, arduous wait times.
Error messages were ambiguous, unconstructive and cascading—often failing to point to specific issues and thereby allowing users no way for rectification.
Needless to say, the website had managed to violate every single usability heuristic known to mankind right from the very first hour of the launch.
During the first week of the launch, only 1% of residents were able to enroll with the healthcare platform.
The largest health reform effort in decades worth $93.7 million had found itself stymied by bad UX, and perhaps that is what led to the awakening of the nation’s design consciousness.
What Went Wrong?
The initial failure of one of America’s most ambitious e-government initiatives raised questions that continue to be pondered upon in the realm of UX design.
In a paradigm where ease of use had occupied a key role in designing a product, HealthCare.gov suffered antiquated flaws uncharacteristic of the era it belonged to.
A usability study of the website conducted by the researchers at the University of Arkansas underscored five key usability problems—relating hardware and software, the home page, scrolling and paging and the user experience.
The study explored the interface design of the website conceptualized through 16 dimensions—wherein each dimension represented a factor that contributed to the usability of websites. The usability was then evaluated by the outcome of a survey conducted among 374 citizens. It was revealed that the interface design conceptualized as 16 dimensions received low ratings—signifying low rates of satisfaction.
The study conclusively proves that at the heart of the fiasco of HealthCare.gov lay a mitigable, foreseeable UX failure.
“Ultimately, even if the infrastructure issues that have received a bulk of the media attention are miraculously resolved, our findings suggest that the site will be found wanting”, revealed the study.
The rollout of the ambitious e-government initiative was stopped dead in its tracks due to an apathetic design, bureaucratic inefficiency, and the lack of testing and troubleshooting.
The Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) made a series of errors throughout the development of the website despite witnessing clear indicators that the federal government arms lacked the relevant technical expertise to execute the launch.
The patterns were all over the place. Over the past decade, research has revealed that over 94% of large-scale technology projects were unsuccessful—of which 50% were delayed or exceeded the budget. About 41.4% failed.
The failure of HealthCare.gov is a case study in how inexperienced vendors, poor leadership and disconnect from the needs of the people yielded a broken product—that would be relied upon by millions for essential healthcare needs.
The failed launch of the exchange platform has also underscored the significance of design in our everyday lives—and established that design, itself, has the power to obstruct, and to empower.