Lessons of Obamacare

Obamacare is in crisis, both for reasons of its own making and for reasons beyond its control.

What do the rules of crisis management suggest the White House did wrong and how can it recover?

Caveat: one of the things I learned at AT&T is that the solution to problems like this always appear simpler from the outside than the inside. And hindsight is indeed 20/20. But having said that, here's what I think it did wrong:

1. It tried to hide the web site problems by claiming too many people were trying to get on at once. While that seemed plausible at first, the real reasons for the problems eventually surfaced and the administration lost credibility.

2. It tried to hide the low level of sign ups by saying it would start reporting monthly figures in November. That seemed defensive from the start, and the actual numbers eventually leaked making it look like the administration was trying to hide something (which it probably was).

3. This lack of information left a vacuum it's opponents were more than happy to fill. The GOP was given a golden opportunity to schedule attention-getting hearings where it could lecture the administration's leaders and suppliers (which it did).

4. It doesn't appear that it had an integrated communications plan in place to deal with any problems even thoughit should have been obvious its opponents would jump on the smallest issue. Opponents had already spent more than $500 million attacking the Affordable Care Act, 36 states refused to run their own exchanges, and the GOP was willing to shut down the government in an effort to postpone, if not cancel, its enactment.

What should the administration have done?

1. When the Affordable Care Act was passed, it should have made someone responsible for all communications related to its implementation. And it should have given that person the authority to cut through red tape, to secure whatever information he or she needed, and to speak with authority.

2. It should have communicated all through the development period of both the program and the web site, announcing what insurance companies had signed up state by state, what milestones had been reached in the web site's development, and how the testing was going.

3. At minimum, even if the web site worked flawlessly, someone should have anticipated what questions would be asked about the program and prepared honest, complete answers. For example, "The president said if we liked our insurance we could keep it, but some insurers are cancelling their plans. What gives?"  

4. When the first problems occured, it shouid have been more forthright, detailing what was known without finger-pointing and explaining what was being done to resolve the issues. 

5. In addition to apologizing, it should have given something back, such as giving the people who signed up during the period of difficulty a break on their first month's insurance bill.

6. Going forward, it should issue regular reports on milestones reached and problems solved. It should set very few goals and when it does, it should ensure that they are modest and achievable.