HealthCare.gov is a health insurance exchange website operated by the United States federal government under the provisions of the Affordable Care Act or ACA, commonly referred to as “Obamacare”, which currently serves the residents of the U.S. states which have opted not to create their own state exchanges.[1][better source needed] The exchange facilitates the sale of private health insurance plans to residents of the United States[2] and offers subsidies to those who earn between one and four times the federal poverty line, but not to those earning less than the federal poverty line.[3] The website also a-sists those persons who are eligible to sign up for Medicaid, and has a separate marketplace for small businesses.
On October 1, 2013, HealthCare.gov was rolled out as planned, despite the concurrent partial government shutdown. The launch was marred by serious technological problems, making it difficult for the public to sign up for health insurance.[4] The deadline to sign up for coverage that would begin January 1, 2014, was December 23, 2013, by which time the problems had largely been fixed. The open enrollment period for 2016 coverage ran from November 1, 2015 to January 31, 2016.[5] State exchanges also have had the same deadlines; their performance has been varied.[6][7][8]
The design of the website was overseen by the Centers for Medicare and Medicaid Services and built by a number of federal contractors, most prominently CGI Group of Canada. The original budget for CGI was $93.7 million, but this grew to $292 million prior to launch of the website. While estimates that the overall cost for building the website had reached over $500 million prior to launch[1][9][10][11][12] and in early 2014 HHS Secretary Sylvia Mathews Burwell said there would be "approximately $834 million on Marketplace-related IT contracts and interagency agreements,"[13] the Office of Inspector General released a report in August 2014 finding that the total cost of the HealthCare.gov website had reached $1.7 billion[14] and a month later, including costs beyond "computer systems," Bloomberg News estimated it at $2.1 billion.[15] On July 30, 2014, the Government Accountability Office released a non-partisan study that concluded the administration did not provide "effective planning or oversight practices" in developing the HealthCare.gov website.[16]
The site functions as a clearing house to allow Americans to compare prices on health insurance plans in their states, to begin enrollment in a chosen plan, and to simultaneously find out if they qualify for government healthcare subsidies.[4] Visitors sign up and create their own specific user account first, listing some personal information, before receiving detailed information about what is available in their area. Designed to a-sist the millions of uninsured Americans, the comparison shopping features involve a visual format somewhat analogous to websites such as Amazon.com and Etsy.[2][11]
HealthCare.gov also details Medicaid options for individuals. This relates to an expansion of the long-running program undertaken as a joint effort under the PPACA.[17] The Congressional Budget Office (CBO) projected that the exchange would be used by an estimated seven million Americans to obtain coverage during the first year after its launch;[4] current estimates suggest that the combined figure is slightly above eight million.[18]