From Huge, 3 Rules For Making Obamacare Exchange Sites Suck Less

Americans recently got their first taste of what it's like to buy health care online through Obamacare. The UX left much to be desired. Here are three rules of thumb for helping users navigate the new health care system.

Earlier this month, new federal and state-run health care exchange websites were overwhelmed with unexpectedly high traffic as millions of Americans got their first glimpse of Obamacare online. Indications of how many people actually tried but failed to enroll are mixed. But reaction to the user experience has been consistent: It sucked. Most users faced slow load times and confusing error messaging, and only a small number registered successfully.

Fortunately, most of these issues will be fixed shortly as traffic slows and back-end issues are resolved. What will become increasingly important in the coming weeks and months is how effective these sites are at educating and encouraging consumers to sign up by the March 31, 2014, deadline.

We’re in the midst of an exciting design opportunity. Consumers can buy almost anything online, so why not insurance? It’s not an easy problem and will require a massive shift in the way we think about health insurance. So what’s the key to a successful shift? Creating seamless and accessible user experiences that work for a diverse population.

I took a look at a number of state-run exchange sites to see how their user experiences align with some of the best practices that guide the UX team at Huge.

1. Engage users quickly.

Unlike in most e-commerce experiences, users aren’t quite sure what they’re looking for or need when shopping for health care online. Exchange sites can reduce information overload by minimizing content on the homepage and providing clear calls-to-action (CTAs) to guide users to the most relevant content.

Maryland Health Connection

Maryland’s site, for example, provides clear, engaging CTAs that get the primary user groups, individuals and small business owners, to the right content, right away.

Hawai’i Health Connector

Hawaii’s main CTA, meanwhile, encourages users to call a number. It’s only after some digging that users discover they can sign up for insurance online—through an entirely separate site.

2. Set expectations clearly.

While many users may be familiar with the process of booking a flight online, few will have any idea what’s involved when purchasing an insurance plan. By exposing all the steps in the process up front, these sites can meet two main user needs at once: 1.) educate users about what’s involved, and 2) keep them motivated to follow through on purchase.

HealthSource RI

Rhode Island’s site walks users through the application process, clearly communicating their current step and how much further they have until completion.


After clicking "Apply" on Vermont’s site, users are taken to this page. It’s a dead-end: most users will need to register, but that link is hidden. It also doesn’t communicate what the user can expect next.

3. Prepare for the worst.

Launch day crashes are all too common. Poorly conceived error handling confuses and frustrates users, potentially deterring them from returning to the site. Plus, it can get expensive—when users can’t navigate a site on their own, they may resort to phoning a call center. Designers should work closely with developers to identify potential problem areas and develop systems and messaging to handle a variety of worst-case scenarios.

Nevada HealthLink

Nevada’s site alerts users to a specific issue on the site in an unobtrusive way and provides users with a single, clear instruction. Also, visitors can still browse and learn about the health coverage while other parts of the site are unavailable.

Massachusetts Health Connector

Massachusetts’s site provides a vague error message that gives users multiple instructions: Keep hitting refresh forever, or check back later. When confronted with zero information, users may not return at all.

[Image via Shutterstock]

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  • sohrab_vossoughi

    President Obama should have just asked Jeff Bezos (Amazon) to design and develop the site. Just think if we could have the same experience with the Obamacare Exchange sites as we have with Amazon!

  • Teresa in Fort Worth, TX

    My understanding is that the problems - and there are MANY - with the site(s) is less a matter of "appealing design" and more a matter of non-functioning architecture.

    All the pretty pictures in the world aren't going to be of any use if the user can't access basic INFORMATION.

    And unfortunately, it seems as if nobody really understands what the information is - not the people in charge of the website, not the people in charge of the program, and not the people providing the product (insurance policies).

    Beyond that, nobody knows which doctors will accept these policies, nobody knows how much they are going to have to pay each month, or to whom (that's a lovely little part that everyone has conveniently overlooked - in most cases it is paid to the government and the insurance company gets reimbursed).

    The government doesn't realize - EVEN THOUGH IT WAS WRITTEN INTO THE LEGISLATION - that people who aren't able to sign up for a policy will be forced to pay a penalty for something which is no fault of their own, and nobody seems to understand that the amount of their "subsidy" (if they qualify for one) will be "reimbursed" in the form of a tax credit at the end of the year - everyone is going to have to pay the full amount up front.

    Where is the page that explains all of that to the average consumer?

    And good luck trying to get that information from a health care "navigator" - most of them don't know any of this stuff to begin with (and neither do their "specialists", who take over a week to get back to you, if at all - I know from first-hand experience in dealing with them BEFORE TSHTF).

    Like I said - the snazzy graphics are the LEAST of this crew's worries.....

  • Bigredinaugust

    A bit clinical, UX isn't just a science. Huge doesn't even have an experience director that will stay more than a month. #overratedagency

  • Sam Weston

    Thanks for taking the time to read the article and sharing your opinion, Bigredinaugust. Because you are obviously someone who is thoughtful, I thought you might want to know that the average tenure for a senior member of our experience team at Huge is actually 4.16 years and across the entire department it is currently about two and a half years.

  • Daniel Kim

    I have been wondering if a non-interactive method could have been used in order to create an alternative to the website for registration.

    For instance, a downloadable form or an interactive desktop app could have been made that would have allowed some of the more mundane information be collected offline. The user could then click a 'submit' button, which would generate an encrypted data file that could perhaps be emailed to a server. During off-peak hours, this server could extract the data and enter it into the database, with a confirmational email returned to the sender, along with a login name and temporary password.

    Such a method could have helped avoid the problems of overloaded servers.

  • Teresa in Fort Worth, TX

    Honey, if what I'm reading is right (and it certainly sounds plausible, given what I've seen so far), these clowns kept their software "design" in-house, and trusted it to people who didn't have the first clue how to set up an interactive "commerce" site - they were the folks who worked on the campaigns, which is a totally different animal altogether.

    It now appears as if some of the software that they were using was open source code - people have already been able to see what they were using, because some damn fool left a ZIP drive out where anyone who knew what they were looking at could take a gander.

    Geniuses, they are not - but you can totes trust them to keep your information "safe" and "private"......

  • bkp100

    The irony is the disaster of the launch has delayed the populace from discovering what a disaster Obamacare itself is...

  • pj

    Got it. It has faults : the first affordable healthcare proposal richest country in the world has EVER provided its citizens. Find ways to fix the faults, and stop complaining.

  • bkp100

    1st - It's *not* affordable. Perhaps you haven't been watching the horror stories of those expecting premium *reductions* and getting huge increases. Additionally, the administrations estimates of an $800 billion cost is now up to $2.5 TRILLION (as per the Feds own OMB). That alone makes it unsustainable.

    2nd - It's not about health insurance or healthcare. It's about control. It's about government power grabs. As Vladimir Lenin put it: "Socialized medicine is the keystone to the arch of the Socialized State."

    3rd - The integral piece of the puzzle -- young buyers aren't buying it... They don't want it. They don't need it. They're telling it to go to hell. And, rightly so.

    4th - It STILL leaves 30 million uninsured... It simply swapped some of the covered and uncovered.

    5th - Whatever happened to "If you want to keep your own doctor, you can... if you want to keep your own insurance plan, you can? Not true.

    6th - It creates ENORMOUS holes for identify theft and abuse of personal information (perhaps you missed it, that the new "Navigators" for the exchanges are ex-ACORN employees being hired with NO background checks. (yeah... big surprise from the Chief Community Organizer).

    Bottom line. It's a major legislative, financial, economic POS.

    Finally, a wise man, named Thomas Jefferson once said (remember him...? one of the Founding Fathers and framers of the Constitution): "To compel a man to furnish funds for the propagation of ideas he disbelieves and abhors is sinful and tyrannical."

    Well, more than half this country now disbelieves and abhors this entire travesty...

  • archie_stanton

    All true and all very good reasons why it's an abominable failure.
    How about the ultimate suggestion that's not even brought up here: give people choices and options and the freedom to shop for a commodity the same way Amazon or Apple supplies them? This useless exercise is like debating the color of an Abrams tank as it crushes your legs.

    The ACA cheerleaders are just focusing on how to improve the experience of being forced to sign up to comply with an awful, bloated, underfunded law that can only succeed at making things completely wretched for everyone.

  • bkp100

    Great suggestion.
    Unfortunately, "choices," "options," and certainly "freedom" is not in the Left's vernacular...

  • Daniel Kim

    But now, people will be able to experience this disaster first-hand! The experience will be so terrible that it will make the Democratic Party practically radioactive for a generation.

    Sometimes, the country has to go through the fire to know that a particular road is the one to hell. You should be glad that the question of government-managed health coverage will be settled once and for all.

  • bkp100

    As long as the 'low-information' voters can connect the dots on this... I've lost buko confidence in the American public to figure out what's going on in their own backyard, much less Washington...

  • Hugh J

    The most important thing to remember is that the money for the premiums will come from you, not the rich as we were led to believe.

  • pj

    Instead of finding ways to improve a newly born faulty system, we just hear complaints and dramatic statements – feeling as if we have accomplished so much by these posts. A sad status indeed.
    [ Side Note: Truly Horrible choice of image and type! ]

  • Hugh J

    "Instead of finding ways to improve a newly born faulty system..."

    That's hysterical. One would think that when attempting to "fix" something you would begin with what the 'problem' actually was. Instead we have an ill thought out, engineered to fail monstrosity.

    "Improve" it? As others have noted, believing that this can be made to work is akin to believing that 'you can pick up a turd by the clean end'.