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In early 2014, gotomedia was hired by the California HealthCare Foundation to conduct usability testing on and, two of the portals created as part of the new, controversial healthcare laws in the U.S.

We anticipated that users would experience wrong turns and blockades at every step. After all, and state-run insurance marketplaces like were a major story in the news when they opened in October 2013. When we tested the sites, however, we found a mix of good and bad design. We encountered elements that ran counter to all known best practices of UI design that frustrated even the most patient participants, and some that guided confused users down the right path.

Observing real people as they tried to use and gave us the opportunity to connect the people who use the sites with the people who made them. Showing people struggle to complete basic tasks and form misconceptions about what they were doing painted a clear picture of what needed to be done to make these sites more successful.

43INTERVIEW participants
72hours of video edited

"This information will be used to help us further refine, further improve and make it a much more consumer [focused] experience."


Element 1


Remote interviews were conducted with 35 people, sharing their desktop and webcam when available as they explored the site details, previewed plan options, completed the application, and (sometimes) enrolled in plans.

Element 2


Eight participants were interviewed in their homes rather than remotely, which illuminated the context of use. Participants dug through stacks of paper to find the right documents and called family members into the room to make decisions.


In-depth results were shared with team members and site creators to help improve even the smallest details of the sites. Findings were rated as High, Medium, and Low Impact to help prioritize improvements. Executive presentations were also created. These reports and highlight videos are available on CHCF’s website: and



Stakeholders discovered that usability testing allowed them to observe the exact moments when the difficulty that users experienced entering data into form fields turned to anger and saw firsthand how an overwhelming number of plan options led participants to abandon the application process.

Video Highlights


Results of these studies were shared with those who could make an impact on the site design. Meetings were held with site California officials in Sacramento, CA and federal officials remotely in Baltimore, MD. A live public webinar attended by a few hundred people was also presented and an article was published in UXPA Magazine.


Now that these healthcare agencies see the value in user testing, this practice may be implemented in the design and development phases of critical government-run sites that have an enormous impact on the real lives of Americans.