As part of their investigation into the glitches that plagued the rollout of the cornerstone provision of the Affordable Care Act, the individual insurance exchanges, the Republican-led House of Representatives launched a series of hearings aimed at determining the party responsible for the technical problems and uncovering whether any of the decisions that led to healthcare.gov’s poor design were politically motivated.
The Obama administration has indicated that the high traffic numbers experienced by the federal web portal healthcare.gov, which links consumers to the 36 federally-facilitated exchanges, have exacerbated the technical problems. But the fact remains that software errors have caused hours-long wait times, prevented potential customers from creating accounts and completing the 30-step enrollment process, sent insurers the wrong information, and made it difficult for customers to get an accurate cost estimate.
Exchange glitches have been a particular rallying point for those that oppose the Affordable Care Act, and even President Barack Obama himself, speaking from the Rose Garden of the White House on Monday, admitted, “there’s no sugarcoating it: the website has been too slow.” He also argued that “nobody is madder” than he “about the fact that the website isn’t working as well as it should, which means its going to get fixed.” Obama maintained that purchasing insurance via the online marketplaces is still easier than buying a policy in the private market; there are no longer pages and pages of medical history to fill out, and thanks to the online marketplaces, customers need only visit one website to compare policies rather contact numerous insurers to determine the plan with the best value. But even so, he admitted he wanted “the cash registers to work” and “the check out lines to be smooth.” There are “no excuse for the problems,” the president added.
“The rollout of Obamacare is nothing short of a debacle,” House Majority Leader Eric Cantor, R-Va., said Wednesday. “And the American people are now fearful of their health care. I mean downright scared about what’s going to happen with their health care next year. And all we’re hearing from the administration really is — is really unsatisfactory in terms of answers to the many, many unanswered questions.”
Comparatively, the Obama administration and its supporters have tried to downplay the problems. Even while the president said the system glitches were unacceptable and an army of technical experts are working to fix the problems that have hampered the implementation of the exchanges, Obama argued Monday that the Affordable Care Act as a whole is working as planned. The health care reform is more than a website, he said. Excluding the website, the health care reform is providing new consumer protections to millions of Americans, and new benefits — including mammograms and mental health care services — are now required.
According to Clay Johnson, a former White House presidential innovation fellow between 2012 and 2013, there is evidence government officials rushed implementation. Not only did the administration fail to complete exhaustive testing, but as he told Bloomberg as recently as last week, the marketplace’s computer code contained placeholder language that programmers typically use in preliminary drafts. Obama signed the Affordable Care Act into law more than three years ago, in March 2010, and it may seem surprising that the viability of the exchanges was jeopardized by a time crunch. But there may be an explanation. Officials from CGI Group, a primary contractor for healthcare.gov, told staff of the House Oversight and Government Reform Committee, that the web portal’s design was adjusted just one month before the October 1 debut. The change prevented potential enrollees from comparing prices without registering for an account, according to a letter Republican lawmakers sent to CGI officials.
Hearings began Thursday, with executives of two healthcare.gov contractors, CGI (NYSE:GIB) and QSSI, tesifying before the House Energy and Commerce Committee. From their opening statements, it seems the witnesses are ready to shift the blame on down the line. Senior vice president of CGI Federal, Cheryl Campbell, said in her prepared statement that the company worked diligently to deliver the federally-facilitated marketplaces, and that “no amount of testing within reasonable time limits can adequately replicate a live environment of this nature.” More importantly, she argued that the Centers for Medicare & Medicaid Services, or CMS, is “the ultimate responsible party for the end-to-end performance of the overall Federal Exchange.”
When Campbell testified before the committee in early September, she reassured lawmakers that the website would be functional. Now lawmakers are wondering what changed. “We were told repeatedly that implementation was ‘on track,’ and it is now time for all those responsible to explain what happened,” said Committee Chairman Fred Upton, a Michigan Republican, in a statement this week. Given the committee’s interest in whether any of the decisions that led to healthcare.gov’s poor design were politically motivated, the contractors are also expected to be asked if they faced any political pressure.
Andrew Slavitt of QSSI said in his prepared statement that the website’s functionality may have been affected by “a late decision requiring consumers to register for an account before they could browse for insurance products.” However, he did not say who made that decision. “This may have driven higher simultaneous usage of the registration system that wouldn’t have occurred if consumers could ‘window shop’ anonymously,” Slavitt added.
When asked during a CNN interview with Dr. Sanjay Gupta why the technical problems had not been given more attention ahead of the launch, even though the website crashed during a test, Department of Health and Human Services Secretary Kathleen Sebelius said, “waiting was not an option,” and that she had been optimistic that the rollout would be smooth. She brushed off Gupta’s question about the last-minute change to the application process and instead reiterated Obama’s insistence that the “product is good,” even though the checkout process has been rocky. Through several people familiar with the website’s development, the Washington Post learned that days before the launch, during simulation conducted government contractors and officials, the web portal crashed after just a few hundred people tried to log on simultaneously.
Sebelius, whose agency was responsible for implementation, will testify before the Energy and Commerce Committee on October 30. “With hundreds of millions of taxpayer dollars spent for a system that still does not work, Congress and the American people deserve answers,” Upton said in the statement. “And as the administration continues to withhold important details and enrollment figures, I hope Secretary Sebelius is ready to give answers and finally live up to the president’s celebrated claims of transparency.
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