For a president who sailed into office on a digital-heavy campaign that helped engineer his victory, the crippling glitches plaguing the October 1 HealthCare.gov rollout were a rare mar on the administration’s tech-savvy record. Now the website snafu is fostering an intense hatred of the word “glitch” and fueling a steady stream of vitriol at Capitol Hill hearings.
To date, nearly 700,000 applications have been submitted to the federal and state marketplaces, and more than 20 million unique visits have been tracked by HealthCare.gov, the Web site that facilitates the program. But on Tuesday the administration remained mum on how many applicants were eligible for coverage or will ultimately enroll, saying such data will be available in mid-November. Officials also remain tight-lipped on what specific debugging fixes are taking place. Thanks to the provision of the Affordable Care Act which set up a new Health Insurance Marketplace, three dozen states currently depend on exchanges run by the federal government while 14 states have set up their own state-run marketplace.
Top lieutenants from the Centers for Medicare and Medicaid Services and Health and Human Services have been called before Congress this week to defend the problem-laden federal Web site. So far technical answers have not been forthcoming. First up on the Hill this morning was Marilyn Tavenner, the administrator for the Centers for Medicare and Medicaid Services.
“I want to apologize to you that the Web site is not working as well as it should," she told the House Ways and Means Committee. It is fixable, she said. Still, technical details revealing the issues were scant. In her prepared testimony she spoke of updating the site “several times with new code,” adding more capacity, and putting in place “tools” to monitor where consumers are encountering errors. The site is working, she said. “Just not at the speed we want.” She pinpointed two general problem areas: the exchange’s issues stem from the volume of interest and flaws in the site that can and will be worked out by the end of November, she says. And while consumers can still sign up for services with a paper application or enroll through a call center, the public and political focus has been on the flagship online exchanges that would allow consumers to price-shop and scour side-by-side plan information at their computers.
A complex web of contractors and subcontractors were paid to create the technical scaffolding for the health insurance exchange launch, but the buck stops with the Obama administration. Although Tavenner is the official in charge of the insurance marketplace and offered the most complete administration apology to date, HHS Secretary Kathleen Sebelius has borne the brunt of criticism of the rollout, with Republicans calling for her ouster. Thirty-three GOP congressmen have signed a letter calling for her resignation. “The scope of the problem is so great that were this a private company or military command, the CEO or general would have been fired,” the letter reads. Republicans' treatment of Tavenner today provided a glimpse of what Sebelius will face tomorrow.
But hopes are not high that real answers on the site's issues will be forthcoming this week. At each of the Capitol Hill hearings thus far, technical experts who could provide the real answers for exactly what caused the “glitches” in the system were not the ones that lawmakers are hearing from. As David Auerbach astutely noted in Slate.com last week, the contractor representatives last week were neither techies nor project managers. And the chorus of nonanswers continued this week.
Meanwhile the bad press keeps piling up. A major data hub that routes applicant information to the federal Web site and similar state-based sites failed on Sunday, and consumers trying to enroll were faced with a note saying the system was down. And the December 15 deadline for people to enroll for health coverage without receiving tax penalties was just clarified to say that as long as consumers buy health insurance by March 31 they will avoid any penalties. The Obama administration has also brought in a fleet of tech experts to fix the problems and handed over oversight of fixing the site to UnitedHealth’s QSSI, a role formerly filled by officials at the Centers for Medicare and Medicaid Services.
Few bright spots emerged in today’s hearing before the House Ways and Means Committee–for the administration or consumers. One helpful hint was offered in response to questioning from Representative Kevin Brady (R-Texas). Consumers who are nervous about a health care gap come January 1 (when prior coverage may lapse) because they are still struggling to use the exchange online should use the call center to enroll or sign up with local help in person, Tavenner says. “There are more methods than the Web site, and I think that’s important.”