Private contractors working on the troubled federal health insurance marketplace told a congressional committee Thursday that they needed several months, but only had two weeks, before the launch date to fully test what could be the most complex government IT system in U.S. history.
The task was further complicated by the Obama administration’s late decision to require users to create personal accounts before they could browse and compare health plans on the marketplace portal, the Healthcare.gov website.
User bottlenecks created by the required accounts, along with the abbreviated test period, appear to be the main causes of the marketplace crash that disabled the website shortly after its midnight launch on Oct. 1, the contractors testified. The crash occurred when just 2,000 users across 36 states tried to access the system.
Thursday’s hearing before the House Energy and Commerce Committee gave lawmakers their first opportunity to question several key marketplace architects about the rampant problems that have plagued the system and created a political firestorm for President Barack Obama and Health and Human Services Secretary Kathleen Sebelius.
Congressional Republicans want the administration to waive the health law’s fines for people who don’t obtain coverage until the marketplace problems are ironed out. Had it done so previously, said Rep. Brett Guthrie, R-Ky., House Republicans wouldn’t have moved to shut down the government during the debt ceiling standoff earlier this month.
Democrats remain largely supportive of the Affordable Care Act and often used the phrase “fix it, don’t nix it,” during the hearing to describe their feelings about the problematic Healthcare.gov website. But some have begun to publicly express anger over the marketplace controversy.
Sen. Jeanne Shaheen, D-N.H., has called for extending the six-month open enrollment coverage period, and others, like Sen. Bill Nelson, D-Fla., said administration officials should fire someone over the problems.
Both sentiments were on display during the four-hour hearing, which at times veered from confrontational to comical.
Committee Chairman Fred Upton, R-Mich., expressed the feelings of most Republicans when he described the website as “not ready for prime time.”
After Rep. Joe Barton, R-Texas, repeatedly questioned a witness on whether an obscure website disclaimer would violate a federal privacy law regarding personal health information, Rep. Frank Pallone, D-N.J., angrily called the hearing a “monkey court,” noting that the health privacy law wasn’t at issue because the website doesn’t seek any personal health information from applicants.
A one-stop, online shopping center to purchase health insurance required under the Affordable Care Act, the federal marketplace is not a standard consumer website. Databases for numerous federal agencies, more than 170 insurance companies and information on more than 4,500 health plans in 36 states are integrated into the system. It also determines consumers’ eligibility for government health plans and federal subsidies that help pay for private insurance.
Government reports indicated that testing for the complex system was months behind schedule, due in part to delays by the administration in drafting guidelines for marketplace operation. But in numerous appearances before the committee, HHS officials and contractors indicated the project was proceeding on schedule with no problems.
“This is on us,” White House Press Secretary Jay Carney said during his Thursday briefing. “And that goes from the president on down. This website needs to work effectively for the American people. And we need to get the product that they so clearly desire to them as efficiently and effectively as possible.”
At the hearing, Cheryl Campbell, senior vice president of CGI Federal, the contractor that designed and developed the federal marketplace, testified that the system passed eight technical reviews before going live on Oct. 1. She said her team never suggested delaying the site launch because that decision was up to HHS, which served as the site development manager.
“Our portion of the application worked as designed,” Campbell told Upton during direct questioning.
But in earlier testimony, she said, “We acknowledge that issues arising in the federal exchange made the enrollment process difficult for too many Americans.”
Those problems, Campbell said, stemmed from issues with the “front door” to the marketplace, where people register and create personal accounts. That application, designed by Quality Software Services Inc., “created a bottleneck preventing the vast majority of consumers from accessing” the marketplace, she testified.
Andrew Slavitt, executive vice president of Optum, which owns Quality Software, explained the front door bottleneck to lawmakers: “It appears that one of the reasons for the high concurrent volume at the registration system was a late decision requiring consumers to register for an account before they could browse for insurance products. This may have driven higher simultaneous usage of the registration system that wouldn’t have otherwise occurred if consumers could ‘window shop’ anonymously.”
Campbell testified that she believed the window shopping feature was ordered to be disabled in August by Henry Chao, deputy director of the Office of Information Services in HHS’ Centers for Medicare and Medicaid Services.
Julie Bataille, communications director at the center, known as CMS, called the move a “business decision” to make sure that users understood their eligibility for a tax credit before enrolling in a plan.
Slavitt said he raised concerns with CMS about the risks associated with the lack of system testing on several occasions during the site construction process. He said he was told they “understood the concerns “
But Bataille acknowledged the fully integrated system – not just its individual parts – wasn’t tested properly. “Due to a compressed time frame, the system just wasn’t tested enough,” she said in a telephone briefing Wednesday.
While testing of the fully integrated system didn’t occur until two weeks before the Oct. 1 launch, both Campbell and Slavitt said that several months of testing would have been optimal for a project this complex.
Rep. John Shimkus, R-Ill., said he believes “political appointees manipulated the system to hide (test) data they didn’t want the public to know. And we’re going to find out who that is because that’s the crux of this problem.”
At the White House, Carney dismissed a question of whether the administration was so wedded to the Oct. 1 rollout that it didn’t allow adequate testing. He called the question “Monday morning quarterbacking.”
“The fact that some critics of the Affordable Care Act, who have worked assiduously for years to try to do away with it, repeal it, defund it, sabotage it, are now expressing grave concern about the fact that the website isn’t functioning properly, I think should be taken with a grain of salt,” he said.
Meanwhile, at the hearing, Slavitt said Quality Software fixed the registration application to meet the site’s “unexpected demand.” By Oct. 8, he said, the system was processing personal accounts “at error rates close to zero.”
But Rep. Anna Eshoo, D-Calif., said the complaints about “unexpected demand” were bogus and that other websites routinely handle similar, if not greater, volumes. “That really sticks in my craw,” she told Campbell and Slavitt. “I think that’s really kind of a lame excuse. Amazon and eBay don’t crash the week before Christmas and ProFlowers doesn’t crash on Valentine’s Day.”
Campbell said she believes the website will be functioning properly in time for people to purchase coverage by Dec. 15, the cutoff date to enroll in coverage that begins on Jan. 1, 2014. The Obama administration is preparing regulations that allow coverage under the health law for 2014 to be purchased up until March 31, 2014, the end of the open enrollment period.
To date, 700,000 people have completed applications and gotten determinations on their eligibility for government coverage and federal subsidies to buy private coverage. The administration has said that in November it would provide the number of people who have so far signed up for coverage on the federal website.