WASH INGTON – Nearly a month into the dysfunctional rollout, the Obama administration acknowledged the wide extent of its health care website’s problems Friday and abruptly turned to a private company to oversee urgent fixes. Setting a new timetable, officials said most issues will be repaired by the end of November.
It will take a lot of work, but “HealthCare.gov is fixable,” declared Jeffrey Zients, a management consultant brought in by the White House. By the end of next month, he said, there will be many fewer signup problems such as computer screen freezes – but he stopped short of saying problems will completely disappear.
The administration also said it is promoting one of the website contractors, a subsidiary of the nation’s largest health insurance company, to take on the role of “general contractor” shepherding the fixes.
Quality Software Services Inc. – owned by a unit of UnitedHealth Group – was responsible for two components of the government’s online insurance system. One is the data hub, a linchpin that works relatively well, and the other is an accounts registration feature that initially froze and caused many problems.
Zients reported that his review found dozens of issues across the entire system, which is made up of layers of components meant to interact in real time with consumers, government agencies and insurance company computers.
HealthCare.gov was supposed to be the online portal for uninsured Americans to get coverage under President Barack Obama’s health care law. Envisioned as the equivalent of Amazon.com for health insurance, it became a huge bottleneck immediately upon launch Oct. 1. A major embarrassment for the administration, it is likely to end up as a case study of how government technology programs can go awry.
The briefing from Zients came a day after executives of QSSI and the other major contractor, CGI Federal, told Congress that the government didn’t fully test the system and ordered up last-minute changes that contributed to logjams. Next week, Health and Human Services Secretary Kathleen Sebelius is scheduled to testify on Capitol Hill.
Visiting a community health center on Friday in Austin, Texas, Sebelius said that “in an ideal world there would have been a lot more testing.” But she added that her department had little flexibility to postpone the launch against the backdrop of Washington’s unforgiving politics. Republicans hoping, in the words of their TV ads, to “defund Obamacare” precipitated a government shutdown.
Some Republicans have been calling for her ouster, and she addressed that issue a day earlier in Phoenix. She said, “The majority of people calling for me to resign I would say are people who I don’t work for and do not want this program to work in the first place.” She added, “I have had frequent conversations with the president, and I’ve admitted to him that my role is to get the program up and running and we will do just that.”
Zients gave some new details about the extent of the problems, but administration officials are still refusing to release any numbers on how many people have successfully enrolled. Although 700,000 have applied for coverage through the new online markets, it’s believed only a fraction of that number actually have managed to sign up. Prior to the website going live, an administration estimate projected nearly 500,000 people would sign up in October alone.
The marketplaces are the gateway to obtaining health insurance under the new health care law, which requires most Americans to have coverage by Jan. 1. Middle-class people who don’t have insurance on the job can purchase private plans with new tax credits to make the premiums more affordable. Low-income people will be steered to an expanded version of Medicaid in states that agree to extend the safety net program.
The federal government is running the insurance markets or taking the lead in 36 states. The rest were set up by states themselves.
Consumers have until Dec. 15 to sign up for coverage to take effect Jan. 1. Under the law, pre-existing medical conditions will no longer be a barrier. But the markets also need lots of young, healthy customers to keep premiums affordable. Open enrollment season extends until March 31, and the administration says it is working to ensure that people who sign up by that date will not face a penalty for being uninsured.
Zients said almost daily fixes are already having an impact. For example, over 90 percent of users can now complete one of the first steps, creating an account.
But the application process, which involves submitting and verifying personal information and income details, remains “volatile,” he said. At one point, as few as one-third of users were getting through that part.
Zients said there are two big categories of problems. Performance issues involve the speed and reliability of the website. Functional issues are bugs that keep the software from working as intended. He said the government has a “punch list” of needed fixes that adds up to dozens in each broad category.
Near the top of the list: insurers are getting enrollments with incomplete, incorrect or duplicative information.
Until now, officials at the federal government’s Centers for Medicare and Medicaid Services have taken the lead operational role on HealthCare.gov. The government operates a successful e-commerce site for Medicare coverage, but it appears to have to have gotten in over its head when it comes to Obama’s law. Maryland-based QSSI will now be responsible for the execution.
The company built a component of the website called the federal data hub that appears to be working relatively well. The hub is a conduit for verifying consumers’ personal information with government agencies.
An executive of the parent company, Andrew Slavitt, told Congress this week that QSSI had concerns about the federal website and relayed those to the government. Officials said the company’s new role as “general contractor” will be an expansion of its current contract.
Its parent company also owns UnitedHealthcare, the nation’s largest provider of Medicare Advantage plans, a popular private insurance option available to seniors.
One of Obama’s top campaign fundraisers was Anthony Welters, executive vice president of UnitedHealth Group. According to information from the nonpartisan Center for Responsive Politics, Welters ranked 31st among Obama’s top “bundlers,” raising more than $785,000 toward the president’s 2012 campaign. Welters’ wife, Beatrice, is the former ambassador to Trinidad and Tobago. She also raised money for Obama in 2008.