Federal insurance website living up to 'train wreck' forecast
- Article by: ROBERT PEAR, SHARON LAFRANIERE and IAN AUSTEN
- New York Times
- October 12, 2013 - 6:41 PM
WASHINGTON – In March, Henry Chao, the chief digital architect for the Obama administration’s new online insurance marketplace, told industry executives that he was deeply worried about the website’s debut. “Let’s just make sure it’s not a third-world experience,” he told them.
Two weeks after the rollout, few would say his hopes were realized.
For the past 12 days, a system costing more than $400 million and billed as a one-stop, click-and-go hub for citizens seeking health insurance has thwarted the efforts of millions to simply log in. The growing national outcry has deeply embarrassed the White House, which has refused to say how many people have enrolled through the federal exchange. Even some supporters of the Affordable Care Act worry that the flaws in the system, if not quickly fixed, could threaten the fiscal health of the insurance initiative, which depends on throngs of customers to spread the risk and keep prices low.
“These are not glitches,” said an insurance executive who has participated in many conference calls on the federal exchange. Like many people interviewed for this article, the executive spoke on the condition of anonymity, saying he did not wish to alienate federal officials with whom he works. “The extent of the problems is pretty enormous.
Interviews with two dozen contractors, current and former government officials, insurance executives and consumer advocates, as well as examination of confidential administration documents, point to a series of missteps — financial, technical, managerial — that led to the troubles.
Dr. Donald Berwick, the administrator of the federal Centers for Medicare and Medicaid Services in 2010 and 2011, said the time and budgetary pressures were a constant worry. “The staff was heroic and dedicated, but we did not have enough money, and we all knew that,” he said Friday.
Scrambling to fix
Administration officials have said there is plenty of time to resolve the problems before the mid-December deadline to sign up for coverage that begins Jan. 1 and a March 31 deadline for coverage that starts later. A round-the-clock effort is underway, with the government leaning more heavily on the major contractors, including the U.S. subsidiary of the Montreal-based CGI Group and Booz Allen Hamilton.
Confidential progress reports from the Health and Human Services Department show that senior officials expressed doubts that the computer systems for the federal exchange would be ready on time, blaming delayed regulations, a lack of resources and other factors.
The biggest contractor, CGI Federal, was awarded its $94 million contract in December 2011. But the government was so slow in issuing specifications that the firm did not start writing software code until this spring, according to people familiar with the process.
One decision, reached early in the project, proved critical: The Medicare and Medicaid agency assumed the role of project quarterback, responsible for making sure each separately designed database and piece of software worked with the others, instead of assigning that task to a lead contractor. An internal government progress report in September 2011 identified a lack of employees “to manage the multiple activities and contractors happening concurrently” as a “major risk” to the whole project.
Early this year, people inside and outside the federal bureaucracy were raising red flags. “We foresee a train wreck,” an insurance executive working on information technology said in February interview. “The level of angst in health plans is growing by leaps and bounds. The political people in the administration do not understand how far behind they are.”
The Government Accountability Office warned in June that many challenges had to be overcome before the rollout.
Marilyn B. Tavenner, the administrator of the Centers for Medicare and Medicaid Services, and Kathleen Sebelius, the secretary of health and human services, both insisted in July that the project was not in trouble.
Said Timothy S. Jost, a law professor and a consumer representative to the National Association of Insurance Commissioners: “Even if a fix happens quickly, I remain very disappointed that the Department of Health and Human Services was not better prepared for the rollout.”
© 2013 Star Tribune