HealthCare.Gov the Political Game of Finger Pointing

We all know that HealthCare.Gov has had a rocky launch, but a clear prognosis for the “glitches” or more significant architectural problems have yet to be released to the general public. Or perhaps they have simply been drowned out by the political noise that is common to any Obamacare (ACA) conversation. A quick trip through mainstream media oscillates between a positive outlook once the site is fixed and the anti-ACA sentiments that paint this as a catastrophic example of why government has no place in health. Neither of which actually point to a real problem.

In a public attempt to demand answers, House Oversight and Government Reform Committee Chairman Darrell Issa, R-Calif., and Senate Health, Education, Labor and Pensions Committee Member Alexander, R-Tenn., released a letter requesting answers fron HHS Secretary Kathleen Sebelius, for the system failures preventing people from creating accounts, inaccurate determinations of federal subsidies, a breakdown in communication with Medicaid agencies that will last into November, and the significant issue of insurers receiving incomplete or corrupted applications. The Committee on Oversight and Government Reform, in an October 23rd letter also subpoenaed contractor QSSI, seeking information regarding the HealthCare.Gov website failures, and mentioning the $400-600 million already paid in contracts (including QSSI's $55m CMS contract) for the development of the federal exchanges and the federal data service hub. These failures and their subpoenas have lead to a series of hearings to determine not only the extent to which the system must be modified but also to potentially determine the source of these problems.

In the past week outside contractors such as CGI Group GIB and QSSI have testified before the House Energy and Commerce Committee and Medicare Chief, Marilyn Tavenner has testified before the House Ways and Means Committee. The general sentiment from outside contractors, as can be seen in prepared testimonies such as the CGI prepared testimony, was that there was hardly enough time to test and stress the complex system prior to its October 1 launch. And that while their portions of the website were fully functional, the government failed to initiate proper end-to-end testing exposing HealthCare.Gov to a number of problems. Contractors also stated that system failures were being experienced and reported during testing and were unresolved by the date of launch. Tavenner on the other hand, made the first public apology for the problems that have occurred, and deferred questions regarding how many individuals attempted to sign up for Healthcare.gov and the actual implications of the site issues.

These first two hearings were followed up by today’s testimony of HHS Secretary Kathleen Sebelius before the Energy and Commerce Committee. Sebelius’ unwillingness to testify earlier has generated a number of politically driven statements about the administrations inability to handle or worse understand the issues being faced. Regardless of speculation Sebelius' prepared testimony made a clear point that the private contractors utilized for the building of HealthCare.gov “have not met [the] expectations” of HHS and the Obama administration. Today, in a politically brave act, Sebelius has told the House to blame her if they need to blame someone. It was clear that the Committee was looking for someone to blame as opposed to determining the feasibility of the plan to correct these errors and the ability of the the current team to execute on these plans. Sebelius was also asked to answer for the cancellation of thousands of health policies across the United States. In recent weeks hundreds of thousands of cancellation letters have been sent to Americans that were under the impression that they could keep their current policies if they so desired. The cancellations are a result of compliance requirements under the ACA, and involve policies that offered sub-par coverage. While many of these individuals will simply be able to sign up for better coverage, the cancellations have left the American public frustrated with the promises of the Obama administration and have amplified the sentiments associated with the Healthcare.gov glitches and based on recent testimonies, it appears Washington wants someone to blame.

These HealthCare.Gov glitches have resulted in an enormous amount of political “he said, she said, it’s all their fault”, but the reality is that with a complex system of this nature, everyone played a role. The federal government lacks the ability to move quickly, and it is highly likely that information was released far too close to the launch date. At the same time, private contractors exist in these federal systems because the technical component and system architecture is beyond the ability of our government alone; And it is the responsibility of these contractors to not only set clear expectations of what a system is capable of and what tests must be run, but also to be accountable for the final product. Politics and pride also likely led to unwillingness to delay the October 1 launch, or determine a better way to roll out the website state-by-state. What is clear, is that every party involved in this launch had the opportunity to do something more efficiently, take better control of the outcome or to vocalize a potential problem, and chose not to for a yet to be determined reason.

HealthCare.Gov was unable to handle the volumes and/or the requirements of a national health exchange, the launch has been used to fuel too many political fires, the blame game has detracted from the real issues, and the American people are losing faith in the veracity of the information that is being provided to them. For the sake of the millions of Americans that wish to sign up to on the insurance exchanges, Washington needs to stop pointing fingers and start determining the next steps. Hearings that focus on internal communications and the need to determine the responsible party may be necessary but are doing little in terms of fixing the extensive problems that have been experienced.

We know government (like healthcare) could use a systems upgrade, and that Washington wants someone to blame for the sake of politics, but as Marilyn Tavenner told the House Ways and Means Committee, the Affordable Care Act is more than just a website, and we all need to keep this in mind.