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FCW : November 15, 2013
November 15, 2013 FCW.COM 17 On Oct. 1, as the government was prepar- ing to shut down non-essential operations, one agency was powering up one of the most visible public-facing pieces of federal IT in history. HealthCare.gov is the front door to a sprawling system made up of Federally Facilitated Exchanges that cover the 36 states that opted out of creating their own online health insurance exchanges and a data hub that checks a variety of government databases to verify applicants identities and see whether they qualify for insurance under the Afford- able Care Act or for Medicaid services in certain states. More broadly, HealthCare.gov is the public face of the signature domestic policy initiative of the Obama admin- istration and so hated by the GOP that efforts to defund or delay its launch pushed Congress and the administration into a political stalemate that resulted in a 16-day partial shutdown of the federal government. Throughout the run-up to the launch, House Republicans took every opportu- nity to challenge the legitimacy of the health care law. They summoned lead- ers from the Centers for Medicare and Medicaid Services, senior executives from the lead contractors, and health IT experts to committee hearings designed to publicize the potential for functional- ity and security aws in the system. As late as Sept. 10, executives from CGI Federal and Quality Software Services Inc. assured lawmakers that the system would work as advertised. At the same time, administration of cials were holding behind-the-scenes brie ngs for Democratic lawmakers and journalists touting HealthCare.gov. Hiccups in the tech- nology were anticipated but not the near-total meltdown that occurred, with users unable to create accounts, glacial load times for those who did manage to register, incor- rect subsidy determinations and garbled transmissions to insurance carriers. Where were the red ags? Of cials at the Department of Health and Human Serv- ices have, as of this writing, de ected questions about when of cials were made aware of serious problems with HealthCare.gov. CMS Commissioner Marilyn Tavenner and HHS Secretary Kathleen Sebelius testi ed before Congress as FCW was going to press; both said the extent of the site failures came as a surprise. QSSI did some independent testing of code for com- ponents of the site that it did not build and alerted CMS of potential problems in the two weeks before launch. But Andrew Slavitt, group executive vice president of Optum, the division of UnitedHealth Group that owns QSSI, testi ed at an Oct. 24 hearing of the House Energy and Commerce Committee that "we didn t see full end-to- end testing until a couple of days leading up to the launch." Cheryl Campbell, senior vice president of CGI Federal, said at the same hearing that her company s components were successfully tested and that systemwide assessment was the responsibility of CMS. She named Deputy CIO Henry Chao and Chief Operating Of cer Michelle Sny- der as her CMS points of contact; both are career public servants. Chao has not commented publicly since the Oct. 1 launch but apparently had misgivings about the system dating back at least to early 2013. In remarks about online enrollment to an insurance indus- try gathering in March, Chao said, "Let s just make sure it s not a third-world experience." According to U.S. Chief Tech- nology Of cer Todd Park, the sys- tem was built to accommodate 60,000 users at a time, but dur- ing the rst week of enrollment, HealthCare.gov was visited by more users than it was designed to handle. There s evidence, however, that even without the traf- c jam, problems would have occurred. An early test of 2,000 users caused the system to fail. And a subsequent troubleshooting effort that involved Park, some Presiden- tial Innovation Fellows and unnamed private-sector tech rms found dozens of problems that require repair. Some are related to performance issues, and some are related to bad code. Jeffrey Zients, the Obama administration s designated point man for the repair efforts, promised that the system would be working for most users by the end of November. And there are signs that CMS had inklings of trouble. A few days before the launch, the agency expanded the scope of work to be performed by Serco, the contractor responsible for handling paper applications and staf ng phone banks. When Serco s original contract was awarded in June, of cials anticipated 6.2 million people would le paper applications, and Serco program manager John Lau testi ed at the Oct. 24 hearing that those applications "LET'S JUST MAKE SURE IT'S NOT A THIRD-WORLD EXPERIENCE."
October 30, 2013
November 30, 2013