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Finding A Cure For What Is Ailing Healthcare.gov and the Affordable Care Act
by Nona O.
Kathleen Sibelius testifying before the House Energy and Commerce Committee, 10-31-13

Last week, both Kathleen Sebelius, Secretary of the U.S. Department of Health and Human Services (HHS) and Marilyn Tavenner, Administrator of the Center for Medicare and Medicaid Services (CMS), testified before Congressional Committees as representatives of the Obama Administration giving their side of the story regarding the failed Open Enrollment launch of the Affordability Care Act (ACA). Just when we were hoping that Healthcare.govwas on the mend because of the announcement that Optum/QSSI was taking the role of system integrator and additional help was coming from Silicon Valley and Jeffrey Zients, Director of the National Economic Council and founder/former CEO of Portfolio Logic, Healthcare.gov suffered another setback. This time Verizon was reported to be responsible for a system outage that occurred the weekend before Secretary Sebelius and Administrator Tavenner testified before Congress.

On Wednesday, October 31, Secretary Sebelius faced a tough crowd of Republicans with a series of questions about not only the website’s maladies, but also privacy and security issues/breaches and health insurance cancellation notices received by two millions[i]Americans from insurers who blamed the cancellation on ACA’s requirements.  They also peppered her with questions about whether the President intentionally deceived or misled the American public when he repeatedly said that people could keep their existing insurance plans if they liked it, and the 50% or higher rate increases for new plans insurer are offering those whose plans have been cancelled. Insurers are justifying the rate increases by saying the ACA law is forcing the change. Although Democrats were generally supportive, they too wanted substantive answers on why the website continues to be plagued by problems.

Ms. Sebelius apologized in her opening statement for the inexcusable: a failed launch of Healthcare.gov. She committed to fixing the website, and earning back the confidence of the American public.  But even as she tried to move the conversation away from the website by talking about the goals and other successes of the ACA, such as:

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Healthcare.gov: Usability Not Blame
by Nona O.
Figure 1--Daily U.S. Unique Visitors to Healthcare.gov

According to a recent U.S. Census Report, 48 million Americans need health insurance. President Obama commented from the Rose Garden of the White House on October 21st that there had been 20 million total visits to theHealthcare.gov website indicating that despite the difficulties encountered when trying to register via the website, there is still a lot of individuals who are interested in checking out what the Affordable Care Act has to offer in terms of its affordable health insurance rates. The Center for Medicare and Medicaid Services (CMS) said in a briefing on Thursday, October 24th that 700,000 people have begun the enrollment process via the federal or a state-based exchange[i] Although the unique visitors to Healthcare.gov has declined significantly since October 1st as shown in Figure 1, a considerable amount of new individuals are still visiting the site to shop for health insurance. The question is will the site work as intended enabling Americans to view realistic health insurance rates and make purchase decisions?

In the first Congressional Hearing held by the Energy and Commerce Committee in the House of Representatives on Thursday, October 24, there was hope that committee chairman Fred Upton’s (R-MI) remarks before the testimony of the four companies primarily responsible for building the Healthcare.gov website, marketplace and data services hub would set a tone similar to what you would expect in an “After-Action” Review or a Lessons Learned/fact-finding session.  He said, “This is not about blame – this is about accountability…”   CGI Federal Inc., Optum/QSSI, Equifax Workforce Solutions, and Serco, had recently appeared before the Energy Committee on September 10th and said that their testing of the system had not revealed any major problems.  They assured the Committee that the Federal Exchange and Data Services Hub would be ready for Open Enrollment on October 1.  This did not turned out to be true.

And the hope for a hearing focused on identifying the implementation failures of Healthcare.gov (e.g., system, procurement, and/or program management issues, etc.), which was what the CGI Federal Inc., Optum/QSSI, Equifax Workforce Solutions, and Serco witnesses were there to testify to, was dashed when the discourse among congressional members descended too often into partisan “back and forth” sparring. 

Citing some of the popular benefits of the Affordable Care Act which include prescription drug savings, coverage for young people up to age 26 under their parents’ plan, rebates from health insurers who spend more than 20% of insurance premiums on overhead costs, and free preventative care, etc., Representative Henry Waxman of California, the ranking Democrat on the committee, in his opening remarks endeavored to separate... 

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