Probe exposes flaws behind health care exchange rollout
WASHINGTON — A nonpartisan congressional investigation has concluded that management failures by the Obama administration set the stage for the computer woes that paralyzed President Barack Obama's health care program website last fall, officials told The Associated Press.
The findings are in a report to be released Thursday by the Government Accountability Office, which has spent months investigating the health law's chaotic rollout. GAO is the nonpartisan investigative agency of Congress.
Investigators found that the administration kept changing the contractors' marching orders for the HealthCare.gov website, creating widespread confusion and leading to tens of millions of dollars in additional costs.
Republican and Democratic congressional aides briefed on the report told the AP that it faults the Centers for Medicare and Medicaid Services — which is part of the Department of Health and Human Services — for ineffective oversight of contracts for the site's computerized sign-up system and its electronic back office. The Medicare agency, known as CMS, was designated to administer Obama's health care law.
The aides said they were briefed by GAO on a late draft of the report. They spoke only on condition of anonymity, saying they couldn't be quoted by name discussing the report ahead of its official release.
* Contractors were not given a coherent plan, and instead they were kept jumping around from issue to issue.
* The cost of the project grew by tens of millions of dollars as the contractors tried to accommodate administration requests.
* CMS, the lead agency, failed to follow up on whether contractors were doing the work assigned to them, and to review that work for quality.
* CMS sent conflicting signals, at one point notifying one contractor it was so dissatisfied that it would start withholding payments, and then quickly rescinded that decision.
* The type of federal contract that the administration selected for HealthCare.gov was open-ended, which may have encouraged costly changes.
Two contractors took the lead on the computerized system:
Virginia-based CGI Federal built HealthCare.gov, the online gateway to subsidized private health insurance provided under the law. The site serves 36 states, while the remaining states built their own systems, with mixed results.
QSSI, based in Maryland, was responsible for an electronic back office that helps verify personal and financial information to determine if consumers are eligible for tax credits to help pay their premiums.
The front end of the system locked up the same day it was launched, Oct. 1, and it was down most of that initial month. The electronic back office had fewer problems.
Confronted with an embarrassing spectacle, the White House sent in management consultant Jeff Zients as a troubleshooter. One of his first decisions was to nudge CMS aside as project leader and give the agency a supporting role.
CMS administrator Marilyn Tavenner later personally apologized to Congress that, "the website has not worked as well as it should."
Zients' rescue operation got the site working by early December. Another major contractor, Accenture, was brought in to help fix things. Eventually, some 8 million people managed to sign up, far exceeding expectations.
Nonetheless, Health and Human Services Secretary Kathleen Sebelius stepped down amid complaints by White House officials that the president was blind-sided by the problems.
The original contractors testified to Congress that they did not have nearly enough time to test the system before it went live. Indeed, Tavenner took the unusual step of signing the operational security certificate for HealthCare.gov herself, after CMS security professionals balked. The site has since passed full security testing.
The GAO's findings amplified earlier conclusions in a report by Zients himself after the website was restored to working order.
In addition to hundreds of software bugs, insufficient infrastructure and subpar monitoring of problems, the White House troubleshooter said that "inadequate management oversight and coordination among technical teams prevented real-time decision making and efficient responses to address the issues with the site."
The House Energy and Commerce Committee will hold a hearing Thursday on GAO's investigation.