Wednesday’s grilling of Health and Human Services Secretary Kathleen Sebelius veered into the land of Oz, taking participants on a trip down the yellow brick road through questions about male maternity benefits and whether Sebelius should drop her generous health insurance plan to sign up on the troubled federal exchange.
The metaphor might apply to the long journey still ahead of the Obama administration over the health reform law. Every day throws up a new and unexpected twist, and it's not clear if the Emerald City is within reach, or even if it's an illusion.
As Sebelius was forced to shift gears from queries about insurance policy cancellations to whether contractors had known about the website’s weaknesses before it launched, her department and the White House were slapped with revelations about possible security issues on the site and another outage on Tuesday night.
President Barack Obama took some of the heat. "The website is too slow, too many people have gotten stuck. And I am not happy about it," Obama said on a visit to Boston. He was highlighting some of the setbacks and successes that had marked the 2006 rollout of Massachusetts’s health reform law – a law signed by then-governor Mitt Romney, a Republican, and a model for the 2010 Affordable Care Act.
But Sebelius herself endured more than three hours of questioning from the House Energy and Commerce Committee. Rep. Joe Barton, a Texas Republican, couldn’t resist the Wizard of Oz analogies as he questioned the former governor and state insurance commissioner of Kansas. “We are not in Kansas any more,” Barton informed her.
Four weeks after the much heralded website launched, the administration has started to try to make amends. “I cannot tell you how frustrated I am,” Sebelius said. “You deserve better. I apologize.”
Again and again the secretary acknowledged that the Center for Medicare and Medicaid Services failed to anticipate just how many things could go wrong with the highly ambitious and complicated insurance website.
“Clearly I was wrong. We were wrong. We knew that in any big complicated system there would be problems,” Sebelius said, keeping,mostly, her trademark calm demeanor. “We must fix it.”
But she refused to back down over a whole new area of controversy – whether Obama broke his promise, or deliberately lied, when he said anyone who liked his or her health insurance plan could keep it.
She pointed out that 95 percent of Americans who have health insurance have either an employer-sponsored plan or a public plan such as Medicare, and said only 12 million have the type of private, individual insurance that is being cancelled. And she said a third of people with such policies have them for six months or less and are not the people that Obama was talking to when he promised that existing plans could be “grandfathered” under the law.
“A portion of them, a fraction of those 12 million will have a plan that doesn’t meet the criteria,” she said.
Obama made a similar defense, tweaking his wording a little bit. "For the vast majority of people who have health insurance that works, you can keep it. For the fewer than 5 percent of Americans who buy insurance on your own, you will be getting a better deal," he said.
And Sebelius noted one big glitch -- the site's troubles, she said, meant her department cannot make a reliable estimate of just how many people have managed to sign up for health insurance policies. "The system isn’t functioning so we are not getting that reliable data. We know that there are 700,000 applications," she said.
Several members of the committee pointed out as the questioning unfolded that the Healthcare.gov site was still down. After the hearing ended, a CMS spokeswoman said the outage was due to a Verizon subsidiary, Terremark, which supports the data center. Even after it’s fixed “it will take a few hours to bring systems fully online,” said spokeswoman Julie Bataille.
Several Democrats tried to come to Sebelius’ rescue by asking friendly questions and offering stories from constituents praising the new law in an effort to counter horror stories of raised premiums recounted by Republicans.
Frank Pallone, a New Jersey Democrat, even played off the Oz references. “I know we're not in Kansas, but I do believe increasingly we're in Oz because of what I see here,” he said to laughter. “I don't know how you keep your cool, Madam Secretary.”
The questioning also occasionally veered into unpredictable waters. Renee Ellmers, a North Carolina Republican, asked why the law required men to pay for policies that include maternity care. As Sebelius tried to explain that all policies cover conditions that customers might not necessarily have, Ellmers interrupted her. “To the best of your knowledge has a man ever delivered a baby?” she demanded.
And two Republicans -- Cory Gardner of Colorado and Billy Long of Missouri -- tried to force Sebelius to reveal her age, repeatedly asking her why she hadn't signed up for the exchange.
Sebelius just turned 65 this year and is thus eligible for Medicare. The exchanges are meant for people who don't have insurance already through employers or via a government program such as Medicare. Sebelius was shaken enough to make a mistake in explaining why she hadn't dropped her own coverage, stammering out that it would be illegal. It's not illegal, just illogical.
Next week, the Senate plans to hold a friendlier hearing. The Health, Education, Labor and Pensions committee said it would hold its own hearing. And Fred Upton, the Michigan Republican who chairs the house Energy and Commerce Committee, said he’d look forward to seeing Sebelius back in December.
One new issue popped up late in the hearing. Documents show that the lack of testing for the site threw up security concerns. Administration officials are sure to face more questioning over this.
House Republicans, who did not vote to pass the 2010 Affordable Care Act and who have voted more than 40 times to repeal it, say they won't stop trying. "There is no way to fix this monstrosity,” House Speaker John Boehner (R-OH) said Tuesday. "We want to repeal Obamacare and replace it with patient-centered health care."
And it’s clear the website bugs will continue to cause headaches. HHS officials detailed some of the recent fixes in a blog post Tuesday. "We can now process nearly 17,000 account registrants per hour – or five per second – with an error rate near zero," it reads.
"We replaced the virtual database with a high-capacity physical one, which allowed more efficient, effective processing and significantly reduced the error rate, or account registration failures," it adds. Technicians also doubled the number of servers and made the database more efficient, they said.
"We pushed through a patch release with four software fixes to address users that were having a hard time logging in to their accounts," the blog added.
Polls have shown that Americans are most worried about cost, and that's where the White House wants to keep the message.
“A lot of people will qualify for new tax credits under this law that will bring down costs even further, so that if you lose your job, or you start a new business, or you’re self-employed, or you're a young person trying several jobs until you find that one that sticks, you’re going to be able to be insured -- insurance that goes with you and gives you freedom to pursue whatever you want, without fear that accident or illness will derail your dreams," Obama said.
The back and forth appears to be a turnoff. An NBCNews/Wall Street Journal poll shows 42 percent of Americans approve of the president’s job performance, which is down five points from earlier this month. And just 22 percent approve of the GOP.