Federal government officials, clearly stung by the embarrassing rollout of the health insurance websites, finally opened up a little bit about the problems on Thursday, admitting they rushed through testing too fast and tried to do too much, too soon, to make an Oct. 1 launch.
The Centers for Medicare and Medicaid Services held the first of a promised series of briefings about the troubles affecting the website — just as a series of contractors told hostile questioners in Congress that final testing of HealthCare.gov had been rushed and ineffectual.
“The system just wasn’t tested enough, especially for high volumes,” CMS spokeswoman Julie Bataille told reporters on a conference call. “Obviously, due to a compressed time frame, the system wasn’t tested enough.”
Just minutes before she spoke, contractors were telling the House Energy and Commerce Committee the same thing. And, they said, the final end-to-end testing of all the various components put together by disparate contractors only happened in the last two weeks of September, right before the Oct. 1 launch.
“We would have loved to have had months,” said Cheryl Campbell, senior vice president at CGI Federal Inc. “CMS decided to conduct tests in that two week time period.”
“Months would be nice,” agreed Andrew Slavitt, a vice president at contractor Optum/QSSI, which built the site’s Data Services hub. “Ideally, integrated testing would have occurred well before … with enough time to correct flaws before they began.”
Slavitt says his company warned CMS of potential problems. The federal government has been slammed for saying repeatedly the Internet-based marketplace, one of the main pillars of the 2010 health reform law, would be ready to go on time with only a few minor glitches.
"We all know that that was one big, fat, lie," Rep. Pete Olson, a Texas Republican, said at the hearing. Even Democrats were critical. "I think the administration should have known how difficult it was going to be to have 35 million, or 40 million people to suddenly hook up to a place to go on the Internet," Senate Majority Leader Harry Reid told KNPR radio.
After launch, the separate systems made by many different contractors did not work properly together, Slavitt added. “Many of the critical components developed by these multiple vendors were overwhelmed — the virtual data center environment, the software, the database system, and the hardware, as inability to test as much as would have liked.”
But Campbell and Slavitt also said the system was improving day by day and they predicted the site would be working well enough for people to sign up for health insurance by Dec. 15 so they can get coverage that starts Jan. 1.
“We anticipate that people will be able to enroll in the time frame allotted,” Campbell said.
CMS’s Bataille expressed similar confidence. “We know that we have a lot of work to do,” she said. But she noted several times that people have six months to sign up in order to get health insurance for 2014.
But Bataille declined to give details about who knew about the problems with the site, or when, and she also refused to say just how many people have in fact been able to buy health insurance on the glitchy website.
“CMS made a business decision that we felt was best at the time,” she said.
She said 700,000 people have started the enrollment process — but she added that that number includes people who have managed to sign up on separate state health insurance websites. She said she could not break out the separate federal numbers. The federal government is running websites for 36 states; the rest are doing their own.
The hearing and the briefing capped a week during which President Barack Obama admitted the website isn’t up to snuff and promised to fix it.
"We knew and said prior to October 1st that there would be some glitches or hiccups or problems with the rollout of a large-scale and complex website like healthcare.gov," White House spokesman Jay Carney said in a briefing Thursday. "But what we did not know was that we would encounter the kind of and scale of problems that we've seen, and that's unacceptable."
Three weeks into the troubled rollout of the websites — the crowning glory of the ACA — Obama has appointed his new top economic adviser, Jeff Zients, to spent the next few weeks working on the site. He said he was bringing in the “best and the brightest” in the technology world in a full court press to help repair it. But Bataille declined to say precisely who these people were.
Republicans in Congress have made it clear they intend to focus on the failures as part of their broader attack on the 2010 Affordable Care Act, aka Obamacare.
The Republican-controlled House Energy and Commerce Committee hauled executives of the companies that built the troubled healthcare.gov website in for questioning in a long and testy hearing. The four contractors all said they felt their pieces of the giant website puzzle were working. But when all the parts were put together, in what’s called an “end-to-end” product, the system fell apart.
Slavett says volume did hurt the sites. “After the launch, HealthCare.gov was inundated by many more consumers than anticipated,” he said. And Campbell says no site as complex as this one could be expected to roll out trouble-free.
"This is true regardless of the level of formal end-to-end performance testing — no amount of testing within reasonable time limits can adequately replicate a live environment of this nature," she said.
One big problem: People had to go through full registration before they could “window shop”. States such as Kentucky, which report a much smoother roll-out of their own health insurance websites, have let people “window shop” first without creating accounts. CMS changed that about 10 days after the site opened.
Bataille said it was in response to consumer feedback. She said people can expect to see “incremental” changes as software engineers tweak the coding and changes are made to hardware. Campbell said her team at CGI was doing the same thing, 24/7.
“We are continuing to run queries on our database,” Campbell said. “We continue to fine-tune our servers.” She says any company would do this in rolling out a new website. “It is by far for our country one of the most complicated large-scale systems,” she added. "We are not excited nor are we pleased with what we delivered."
Bataille continued to characterize many of the problems as coming from sheer volume. “People have pent-up demand for the product,” she said, adding that people had made 1.6 million calls to the call center. A third of visitors to the site seem to be seeking information only, while two-thirds are trying to sign up,” she said.
House Republicans say the website problems only illustrate underlying issues with the law overall, which they have opposed from the beginning.
“This is more than a website problem — and frankly, the website should have been the easy part,” House Energy and Commerce Committee Chairman Fred Upton, a Republican from Michigan, said. “I’m also concerned about what happens next. Will enrollment glitches become provider payment glitches? Will patients show up at their doctor’s office or hospital only to be told they, or their coverage, aren’t in the system?”
Democrats on the committee accused Republicans of scare-mongering to frighten people away from the website. “You are trying to scare people so they don’t apply,” New Jersey Democrat Frank Pallone told Texas Republican Joe Barton, who had just asked about whether the contractors were respecting patients’ privacy rights.
“I would just ask the public please try to find a means to enroll," Pallone pleaded, calling the hearing a “monkey court”. “There is no legitimacy to this hearing,” Pallone said, as Barton pointedly walked out.
Thursday’s hearing is the first of three scheduled over the next week. Health and Human Services Secretary Kathleen Sebelius is scheduled to testify next week, Oct. 30.
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