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How did Obamacare site go so wrong? 5 questions Sebelius must answer

Two down and one to go. House Republicans have battered the Obama administration with a series of hearings digging into how the health-insurance website, an online marketplace where people were supposed to be able to shop, got off to such a bad start.

The balkiness of the site, its inability to handle the crush of users and its breakdowns at key points, all have critics asking whether it plays straight into Republican accusations that the government cannot be trusted to handle health care.

Marilyn Tavenner, administrator of the Center for Medicare and Medicaid Services, apologized outright on Tuesday at a hearing before the House Ways and Means Committee. Last week, officers of four of the main government contractors that built and are running different parts of the site, said the final testing had been too rushed — and a CMS spokesperson agreed.

Now, it’s time for Health and Human Services Secretary Kathleen Sebelius to take her turn at hearing today. These questions remain unanswered:

How could the administration not have tested the site until the last two weeks?

Officials have said repeatedly that they didn’t have time, and that the final tests didn’t indicate any particular trouble. “We had tested the website and we were comfortable with it,” Tavenner said in testimony Tuesday. “We were working in a compressed time frame, for sure.”

Republicans aren’t buying it. “I want to know why sufficient systems integrated testing was not conducted, and you made the decision to move forward with the website,” said Tennessee Republican Diane Black who, like Tavenner, started her career as a registered nurse.

Sebelius will certainly be asked that question again and again — and in many different ways.

Why wasn’t the launch delayed when the problems became clear?

The site slowed to a standstill almost as soon as it opened just after midnight on Oct. 1. The White House and HHS have said there was a mass onslaught of people signing on — five times as many as anticipated. Millions evidently did try to get on that first day, not just people trying to sign up for insurance, but those who were merely curious as well.

Tavenner has admitted that CMS wasn’t aware of the depth of the problems in the first day or two. But Sebelius will have to answer for why not.

Will people still have time to sign up?

The White House and HHS have both pledged that the site will be working smoothly for “the vast majority” of users by the end of November. Jeff Zients, a management expert who’s been appointed to fix the website while he’s waiting to take over as the chief White House economic adviser next year, says little fixes are being made day by day.

"We are bringing in people from both inside and outside government to scrub in with the team and help improve," Sebelius says in her prepared testimony.

But Republicans and Democrats alike say they’re skeptical. “You have to acknowledge this initial experience has done some damage to Americans’ confidence,” said Pennsylvanian Democrat Allyson Schwartz, a Ways and Means committee member who’s a solid supporter of the Affordable Care Act.

HHS keeps repeating that there’s a six-month open enrollment period with plenty of time to get people signed up even if the site is glitchy. But if CMS and HHS missed all the problems that have marred the site so far, Sebelius will be hard-pressed to persuade her critics that the new team of experts brought in to fix the problem will do a better job.

How can we trust that other aspects of the site are working, like the subsidy calculator?

The health-insurance marketplace website is extremely complicated — one of the most complex projects ever undertaken, according to Cheryl Campbell, senior vice president at CGI Federal Inc., a chief contractor. Users have to create an account and provide large amounts of personal information, including date of birth and social security number, so that the program can check this against databases at the Internal Revenue Service, Social Security Administration and other government departments and agencies.

Given the complexity, supporters and critics alike are worried that people may not know a mistake has been made in calculating a government subsidy, for instance, or even whether all family members are covered by an insurance policy, until it’s too late.

Why haven’t you been more open about the problems?

HHS has refused from the beginning to publicly name all the contractors involved on the site, and will not name the “A-team” of experts brought in to fix the problem. Members of Congress have been so frustrated by this that they’ve subpoenaed tech companies and even sent letters randomly to large companies, such as Microsoft, asking if they were involved.

Microsoft answered one such letter last week. “To the best of our knowledge, no Microsoft employee has provided technical services or technical advice to the federal government or federal contractors concerning the challenges associated with the launch of the website,” one company lawyer, Robert Kelner of Covington and Burling, LLP, wrote the Ways and Means Committee last week.

Only after three weeks of criticism and an editorial in the New York Times by former White House health adviser Ezekiel Emanuel did CMS start daily briefings on the problems and what is being done to fix them.

“Given the disappointing rollout of the Web site, Americans are justifiably suspicious,” Emanuel wrote. “Starting now, the administration needs to initiate a concerted effort to win back the public’s trust. 

CMS officials have said they don’t want contractors distracted from their job. But Congress will certainly want Sebelius to explain why this doesn’t look like a cover-up.

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