Healthcare leadership in the hot seat
CMS' Marilyn Tavenner and HHS' Kathleen Sebelius face federal lawmakers on troubled Healthcare.gov
The criticisms of Healthcare.gov and the leaders responsible for the roll out have been coming fast and furious since the beginning of October. This week, two of those leaders were in the hot seat.
Marilyn Tavenner, the administrator of the Centers for Medicare & Medicaid Services, was up first on Tuesday. She testified for three hours before the House Ways and Means Committee.
The hearing Tuesday on the status of the Affordable Care Act’s implementation was intended to aid the committee in overseeing the law, but it frequently devolved into intense finger-pointing.
“Instead of plowing forward with this unworkable law, the administration should, at a minimum, seriously consider delaying the law for families and individuals, just as it has done for big business,” said Dave Camp (R-Mich.), the committee chairman.
While claiming that as head of CMS she was responsible for the website’s roll out, Tavenner attributed the bungled launch to a major underestimation in the number of people who would come to the site to apply for coverage. The site was tested end-to-end before the launch, based on estimates derived from the Medicare Part D prescription drug site when it launched. The number of people who came to HealthCare.gov was many times over that number – something CMS and its contractors did not expect to happen, she said.
Tavenner said that the data hub for HealthCare.gov has operated successfully since the launch and has helped states with their application processes in a timely fashion. The problems have come for states that did not opt to participate in the health insurance exchange program, and thus must use the federal marketplace to enroll their beneficiaries.
“It’s working quite effectively in states that are running those sites,” Tavenner said of the states that created their own marketplaces. “The irony is, the GOP has put hurdles in the way of states.”
To remedy what ails HealthCare.gov, the federal government has designated one of the program’s contractors, Quality Software Services Inc. (QSSI), to oversee the fixes and has bumped up the number of technicians working on the solutions. The deadline for fixing the system is Nov. 30.
Tavenner said she fully expects there to be enough time from Nov. 30 to the March 31 deadline for uninsured Americans to access the marketplace and enroll.
“The flaw is the law, itself. Not the website,” said Rep. Kevin Brady (R-Texas), summing up what most Republicans had implied throughout the hearing.
Rep. Jim McDermott (D-Wash.) called for a little patience. “This is one of the biggest changes we have ever made, and we are only four weeks into it.” Medicare and Part D were not without their glitches at the start, he said.
On Wednesday, it was Kathleen Sebelius’ turn. The secretary of the Department of Heath and Human Services tried to placate members of Congress with promises of steady progress for Healthcare.gov and, in the face of calls for her resignation, took full responsibility for the troubles with the website’s roll out.
“I'm responsible for this debacle,” Sebelius told members of the House Energy and Commerce Committee.
While there was some of the same finger-pointing as in Tavenner’s hearing, committee members got down to brass tacks with Sebelius, demanding to know how much was being spent on the website, what sort of testing had been done and when enrollment data would be available.
Sebelius said that HHS had spent about $118 million on the website and another $56 million on other IT support for it. Some $197 million has been obligated to CGI – one of the major contract vendors in charge of the entire website application – to last through March 2014. About $104 million of that has already been expended, Sebelius said.
Sebelius said she wasn’t sure if an end-to-end security test had been done prior to the site’s launch, but she did agree that two weeks for testing was inadequate.
While lawmakers pressed her to release more enrollment data, Sebelius refused. “The system isn't functioning, so we're not getting that reliable data,” she said, confirming reports of insurers getting errant enrolment data. And the federal marketplace isn’t yet integrated with state insurance exchanges and Medicaid programs, so HHS won’t be able to provide enrollment data until November.
“We’ll see the numbers at the end of the month and share them with the public,” Sebelius said.
This story is based on stories written by Diana Manos, senior editor of Government Health IT, Anthony Brino, associate editor of Healthcare Payer News, and Erin McCann, associate editor of Healthcare IT News.
