House Republicans will set their sights Wednesday on Health and Human Services Secretary Kathleen Sebelius, who is scheduled to testify for the first time since the messy launch of HealthCare.gov.
The site’s well-documented technical problems have caused fresh political headaches for the White House and Democratic incumbents facing tough races next year. The flaws are also having a substantive effect—keeping people from signing up for health care plans that the White House has been promoting for years.
Sebelius’s prepared testimony acknowledges that the site’s rollout has been “frustrating” for consumers, but doesn’t concede any mistakes by HHS. It puts the blame on the contractors who built the site—not on HHS or the Centers for Medicare and Medicaid Services, the HHS agency that directly oversees Obamacare implementation.
That likely won’t sit well with Republicans on the Energy and Commerce Committee, who are hoping to use the technical problems as part of a broader case against the federal government—not against government contractors.
Here are four questions for Sebelius—questions she’s either likely to face, or that would help shed light on what really went wrong with HealthCare.gov:
If HHS didn’t make mistakes, are you fixing problems that don’t exist?
HealthCare.gov’s contractors faulted CMS last week for putting itself in charge of integrating the systems built by various private companies, rather than putting one of them in charge of pulling everything together. They said the individual pieces worked fine; the system broke down once CMS integrated it all and tested it from front to back.
Sebelius’s prepared testimony directly challenges that charge, putting the blame back on the contractors.
“CMS has a track record of successfully overseeing the many contractors our programs depend on to function. Unfortunately, a subset of those contracts for HealthCare.gov have not met expectations,” Sebelius’s testimony says.
But here’s the thing: The way the White House has responded to the site’s initial failure seems to suggest that oversight was indeed lacking. The administration brought in former White House budget director Jeffrey Zients, who has a background in management consulting, to quarterback the repair effort. And Zients designated one contractor to take the lead in coordinating everyone’s fixes.
So if, as Sebelius says, the problem wasn’t with CMS’s management of the site, why have the most visible changes so far dealt with management and oversight?
When did you find out the site failed certain tests, and what did you do about it?
Sebelius’s deputy, CMS Administrator Marilyn Tavenner, said Tuesday that she wasn’t prepared for the magnitude of problems the site experienced once it launched—even though the contractors said they notified their contacts at CMS that late-stage testing wasn’t looking good.
So did senior HHS officials not know that the site was performing poorly in tests right before its launch? If not, why not? Isn’t that exactly the kind of thing Sebelius should have been on top of?
Or did they know big problems were coming and simply sugarcoated their expectations for lawmakers and the press? If that’s the case, why did HHS keep telling Congress and the public it would be ready on time? Was there any discussion of a delay? Any behind-the-scenes consequences for the failure to launch?
Neither scenario looks great for the administration, but it’s a key question in tracing accountability for the website’s failures.
Reporters have been shut down without so much as an evasive nonanswer when they’ve asked when Sebelius knew about the site’s problems. Maybe Energy and Commerce will have better luck.
Why are insurance companies getting inaccurate data?
CMS said Tuesday that it has made strong progress on the most glaring problem with HealthCare.gov—the process for creating an account. Also on the top of Zients’s “punch list” for repairs, though, are serious problems with the data the site is feeding to insurance companies. Insurers are getting duplicate records, inaccurate records, and enrollments followed by cancellations.
Sebelius’s testimony reiterates the administration’s explanation that heavy traffic contributed to HealthCare.gov’s problems. But traffic almost surely didn’t cause the back-end problems with insurers, and fixing those issues is critical to successful enrollment.
Are you sure you know the extent of the problems?
Zients and CMS haven’t released their full “punch list,” but they’ve said they’re confident the site will be ready by the end of November. Especially given the problems on the back end, can HHS say for sure that its diagnosis has been complete, and that other problems won’t emerge and sideline the process before it’s finished?
This article appears in the October 30, 2013, edition of NJ Daily as Four ACA Questions Sebelius Just Might Get.