Health site woes blamed on scant testing

Contractors say late changes also doomed launch of healthcare.gov

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WASHINGTON -- Private contractors working on the troubled federal health insurance marketplace told a congressional committee Thursday that they needed several months, but had only two weeks, before its Oct. 1 launch date to fully test the healthcare.gov website.

The task was further complicated by the Obama administration's late decision to require users to create personal website accounts before they could browse and compare health plans.

User bottlenecks created by the required accounts, along with the abbreviated test period, appear to be the main causes of the marketplace crash that disabled the website shortly after its launch Oct. 1, the contractors testified. The crash occurred when just 2,000 users across 36 states tried to access the system.

Thursday's hearing before the House Energy and Commerce Committee gave lawmakers their first opportunity to question several key marketplace architects about the rampant problems that have plagued the system and created a political firestorm for President Barack Obama and Health and Human Services Secretary Kathleen Sebelius.

Congressional Republicans want the administration to waive the health care law's fines for those who don't obtain coverage until the marketplace woes are ironed out. Had it done so earlier, said Rep. Brett Guthrie, R-Ky., House Republicans wouldn't have moved to shut down the government and create the debt-ceiling standoff this month.

Democrats at the hearing remained largely supportive of the Affordable Care Act and used the phrase "fix it, don't nix it," to describe their feelings about the website. But some have begun to express anger publicly over the marketplace controversy.

Sen. Jeanne Shaheen, D-N.H., has called for extending the six-month open enrollment period, and others, such as Sen. Bill Nelson, D-Fla., said administration officials should fire someone because of the failings. Both sentiments were on display at the four-hour hearing.

Committee chairman Fred Upton, R-Mich., expressed the feelings of most Republicans when he described the website as "not ready for prime time."

After Rep. Joe Barton, R-Texas, repeatedly questioned a witness about whether an obscure website disclaimer violates the federal privacy law for personal health information, Rep. Frank Pallone, D-N.J., angrily called the hearing a "monkey court," noting that the privacy law didn't apply because the site doesn't seek applicants' personal health data.

The federal marketplace -- a one-stop, online shopping center to purchase health insurance required under the Affordable Care Act -- is not a standard consumer website. Databases for numerous federal agencies, more than 170 insurance firms and information on more than 4,500 health plans in 36 states are integrated into the system. It also determines consumers' eligibility for government health plans and federal subsidies that help pay for private insurance.

Government reports indicated that testing for the complex system was months behind schedule, due in part to administration delays in drafting guidelines for its operation. But in numerous committee appearances, HHS officials and contractors indicated that the project was on schedule with no problems.

At the hearing, Cheryl Campbell, senior vice president of CGI Federal, the contractor that designed and developed the marketplace, testified that the system passed eight technical reviews before going live Oct. 1.

She said her team never suggested delaying the launch because that decision was up to HHS, which served as the site development manager. "Our portion of the application worked as designed," she told Mr. Upton.

But in earlier testimony, Ms. Campbell said, "We acknowledge that issues arising in the federal exchange made the enrollment process difficult for too many Americans." Those problems, she said, stemmed from issues with the marketplace's "front door," where people register and create personal accounts. She said that application, designed by Quality Software Services Inc., "created a bottleneck preventing the vast majority of consumers from accessing" the marketplace.

Andrew Slavitt, executive vice president of Optum, which owns Quality Software, explained the front-door bottleneck to lawmakers: "It appears that one of the reasons for the high concurrent volume at the registration system was a late decision requiring consumers to register for an account before they could browse for insurance products. This may have driven higher simultaneous usage of the registration system that wouldn't have otherwise occurred if consumers could 'window shop' anonymously."

Ms. Campbell testified that she believed that the window-shopping feature was ordered disabled in August by Henry Chao, deputy director of the Office of Information Services in the Centers for Medicare and Medicaid Services, or CMS. CMS communications director Julie Bataille called the move a "business decision," to make sure users understood their eligibility for a tax credit before enrolling in a plan.

Mr. Slavitt said he raised concerns with CMS about risks from a lack of system testing on several occasions amid site construction. He was told that they "understood the concerns," he said.

But Ms. Bataille acknowledged that the full system, not just its individual parts, wasn't tested properly. "Due to a compressed time frame, the system just wasn't tested enough," she said in a phone briefing Wednesday.

While testing of the fully integrated system didn't occur until two weeks before the launch, both Ms. Campbell and Mr. Slavitt said several months of testing would have been optimal.

At the White House, Mr. Carney dismissed a question of whether the administration was so wedded to an Oct. 1 rollout that it didn't allow adequate testing.

"The fact that some critics of the Affordable Care Act, who have worked assiduously for years to try to do away with it, repeal it, defund it, sabotage it, are now expressing grave concern about the fact that the website isn't functioning properly, I think should be taken with a grain of salt," he said.

At the hearing, Mr. Slavitt said Quality Software fixed the registration application to meet the site's "unexpected demand." By Oct. 8, he said, the system was processing personal accounts "at error rates close to zero."

Ms. Campbell said she believes the website will be functioning properly in time for people to enroll for insurance by Dec. 15, the cutoff date for coverage that begins Jan. 1, 2014. The Obama administration is preparing regulations that allow 2014 coverage to be bought until March 31, the end of the open-enrollment period.



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