October 24, 2013 in Nation/World

Democrats criticize health care law rollout

Tony Pugh McClatchy-Tribune
 
Associated Press photo

Health and Human Services Secretary Kathleen Sebelius has been under fire because the nation’s health care reform process has gotten off to a rough start.
(Full-size photo)

Insurance website complaints

Among the bugs during rollout:

• Unexpectedly high consumer interest that overwhelmed the system in its initial days.

• Lack of a way for consumers to browse health plan options without having to set up a user account. A partial fix is in place.

• Incorrect or duplicate information in enrollments is being delivered to insurance companies. Some software fixes that should help address the issue have been completed.

• General difficulties for consumers.

WASHINGTON – Republicans have always been harsh critics of the Affordable Care Act.

Now President Barack Obama’s signature health care law – commonly referred to as Obamacare – is taking heat from Democrats, too. More than three weeks after the problem-plagued rollout of the federal marketplace where consumers can sign up for health insurance, support for major provisions of the Affordable Care Act is weakening among some Democrats, who want to see someone fired over the botched debut.

“I absolutely believe that somebody should be held accountable,” said Rep. Xavier Becerra, D-Calif., chairman of the House Democratic Caucus.

As lawmakers prepare to grill federal contractors today about the performance of the Healthcare.gov website at a House Energy and Commerce Committee hearing, the marketplace has grown from a public relations black eye into the most immediate threat to the law’s early success.

Wednesday was the first full day the House of Representatives had met since controversy erupted over the insurance marketplaces, and the political fallout was everywhere. Republicans paraded one by one onto the House floor offering one-minute speeches blasting the law. House Democrats met and expressed frustration.

Sen. Jeanne Shaheen of New Hampshire broke with fellow Democrats and called on Obama to extend the open enrollment period beyond March 31, 2014. In a letter to Obama, Shaheen said the website problems were “incredibly frustrating and disappointing.”

Even the chairwoman of the Democratic Party, Rep. Debbie Wasserman Schultz of Florida, embraced Shaheen’s idea, telling MSNBC, “There should absolutely be an openness to extending the open enrollment period. I don’t think there’s anything wrong with that.”

But House Minority Leader Nancy Pelosi, D-Calif., shot down Shaheen’s proposal at her weekly news conference.

“I don’t support that,” Pelosi said, adding that the state-run California insurance marketplace is working just fine. “So I think we should try to fix what we have, move forward with the deadline we have, respectful of what her experience may be and her suggestion, but not (be) supportive of it.”

White House press secretary Jay Carney said Wednesday that it was too soon to extend the enrollment period, saying the six-month sign-up period was still in the early stages. He said that consumer struggles with the website were “extremely unfortunate” and that the Obama administration takes responsibility for the problems.

But he said those problems “pale in comparison” to the uncertainty facing sick people who would be unable to get health insurance without the law.

While support for Obamacare among Democrats has never been unanimous, Wednesday’s developments show a growing unease among the president’s supporters with the law’s implementation.

Since the launch of the 2014 open enrollment period on Oct. 1, the federal marketplace, which serves 36 states, has frustrated millions of consumers, drawn the ire of Obama and triggered calls for Health and Human Services Secretary Kathleen Sebelius to be fired.

Even a longtime family friend from across the aisle, Sen. Pat Roberts, R-Kan., has abandoned her. Roberts, who got his start on Capitol Hill working for her father-in-law, the late Republican Rep. Keith Sebelius, was an early voice in the calls for Sebelius to resign.

Her decision to travel to Arizona rather than testify about the website’s problems at today’s House commerce committee hearing has angered congressional Republicans, who were also peeved that they weren’t invited to Wednesday’s Democrats-only meeting with federal health officials to discuss the law.

Republicans are scheduled to meet with Department of Health and Human Services officials later this week, and Sebelius is set to testify before the commerce committee next Wednesday.

Federal health officials “and staff have conducted numerous in-person briefings on the Hill, and we are happy to hold additional ones as requests come in,” HHS spokeswoman Joanne Peters said.

There have been no calls on the Democratic side for Sebelius to step down. But Sen. Bill Nelson, D-Fla., told a reporter in Tampa on Wednesday that the website problems were “inexcusable” and “somebody ought to get fired” after they’re resolved.

“They should wait and get the thing up and running and then determine and let somebody be held accountable,” Nelson said in an interview with a Miami television station.

The House hearing today offers the first chance to do so. It will feature representatives from four software contractors, including CGI Federal, the company that designed and developed the federal marketplace. Lawmakers have plenty of questions for the contractors, who worked for more than three years on the marketplace technology only to see problems arise almost immediately.

“As a former computer programmer, I have a lot of serious questions about how the program could be such a dismal failure,” said Rep. Steve Scalise, R-La., a member of the House Energy and Commerce Committee. “This is a national embarrassment.”

Many now question whether contractors were pressured by HHS officials to move ahead with the Oct. 1 launch, even though the system had not performed well and government reports showed that site testing was months behind schedule.

“There’s no question that testing was done and testing should have been more thorough, and therefore we would have been more prepared for this – this kind of challenge,” Carney said.

At first, the Obama administration blamed the website’s delays, malfunctions and crashes on an unexpected deluge of users. Recent reports suggest the problems are much deeper and could take months to resolve. Experts now say much of the system’s software coding must be rewritten and that interfaces with various government databases aren’t working properly.

Insurers report getting duplicate enrollments and misinformation about new enrollees. They also have received faulty determinations on the ability of applicants to get government subsidies to help pay for marketplace coverage.

Sebelius and White House Chief of Staff Denis McDonough met Wednesday with executives from several insurers to discuss the problems. The companies included Aetna, CareFirst, Blue Cross and Blue Shield of Florida, Tufts Health Plan, Health Net Inc., America’s Health Insurance Plans, WellPoint and Kaiser Permanente.

Many of the website’s problems are par for the course for a project this large and complex, said Jim Johnson, president of The Standish Group, a research company that studies information technology project failures.

“It’s not shocking that this didn’t work,” Johnson said. “To me it would be very shocking if it did work.”

An analysis by Standish of more than 3,500 large IT projects of $10 million or more between 2003 and 2012 found only 6.4 percent were successful, Johnson said. Fifty-two percent of the projects were categorized as “challenged,” meaning they either exceeded their budget, failed to satisfy user expectations or were completed behind schedule. More than 41 percent were “failures” that were either terminated or redone.

He said the marketplace’s “big bang theory” rollout – with a well-publicized launch date that was guaranteed to draw large numbers of users – only increased the likelihood of failure. He said the rollout should have occurred incrementally, in stages, possibly in several states at a time instead of all at once.

“They needed to take baby steps,” Johnson said. “Test it out. See that it works. Go to the next step. Do a little more testing, Go to the next step. That’s the way successful projects work.”

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