OBAMACARE OCTOBER 25, 2013
The Obama Administration has spent a lot of time downplaying the problems with healthcare.gov. It hasn’t spent a lot of time talking about the real problems, how extensive they are, or by when it plans to fix them. That changed on Friday, when the Administration made three key announcements during its now-daily conference call on the status of repairs:
1. Jeff Zients, the former Office of Management and Budget official whom the president appointed to advise HHS, has completed his initial review.
2. Based on that initial review, and his assessment of the work to be done, he will be appointing an outside firm to serve as the equivalent of a “general contractor.” The contractor will be QSSI, who is one of the contractors already working on the system.
3. The Administration expects that healthcare.gov will be “running smoothly” by the end of November.
That last part is important. In order to buy coverage that will start on January 1, consumers must enroll in plans and pay initial premiums by the middle of December. If healthcare.gov is not working well by that time, consumers 36 states will have difficulty getting affordable coverage in time for the beginning next year. (It's a different story in the rest of the country, where states and the District of Columbia are operating their own exchanges, with much greater success.)
This kind of analysis and decision-making is precisely the sort of work people expected from Zients, who is on temporary assignment until he takes over formally as head of the president's National Economic Council in January. Zients has experience in the business world and as a manager of technology contractors. Insofar as the problem is lack of coordination, poor decisions about priorities, that’s up his alley. It's what he does.
But Zients not a technology guy himself. And even the better-known technology experts within the administration, like U.S. Chief Technology Officer Todd Park, have more expertise on thinking up great websites rather than building them. (I.e., they're more visionaries than programming geeks.) Outside experts have questioned whether the existing firms handling the work on healthcare.gov—including QSSI—have the expertise to do the job.
When asked on the conference call exactly who had advised the administration on its assessment, officials would not reveal names. Another question is what exactly the administration means by "running smoothly." Officials declined to give too many specifics on that question, as well.
Two reporters (I was one of them) asked how Zients could be so confident about late November, particularly given previous promises that the site would be working by October 1. He said he was basing that on progress to date and a clear-eyed analysis of what needs to be done, which doesn't tell us a whole lot.
Still, the assessment Zients gave over the phone was more candid and detailed than any public accounts administration officials had given previously. He acknowledged, for example, that high volume was one source of trouble for the site—but only one of many. He also explained that the site had two separate series of problems. One group consists of “performance problems”—the issues consumers have encountered, like seeing error messages, delays, and crashes. The other group consists of “functional” issues, which are “bugs” that prevent software from working the way it’s supposed to work. An example of this would be the erroneous data reports that healthcare.gov (like some of the state-run exchanges) have been delivering to insurance companies. Zeints said that problem was at the top of a “punch list” of tasks that need to get done.
Zients also announced that performance has already improved considerably, thanks to repairs HHS and its contractors already made. Initially, he noted, most people could not even get past the initial screens. Now, he said, 90 percent of people who log on are able to create accounts successfully. That’s just one step in the process of obtaining coverage—a point Zeints acknowledged. “It’s going to take a lot of work and some time,” he said, “but there is a clear path forward.”
I'll update this item as I learn more information.