The federal government's health-insurance exchange is seeing improvement and can now register 17,000 customers per hour “with almost no errors,” an Obama administration official said Tuesday at a Senate hearing where the website's underperformance was targeted by both political parties.
Fixes included speeding up the web pages so insurance plans are displayed “in just seconds,” instead of minutes, Marilyn Tavenner, the head of the U.S. Centers for Medicare and Medicaid Services, said in remarks to the Senate Health, Education, Labor and Pensions Committee. The agency also doubled the number of servers and replaced a virtual database with a physical one as it tries to reach a goal of 800,000 sign-ups in the first month.
Tavenner's comments weren't good enough for some Republicans on the committee, as well as Democrats who actually voted for the Patient Protection and Affordable Care Act of 2010. Canceled policies, “sticker shock” on the price of new plans and website outages have shaken the faith of potential customers, said Sen. Barbara Mikulski, D-Md.
“What I worry about is that there's such a crisis of confidence people won't enroll, and the very people we need to enroll, particularly our young people, to make this whole system work, won't happen,” Mikulski said.
Since opening Oct. 1, the federal online exchange serving 36 states has been plagued by delays, error messages and hang- ups that have prevented customers from completing applications.
Tavenner wouldn't provide current enrollment figures, saying the Obama administration plans to release a report next week, though initial sign-ups may be low before picking up in December.
“We are seeing improvements each week, and by the end of November, the experience on the site will be smooth for the vast majority of users,” Tavenner said. Her agency is doing “software upgrades pretty much several times a week” and focusing on “the internal architecture of the site.”
The inability of customers to navigate the federal site, register their information and buy plans puts the government at risk of missing congressional projections for signing up 7 million people in plans through the exchanges for 2014.
“This law is more than a website that won't work — it is a law transforming our health-care delivery system in the wrong direction,” said Sen. Lamar Alexander of Tennessee, the top Republican on the committee. He cited “increasing premiums, canceling insurance plans, destroying relationships with doctors, raising taxes, forcing people into Medicaid.”
U.S. officials blamed the turnout of millions of Americans on the first day for the problems, saying the unexpectedly high numbers overwhelmed the system. Tavenner said today her agency underestimated demand and is now focusing on “performance and speed” of the site.
“We had to go back and catch up and add additional capacity and improve performance,” she said.
This is Tavenner's second appearance before Congress in a week as lawmakers investigate what went wrong with the exchange website that is supposed to let people compare and buy health plans, aided by tax credits. Tavenner, at a House committee hearing Oct. 29, blamed outside contractors for the website woes, though she did apologize for the exchange's flaws.
Kathleen Sebelius, the Health and Human Services Secretary, told a separate panel a day later that her agency is working to achieve “an optimally functioning” exchange by the end of November. Sebelius is scheduled to testify again tomorrow before the Senate Finance Committee.
Some of the website problems can be traced back to the race to construct an online insurance exchange by Oct. 1 that spurred the Obama administration to use an expedited bidding system that limited its choice of a builder to just four companies, including CGI Group Inc.
Eighteen months elapsed after passage of the 2010 health- care overhaul before CGI was selected to begin work, government documents show. That left Montreal-based CGI two years to create a website, healthcare.gov, designed to link consumers with insurers while drawing data from a variety of U.S. agencies, including the Internal Revenue Service.
The Obama administration has identified a number of software flaws that led to the problems, criticized CGI's handling of the work, named another software company to supervise their work and pulled in engineers from Google, Red Hat and Oracle to help get the website working smoothly by the end of this month.
The bidding shortcut the administration used limited the companies that could bid to build the website to a pre-approved list of 16 vendors selected in 2007 for an umbrella contract to work on unspecified systems for the U.S. Centers for Medicare and Medicaid Services. Only four of the 16 companies bid for the work, including CGI. The other bidders weren't identified.
CGI has been paid $104 million already and while no penalties are built into its contract, Sebelius said on Oct. 30 that “paying for work that isn't complete is not something that we will do.”
CGI is due $197 million through the end of March, Sebelius said. The entire website project is budgeted to cost $630 million, said Julie Bataille, a spokeswoman for the Centers for Medicare and Medicaid Services, on a Nov. 1 conference call.
The company's work is now being supervised by Quality Software Services Inc., a unit of UnitedHealth Group Inc. named lead contractor for the project two weeks ago. QSSI built a piece of the healthcare.gov infrastructure, a “data services hub” that feeds information from federal agencies to CGI's site and state-run insurance websites.
Tavenner said today QSSI is now “working with me directly.”
Units of CGI and UnitedHealth told the House Energy and Commerce Committee last month that a branch of the health agency was responsible for the end-to-end testing of the site that should have been done months earlier. The government conducted final tests just days before the site went public, while similar projects are tested for months, the contractors said.