Reform Update: HealthCare.gov wasn't tested enough, CMS says

The massive federal online system designed to enroll Americans in private health plans in 36 states was not tested enough before the Oct. 1 launch of the health insurance marketplaces, the CMS communications chief told reporters Thursday.

Shortly after the House Energy and Commerce Committee grilled the lead contractors working on the federal exchange about the host of problems associated with the Web portal for Americans to buy health insurance, the CMS held a teleconference with reporters to provide what the agency called an “operational update” on the health insurance exchanges. At the House hearing Thursday morning, some of the contractors said they had expressed concerns about a lack of sufficient testing well before the go-live date three weeks ago.

“Obviously due to a compressed timeframe, the system wasn't tested enough,” Julie Bataille, director of communications at the CMS , told reporters on the call. She added that the agency has since “stepped up” its performance testing to ensure that all news systems put in place will be effective over the long term.

Later, Bataille was pressed to answer why the timeframe could be considered “compressed,” given that the Patient Protection and Affordable Care Act became law more than three-and-a-half years ago. “When you look at the complexity of the system and all of the pieces that are interrelated, we had to put those pieces in place,” she responded.

HealthCare.gov has been criticized for lacking a “shop and browse” feature that was easily accessible to consumers from the start, which Bataille referred to only as a “CMS business decision.” A number of state-run exchanges around the country have rolled out more smoothly and have allowed consumers to shop and compare plans without having to first create a personal account.

Meanwhile, Bataille did not answer directly whether HHS Secretary Kathleen Sebelius knew of any technical problems before the launch, saying instead that no one could have predicted the high volume of consumer demand for health insurance. She emphasized that the federal data hub used to determine eligibility for federal premium subsidies is working “just as it should,” and also said the agency is excited about its current “tech surge” that will rely on the guidance and expertise from the some of the country's leading problem solvers.

Those problem solvers include Jeffrey Zients, the businessman who served as acting director of the Office of Management and Budget from January 2012 until April 2013 and will succeed Gene Sperling as director of the National Economic Council in January. Bataille did not provide more information about the other experts the administration will rely on in the tech surge—and at what cost.

Three weeks into the 26-week open-enrollment period that lasts until March 31, 2014, Bataille did not provide enrollment figures but said that nearly 700,000 applications have been completed on the federal online exchange. That means those consumers made it to the point in the registration process where they could determine whether they are eligible for Medicaid or a premium subsidy on the exchanges and could begin shopping. Meanwhile, the CMS's customer service representatives have received 1.6 million calls, including 100,000 calls after President Barack Obama announced the phone number in his remarks from the White House on Monday.

“We are seeing many more consumers successfully creating their accounts and moving on to the plan selection process,” Bataille said. “Our priority now is to fix the bugs so that people can move more quickly” through the system.

Bataille could not answer how many consumers tried to sign up and failed due to problems, but she said that about one-third of the traffic to the site is from people who want educational content and information, while the remaining two-thirds represent those consumers who are actively looking to shop on the marketplace.

At the end of the briefing, Bataille echoed a statement that the vice president of contractor CGI Federal made earlier Thursday at the House Energy and Commerce hearing.

“We are confident consumers will be able to enroll certainly by Dec. 15 for that first coverage in January,” she said. She also said HHS is working on guidance about the administration's decision to allow consumers an additional six weeks to have coverage or else face a penalty and expects “to issue something soon.”

The Obama administration indicated it would delay the open enrollment deadline for people to sign up for a health plan until March 31 to prevent people from facing a tax penalty for not getting coverage, an HHS official said Wednesday. Up to now, people were supposed to sign up by Feb. 15 to avoid the penalty. But administration officials worried that people would be penalized due to difficulties and delays in signing up through the troubled federal exchange website.

The Obama administration says it will start offering regular blogs and CMS press telebriefings on the status of HealthCare.gov technical fixes. In a blog post, HHS Secretary Kathleen Sebelius said the intention is to keep the public informed.

Fourteen insurance industry heavyweights were called to the White House on Wednesday to advise the Obama administration on how to fix the dysfunctional federal health insurance exchange. High on the agenda was the lack of coordination on enrollment data standards connecting the exchange and insurers.

Kaiser Permanente CEO Bernard Tyson, WellPoint CEO Joseph Swedish, Aetna CEO Mark Bertolini and Humana CEO Bruce Broussard were part of the delegation that met with HHS Secretary Kathleen Sebelius, CMS Administrator Marilyn Tavenner, senior White House adviser Valerie Jarrett, White House Chief of Staff Denis McDonough and Deputy Assistant to the President for Health Policy Chris Jennings. They met at the White House to address problems with “834 forms” and direct enrollment, according to a White House news release.

Follow Jessica Zigmond on Twitter: @MHjzigmond