Reform Update: HealthCare.gov will be fixed by late November, officials say

Obama administration officials are promising that HealthCare.gov, the troubled Web portal for Americans to buy private health insurance, will be running smoothly by late November.

Plagued by a series of technical and structural malfunctions since it was launched three weeks ago, HealthCare.gov continues to have “dozens” of problems with both performance and functionality, said Jeffrey Zients, the former acting director of the Office of Management and Budget tapped by the Obama administration to assess problems with the federal website.

“There is a lot of work to do, but HealthCare.gov is fixable,” Zients told reporters during a call that CMS hosted on Friday to provide an update on the website's operations. Zients—who will become director of the National Economic Council in January—said the CMS has a “punch list” of fixes it will punch out, one by one.

To oversee that effort, the CMS appointed Quality Software Solutions Inc. (QSSI)—the UnitedHealth Group business unit that is one of the contractors currently working on HealthCare.gov—as general contractor. Julie Bataille, director of communications at the CMS, said QSSI has “done a good job in their work with the federal data hub” used in the online marketplace and that contract details are not final yet.

According to Zients, QSSI as a general contractor will ensure that all of the involved players—including CMS leadership and the contractors working on the website—will execute at a very high standard to make changes and improvements to the system quickly.

“Each week it will get better,” Zients said. “We are confident that by the end of the month of November, HealthCare.gov will run smoothly for the vast majority of users.”

In a hearing on Capitol Hill yesterday, a representative for CGI Federal, one of the contractors working on HealthCare.gov, said she was confident that consumers would be able to enroll more quickly and efficiently by Dec. 15. On Friday, Zients pledged that continual improvements on the site each week, along with the addition of a general contractor, will lead to a better experience for insurance shoppers ahead of that mid-December date. Consumers must apply by Dec. 15 in order to have coverage by Jan. 1.

HHS Secretary Kathleen Sebelius and CMS Administrator Marilyn Tavenner will get their chance to explain the flawed federal exchange rollout next week when they appear before Congress in separate House hearings. Tavenner will testify before the House Ways and Means Committee on Tues., Oct. 29, and Sebelius is scheduled to appear the next day before the House Energy and Commerce Committee. Prepared testimony was not available from either CMS or HHS as of Friday.

Reform supporters like Dan Mendelson, CEO and founder of consulting firm Avalere Health, recommended Tavenner and Sebelius should acknowledge that mistakes have been made with HealthCare.gov, but then pivot rapidly to a focus on the marketplace that offers competitive health plans in all 50 states for the first time. He also said that if lawmakers grill the two health officials about the website's technical issues, Tavenner and Sebelius should emphasize that call centers and brokers are available to help consumers apply. He noted that there has been so much attention on the federal website, but that people have enrolled in part B and supplemental insurance for 40 years without applying online.

And new research from Mendelson's group released Friday could arm Tavenner and Sebelius with some positive information when they face lawmakers next week: Avalere's analysis (PDF) found that the number of applications submitted so far for coverage in the exchanges (the CMS has said the figure is nearly 700,000) has exceeded comparable enrollment in Medicare part D over the same time period during each program's launch.

“The administration is actually ahead of the pace that was set in Part D,” Mendelson told Modern Healthcare. “Enrollment is going better than Medicare part D enrollment. As long as they have the technical difficulties figured out by the end of the year, they're fine.”

Pointing to the failed rollout of the health insurance exchanges, a group of House Republicans asked President Barack Obama in a letter (PDF) to call for HHS Secretary Kathleen Sebelius' resignation. In Phoenix this week, Sebelius addressed a question about calls for her resignation during a news conference. “The majority of people calling for me to resign, I would say, are people who I don't work for and who do not want this program to work in the first place,” Sebelius said. “I have had frequent conversations with the president and I have committed to him that my role is to get the program up and running, and we will do just that.”

House Oversight and Government Reform Committee Chairman Darrell Issa (R-Calif.) and Senate Health, Education, Labor and Pensions Committee Ranking member Lamar Alexander (R-Tenn.) on Oct. 25 sent a letter to HHS Secretary Kathleen Sebelius demanding that HHS provide documents related to the problems with HealthCare.gov by Oct. 28 or else face the possibility of a subpoena from the House Oversight Committee. The lawmakers' terse letter took Sebelius to task for failing to appear before Congress to answer questions about the troubled rollout of HealthCare.gov. “While you have refused to provide information to Congress, you have been a frequent guest on numerous news and television comedy programs subsequent to Oct. 1, 2013,” the lawmakers wrote. “It is unacceptable that you are providing information to numerous other outlets, but not to Congress.”

Medicare providers remain anxious over the outcome of the upcoming fiscal negotiations between Senate and House lawmakers. The joint budget conference committee—which was created in Congress' recently passed legislation to temporarily fund the government and raise the nation's debt ceiling—will meet for the first time next Wed., Oct. 30.

The U.S. Chamber of Commerce will host its second annual healthcare summit in Washington on Oct. 30 to examine how the private and public sectors can be used to improve outcomes. Dr. Harvey Fineberg, president and CEO of the Institute of Medicine; Larry Merlo, president and CEO of CVS Caremark; and Dr. Ralph de la Torre, chairman and CEO of Steward Health Care System, are among the confirmed speakers for the event.

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