A fresh look at the darkest days of the Affordable Care Act by HHS' Office of Inspector General affirms the criticisms lobbed at the Obama administration in the months after the disastrous 2013 launch of HealthCare.gov. But the OIG also praised the administration for its nimble recovery.
HHS and the CMS “lacked clear leadership” and time management skills as they developed the initially faulty HealthCare.gov website, according to a new OIG report.
The leadership gap led to delays and lack of clarity in decisionmaking, while the mismanagement of time resulted in developers devoting too much time to policy, leaving too little time for software development, according to the 92-page report (PDF).
Those failings combined with poor contract management yielded the fiasco of a website that went live Oct. 1, 2013. It was supposed to be used by Americans to shop for health insurance plans under Affordable Care Act but instead sputtered and stalled, frustrating millions of people for the first few months of the program's initial enrollment period.
The report also breaks down how the administration was able to salvage the website and the crucial first enrollment period for the insurance exchanges.
“Following the launch, CMS and contractors pivoted quickly to corrective action,” an OIG report summary said. The feds reorganized the work and improved execution, it said.
“Key factors that contributed to recovery of the website included adopting a "badgeless" culture for the project, wherein all CMS staff and contractors worked together as a team, and a practice of 'ruthless prioritization' that aligned work efforts with the most important and achievable goals,” the summary said. “CMS recovered the website for high consumer use within two months, and adopted more effective organizational practices.”
So far, the agency said, the CMS reports that more than 9.6 million consumers have selected a health plan through the federal enrollment portal or had their coverage automatically renewed.
The OIG called on the CMS to continue to apply the lessons learned from the failure and recovery "to avoid future problems and to maintain improvement across the agency."
Those lessons, according to the report, include assigning clear project leadership, designing clear strategies for disciplined execution, continually measuring progress, and promoting “acceptance of bad news and encourage staff to identify and communicate problems."