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Wednesday, November 6, 2013

Obamacare Launch Was Worse Than Originally Thought

As bad as one may have thought the introduction of Healthcare.gov was--it was worse than that! Tuesday night Darrell Issa released 175 pages of meeting notes from the group trying to fix the Obamacare website known as the "tiger team" (embedded below). Those notes reveal a startling tale of incompetence.

The notes indicate that it took until one week after the exchange opened for the administration to realize that the problems were huge, much broader than solely high traffic levels, and arrive at the realization they could not be easily fixed. It was like a game of whack-a-mole, as soon as one problem was fixed others popped up. The documents show that officials at the  beginning were focused on addressing individual bugs instead of the bigger issue the entire website needed to be overhauled. 

Below is a CNN summary of the "worst" of Healthcare.gov.
"50% of the call center calls have issues," reads an entry on day three of the sign-up. "Anecdotal evidence supports a widerspread problem (with the call centers)," the October 3 document says.

Phone trouble continued into the next week. "Our call center reps can't see their screens," wrote an unnamed consultant on October 7. "So we need to train them ... with this issue." The following day, another note: "Call Center – Working with them to help them triage their issues."

At the same time, the paper applications starting to arrive were in limbo. "Serco still cannot process online the 500+ applications they have," reads one line from October 8 war room notes. Serco is the company paid to handle all the paperwork involved with the Affordable Care Acts sign-ups. Website problems meant that Serco, like individual consumers themselves, could not file applications online.

This was the first week of deployment, and the Health and Human Services Department has maintained that problems at the call center and paper applications were fixed. HHS did not respond to CNN's request for an on-record comment for this story, and CNN could not verify if the agency agreed with the contractors' assessments.

The updates indicate that contractors waited for HHS before directing people to the paper applications. An October 3 entry reads that navigators needed "approval from leadership" before directing people to the paper option That approval seemed to come by October 21, when another entry indicates navigators should use the paper forms.

The contractor documents are an up-close look at the asteroid field of issues with the Obamacare launch.

According to the war room notes: On day one, October 1, the system mistakenly rejected 90% of Medicaid applicants. The next day, estimates counted 40,000 people in the HealthCare.gov waiting room, while just 100 people had enrolled. By day three, it was clear that insurers were not getting the data for people who had signed up for their plans.

Systemwide issues were compounded by more isolated problems. On day six, Utah asked to shut down its exchange because the main insurance provider in the state had not been able to set up its template in the system. A few days later, on October 9, contractor notes say that the entire system has skipped some questions or information for 30% of all applicants.

A few days later, and another specific problem: insurers in Oklahoma were confused over whether they had to provide coverage for bariatric weight loss surgery (they didn't, sparking the need for changes to some plans).

Issues continued, but after the first week, the trend turned more positive.

On October 9, the war room update for the morning says, "About 60% of applicants are getting into HealthCare.gov without sitting in the waiting room." That left 40% who still had to wait. But the number was a vast improvement from the 90% to 95% percent the week before.
Source: CNN.com

Filed under: Darrell Issa • Healthcare • HHS • Obamacare

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