WASHINGTON – Despite a scathing report on past and ongoing failures with healthcare.gov, the Affordable Care Act’s website will be ready to go when enrollment begins again in November, Andy Slavitt, principal deputy administrator of the Centers for Medicare & Medicaid Services testified to a House subcommittee July 31.
Mr. Slavitt, who took his post 3 weeks ago, was called to Capitol Hill to respond to a Government Accountability Office report that is critical of both the rollout of healthcare.gov and the ongoing management of the portal. The GAO is a nonpartisan agency that serves as the investigative arm of Congress.
Alicia Ault/Frontline Medical News
Andy Slavitt, Deputy Administrator, CMS
Mr. Slavitt acknowledged problems listed by the GAO. "Fortunately, or unfortunately, the GAO report wasn’t news to the people at CMS," he testified before the House Energy & Commerce Committee Subcommittee on Oversight and Investigations.
But many have been addressed, he said, adding that there is more accountability, better communication with contractors, and clearly defined performance goals.
"This coming year will be one of continuous and visible improvement, but not perfection," Mr. Slavitt testified.
The GAO report chronicled mismanagement, limited oversight, and a chaotic planning process within CMS during the lead-up to the launch of healthcare.gov in October 2013. Officials knew that the site was only 65% ready that spring, but put off a review of performance until September, GAO official William T. Woods testified at the hearing.
Constantly changing requirements led to huge cost increases – which appear to have continued. As of March 2014, the federal government had spent $840 million on the website. The CMS did not properly review or approve work by the contractors and "took only limited steps to hold the contractor accountable," Mr. Woods said in written testimony.
The GAO report notes that the cost of working with Accenture Federal Services – the contractor hired to replace the site’s original builder – had ballooned from $91 million to more than $175 million in the first half of 2014, because of new requirements and other changes ordered by CMS.
Despite rising costs, key parts of the website are still not functional, including the financial management module, which handles financial interactions with insurers. That contract continues, "so costs on that particular contract are almost certainly higher today than they were when we completed our audit work," Mr. Woods said.
Rep. Tim Murphy (R-Pa.), chairman of the oversight subcommittee said, "We still don’t know if the Administration has a system in place capable of handling inconsistencies, inaccurate subsidies, or whether CMS will ever put in place a functioning payments system."
Rep. Murphy and his Republican colleagues also questioned whether top CMS officials, such as Administrator Marilyn Tavenner, were aware that the site was so far behind in its performance goals and deadlines. At one point, Rep. Murphy suggested that, if they had known, they might have perjured themselves in appearances before the Energy & Commerce Committee in 2013.
Democrats on the panel said that it was important to acknowledge the failures of the site’s launch, but only to inform future solutions. "We will stipulate the rollout of the ACA was an unmitigated disaster," said Rep. Diana DeGette (D-Colo.). But she and her colleagues said it was time to move forward.
"My point is not to excuse the healthcare.gov problems but to put them in context," said Rep. Henry Waxman (D-Calif.). He said the problems were fixed, though not quick enough for his liking. But, Rep. Waxman added, "I want to learn what went wrong so CMS can do a better job for the next time."
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