Health and Human Services Secretary Kathleen Sebelius has asked her department’s inspector general, Daniel Levinson, to review the contracting and project management problems that led to the bungled rollout of the HealthCare.gov website.
The move is one of three new initiatives Sebelius announced Wednesday morning in a blog post and during testimony before the health subcommittee of the House Energy and Commerce Committee.
The directives come on the heels of new figures that show HealthCare.gov enrollments quadrupled from October to November. That enrollment boost gave Sebelius a rare piece of good news to share with Republicans who have criticized the website’s performance since its disastrous debut on Oct. 1.
The marketplace that serves 36 states enrolled 110,410 people in November, up from just 26,794 in October, when technical problems stifled enrollment and triggered a severe political crisis for Sebelius and President Barack Obama.
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The roughly 365,000 people who gained coverage on the state and federal marketplaces in October and November is far below the 800,000 new signups that the Obama administration had projected. And Sebelius testified Wednesday that the administration originally expected 3.3 million state and federal marketplace enrollees by the end of 2013.
While both projections now seem unlikely, the administration hasn’t changed its original goal of logging 7 million people into marketplace coverage by the end of open enrollment on March 31, 2014.
A massive site repair effort by hundreds of federal and private sector information technology experts is credited with sparking the November enrollment turnaround, which has helped bring more than 28.4 million visitors to HealthCare.gov since Oct. 1.
Calling the website’s debut “flawed, frustrating and unacceptable,” Sebelius said Wednesday that it’s time to review exactly what went wrong.
“I believe strongly in accountability and our obligation as public servants to be good stewards of taxpayers’ dollars,” she testified. “Now that the website is working more smoothly, I’ve determined it’s the right time to begin a process to better understand the structural and managerial policies that led to the flawed launch so we can take action and avoid these problems in the future.”
Sebelius wants Levinson to investigate how contractors were selected, how they performed and how HHS staff oversaw the construction of the federal marketplace and its HealthCare.gov portal. The department will take action on Levinson’s findings, she said.
To address concerns about security shortcomings and the safety of consumers’ personal information, Sebelius has asked Marilyn Tavenner, administrator for the Centers for Medicare and Medicaid Services, to create a new chief risk officer position within the agency.
The risk officer’s first task will be to identify problems with the website launch.
Sebelius also has called for more training for CMS employees in IT procurement and project management.
Asked by Commerce Committee Chairman Fred Upton, R-Mich., whether she would have delayed the site launch based on the information she now has, Sebelius said she’s “not sure what the right answer is.”
“I would have probably done a slower launch, maybe with fewer people, and done some additional beta testing” to make sure the system was operational, she said.
The federal health secretary testified that HHS has paid $319 million of the $677 million in IT costs to set up the online insurance marketplace.
Even before the website troubles, Sebelius’ appearances before House committees, which are controlled by Republicans, have never been love fests. On Wednesday, after Rep. Henry Waxman, D-Calif., appealed to subcommittee members for “more respectful treatment” of the secretary, Rep. John Shimkus, R-Ill, sarcastically said, “I’m going to try to be nice and polite and kind.”
But his questioning quickly turned harsh after he challenged the accuracy of the latest figures showing 365,000 new federal and state marketplace enrollees.
Shimkus said the number was “fraudulent” because it wasn’t clear how many of the new enrollees had actually paid for coverage. Sebelius pointed out that payments aren’t due until the end of December for coverage to begin on Jan. 1.
Shimkus then said Sebelius failed to keep a promise to provide him a list of health plans that cover abortion services. Sebelius said the information is on the federal website, but Shimkus repeatedly asked for the list, prompting a heated exchange in which he argued loudly with Sebelius and Rep. Frank Pallone, D-N.J., who defended the secretary.
In the end, Shimkus said questioning Sebelius is “like talking to the Republic of Korea or something.”