Obamacare

Sebelius dials back expectations on 'tech surge'

Kathleen Sebelius

The nation's top health care official appeared to be trying to lower expectations of how well the troubled HealthCare.gov website would function by the time an ongoing "tech surge" works through a list of problems scheduled to be competed at the end of November.

"We are into the list," Health and Human Services Secretary Kathleen Sebelius told the Senate Finance Committee on Nov. 5. "We're not where we need to be. It's a pretty aggressive schedule to get to the entire punch list."

Quality Software Services Inc., which was tapped as general contractor on the project after the initial launch, is working with integrated teams of government employees and contractors to implement fixes, according to a recent press update from the Centers from Medicare and Medicaid Services. Former administration official and health care entrepreneur Jeff Zients is quarterbacking the effort.

While it has not been publicly disclosed what QSSI is being paid for taking on the additional responsibilities and leading the tech surge, the firm received a $10 million task order recorded in the government contracts database Govini on Oct. 24 for "ACA/ACO testing."

According to Sebelius, the QSSI team has identified a "couple hundred" functional fixes and they have been grouped according to their priority. The site is being taken down from 1 a.m. to 5 a.m. EST on a daily basis to implement fixes. Other patches are being put in place while the site is live.

Cybersecurity hawks Sen. Dianne Feinstein (D-Calif.) and Rep. Mike Rogers (R-Mich.), among others, have suggested suspending access to the site during the entire period of the tech surge. But the internal IT team at CMS and the contractors have advised Sebelius that there is no technical reason to take the site offline while fixes are made.

"I'm relying on the advice of not only the inside team and contractors, but outside experts who have come in to take a look at the system," Sebelius said. "Given that functionality fixes, the codes, have to be written in batches, you don't gain much from just taking the whole system down for a week, a couple of weeks. It's better to do this on an ongoing basis."

One of those experts, CMS CIO Tony Trenkle, will leave the agency on Nov. 15 to take a position in the private sector, according to a report by the New York Times that was confirmed by CMS spokesperson Julie Bataille on a conference call with reporters. Dave Nelson, who heads the Office of Enterprise Management, will step in as acting CIO. Deputy CIO Henry Chao, who was the point of contact for contractors on HealthCare.gov, continues to help oversee repairs to the site.

Sebelius also confirmed that she did not discuss the plans to obtain a temporary Authority to Operate certification for the Federally Facilitated Exchanges portion of the HealthCare.gov service with CMS Administrator Marilyn Tavenner. FFE allows users to create accounts and shop for and purchase insurance, and delivers enrollment information to insurance carriers.

Tavenner made the decision to obtain temporary authorization on the advice of her senior IT and operations team, Sebelius said, because end-to-end testing was not performed on the full system, including components that were pulled back from the initial launch. These include a function that allows users to browse plans before creating an account, and a Spanish language version of the site.

While Sebelius said she was not in the loop on the authority to operate, she told the committee that the White House "was aware of operational issues involving end-to-end testing," but that she didn't have specifics.

The administration indicated that enrollment numbers for the first month would be released next week. A collection of meeting notes from a CMS "war room" team overseeing the launch suggests that numbers are low -- from a trickle during the first week, growing to as many as 70,000 by Oct. 9 -- Compared with Congressional Budget Office projections of  800,000 enrollees by the end of October.

Sebelius noted that plans are in place to re-invite some of the users who begin filling in their information but gave up during the buggy application process. She didn't offer details on how it would work, but she expressed a particular desire for younger visitors to enroll via this process.

"We know that a lot of young folks have impatience with any technology that doesn't work instantaneously, so that audience is particularly important," to contact once the site is back online, Sebelius said.

Plenty of younger, healthier enrollees are essential to making the system economically feasible. If enrollees are skewed toward older, sicker customers, costs of coverage would increase.

Reader comments

Fri, Nov 8, 2013 Hl

I am a federal employee and manage an IT team responsible for building applications and my two cents is that this whole fiasco was the fault of the govt. The hardest part of any new application is in requirements gathering and documentation. For all the various parts of this system that needed to come together, it should have taken 5 years JUST to get the requirements right, then another 4-5 to get it programmed right. My educated guess is that the govt did a poor job with requirements gathering and when it came time to beging programming the contractor was forced to program "on the fly" without known or finalized requirements. And the govt individuals responsible for transmitting the formal requirements to the contractor probably did not really understand how it was supposed to work in total or what the Administration intended in all instances. Nor were they allowed the time to really do a good job with requirements gathering. So, the president blames the contractor, the govt is likely the real problem and the president is "angry at the IT folks in DC". The president needs to look at the helter skelter "politicking" over the past few years with the ACA, with the many promises made and no idea if they could be delivered on in time. "Damn the torpedoes, full speed ahead" might be a good phrase to describe the administration's handling of this. Wow!!

Fri, Nov 8, 2013 Gary

Her comments should be filed under "No sh8t, Sherlock" The fixes are not just to the GUI, they start with the underlying system structure. Major impacts.

Thu, Nov 7, 2013 JP

Actually, the current form of insurance is not a Ponzi scheme. You are perhaps referring to Social Security and ACA? Insurance is a shared risk pool and has been around for centuries. With insurance a group pays in and only a few draw out. By shgaring costs over a large group you reduce the costs to everyone. With CMS running it however the costs will not be small.

Thu, Nov 7, 2013 OccupyIT

Amazing to watch these politicals cherry pick what they 'are in the loop on' and what not. Nobody presses them. Don't know anything about the regulatory requirement to get a security sign-off but am totaling confident that there is little benefit to shutting down the site while you go through a couple hundred issues. No one but the taxpaying public will be inconvenienced (or worse yet compromised like has happened) so let's just keep hacking away with real time pushes to production and hope nobody complains. The comment about the Ponzi scheme is more real than you think. Company provided health insurance plans are now being quoted for 2014 renewal, as a DIRECT RESULT of ACA, rising from between 34% and 58% for plans with less coverage and higher deductibles and copays. This is real and devastating. Did you know that all dependents are now being priced out by individual age and not just by the tier or age of the member. We're seeing EE+Spouse rising for a 50 year old from $380 to $800. Family rates are being hammered as well. This is the single largest tax ever applied to honest workers and their families - it is larger than Social Security and Medicare costs for these people! I don't think people not currently renewing policies are aware of the looming financial disaster this entails. I can't believe how blatantly misleading ACA was sold or that folks believed it was possible for 'free'. They are only talking about the young people joining because they know us workers will now be gauged through our employers. I wish the Republicans were smarter and more centrist so we could have an actual defender against this literal robbery. But, even though the program is a lie, let's go ahead and believe their IT cronies when they say everything's fine, too. Everyone don you lemming suits and get ready to jump!

Thu, Nov 7, 2013

As someone who has managed several large and complicated AIS development efforts, at this stage of development the metric chart most revealing is the "Fault Discovery/Fault Closing" chart. When the two lines are diverging rather than converging then you're discovering more new problems faster than you're closing the ones already discovered. Hence, it means you're NEVER going to finish the project. Of course you must do some testing to discover new problems which may not be the case for HealthCare.gov! Don't know why someone didn't ask to see this metric?

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