The escalation from medium risk reflects critical back-end tasks that remain incomplete and comes after most consumer-facing problems have been fixed.
Six months after the buggy launch of HealthCare.gov, the project has been rated "moderately high risk" by the CIO of the Department of Health and Human Services on the federal IT Dashboard.
Although the move might not seem timely, the Centers for Medicare and Medicaid Services have a number of key releases in the pipeline that have been delayed because of the scramble to make HealthCare.gov operational. Key among them are the financial management system that moves subsidy payments between the Treasury Department and insurance carriers and the planned migration of cloud-hosting services from Verizon Terremark to Hewlett-Packard.
In addition, IT projects designed to support certain features of the law have been delayed. For instance, the provision that requires small businesses to offer coverage has been extended to 2016. When HealthCare.gov was last evaluated, in July 2013, it was rated medium risk.
The IT Dashboard risk rating is done in part to notify oversight bodies and others of potential problems in government IT programs and to provide information for the TechStat oversight process that is used to examine and suggest fixes for troubled IT programs. However, it is not clear if HealthCare.gov is ripe for a TechStat session because the work is being led by a special adviser to HHS Secretary Kathleen Sebelius -- Kurt DelBene, a former Microsoft executive.
The designation comes as CMS is concluding the initial open-enrollment period for health coverage under the Affordable Care Act. After a disastrous launch period during which only a handful of individuals were able to obtain coverage, the government recently announced that 7.1 million had people signed up for coverage via the improved HealthCare.gov site, as well as by phone and in person.
Overall, the government approved around $688 million to $738 million in fiscal 2014 spending on IT related to the health care law. The discrepancy comes from a difference between figures reported by the Internal Revenue Service on the IT Dashboard and the Exhibit 53 document covering the same investments. The total is probably higher because there are more IT projects related to implementation of the health care law than are included in the CMS and IRS reports.
It is also important to note that there is no reliable estimate on how much of the approved funding was actually spent, but future Government Accountability Office reports are expected to provide a more accurate look at overall spending.