How Healthcare.Gov Imploded

The Obama Administration continues to prioritize political success over people as evidenced in the rollout of the public face of Obamacare: Healthcare.gov. As of the end of February 2014, the Administration had spent $834 million developing a healthcare website that was flawed from the outset  and allowed only a few million people to enroll for healthcare coverage, according to a new report by the minority staff of the Senate Finance Committee and the Senate Judiciary Committee.

Five days before Healthcare.gov opened last year, President Obama addressed Prince George’s Community College in Largo, Maryland, promising that Obamacare would help the economy, families and businesses. “Starting Tuesday, you can sign up,” he said, referring to the October 1 rollout, “You can go to the website; you can check it out; you can see if what I’m saying is true … If you talk to somebody who says, well, I don’t know, I was watching FOX News and they said this was horrible you can say, you know what, don’t take my word for it, go on the website.”

That’s what millions of Americans did on October 1 only to find that the website was not functional at all. The minute that the insurance exchange website was live, it flooded with traffic and major glitches were exposed. Users were prevented from setting up accounts, they were provided with faulty links, and the long list of issues weren’t resolved for days. NBC reported that only six people were able to enroll through the Obamacare website on the first day.

The public may have been surprised that the website was not as simple and efficient as Amazon.com—as President Obama and HHS Secretary Kathleen Sebelius had assured taxpayers it would be—but the website’s imminent failure was actually forecasted by high level officials who, under the political pressure to launch at any cost, threw more and more money at an ongoing catastrophe.

A recently released report by the Senate Finance Committee and the Senate Judiciary Committee titled Red Flags: How Politics and Poor Management Led to the Meltdown of HealthCare.gov reveals in detail what led up to the website’s infamous implosion.

According to the report, there was a lack of leadership from the beginning of the project which inhibited unity between contractors and which omitted any sense of accountability for those charged with its construction. Due to the lack of guidelines and collaboration, the Centers for Medicare & Medicaid Services (CMS) and other contractors were in a position to point fingers at each other but no one was ever in a position to take charge and direct the project in any set direction.

Auditors, hired months before HealthCare.gov’s debut, tested the coding and evaluated the progress of the project. At every stage they found serious technical and managerial problems. The results of the audits were recorded and reported to high level officials but they were rarely shared with those actually working on the website. Instead, the White House and HHS continually threw curveballs at the contractors by delaying crucial guidelines and rules—possibly due to the controversial nature of those rules and the upcoming elections—and made it clear that “no level of failure was too low” to merit delaying the October 1 deadline.

It was reported that as developers worked to correct problems conceived at the early stages of development, defects actually increased. Code was being written faster than those hired to fix problems could keep up and initial issues causedothers until the whole system was built upon deficiencies.

The Affordable Care Act was the centerpiece of the Obama Administration, so developers marched forward silently, trying to ignore the obvious issues buried beneath political rhetoric.

“I just need to feel more confident they are not going to crash the plane at take-off,” said Henry Chao, Deputy Chief Information Officer and Deputy Director at the Office of Information Services, in July. When Chao was asked whether he ever considered asking for more time, he said that was not possible.

The report says that “Delaying the launch was never an option. Administration leaders never wanted to hear that the website was going to implode, so the contractors and staff building the website just did their best to get across the finish line with whatever they could cobble together.”

However, the possibility of crashing on opening day was well known among top officials, so much that instead of fixing thousands of already detected errors and increasing the traffic handling capacity of the already existing EIDM (which acts as a front door to the website without which the website cannot be accessed), contractors were ordered to work on a new EIDM—a “just-in-case” backup that was never used.

Despite understanding the extent of the growing problems—not to mention the serious security risks to the system that failed the tests of multiple auditors—the Administration chose to launch anyway.

Leaders were outright misleading as they faced the public. Assistant Secretary for Legislation, Jim Esquea stated, “On October 1, 2013 a Health Insurance Marketplace will be open and functioning in every state. …HHS is extremely confident that on October 1 the Marketplace will open on schedule and millions of Americans will have access to affordable quality health insurance.”

Marilyn Tavenner and Henry Chao, top officials of Centers for Medicare & Medicaid Services (CMS) and Office of Information Services, respectively, testified before a subcommittee of the House Oversight and Government Reform Committee affirming that despite the reported “shortfalls that are in the GAO report”, they would be “100 percent complete on October 1”.

Reports, emails, and subsequent testimonies show despite the fact that those involved with HealthCare.gov were well aware of its flaws, they gave the public a false sense of security based on political motives—or possibly, but not likely, just unreasonable hopes—but their comments were in no way based on facts or professionally predicted outcomes.

In any large undertaking such as national healthcare, imperfections are expected, but HealthCare.gov is unique in that its long and desperate struggle for functionality, mired by arbitrary deadlines, poor management, denial, and most noticeably, political interference, is reflective of this Administration’s legacy: to allow political concerns to trump operational decisions and blur the truth.

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