HealthCare.gov fixes won’t be done until end of November, adviser says

An administration official named Jeff Zients has been tasked with fixing the issues with Obamacare's new website. But who is Jeff Zients? (The Washington Post)

The Obama administration announced Friday that it was putting a private firm in charge of fixing its faulty health insurance Web site and set the end of November as a target date for working out all the bugs, the first indication of how long repairs may take.

One day after contractors on the project publicly suggested that the federal government inadequately tested the site before its Oct. 1 launch, administration officials said that one of those contractors — Columbia-based Quality Software Services Inc., or QSSI — would take over management of HealthCare.gov.

Jeffrey Zients, a former administration official selected by the White House to assess the extent of the online marketplace’s problems, told reporters the site is “fixable.” But he offered a sobering picture of the problems left to tackle, saying there are dozens of issues on a “punch list” that need to be addressed.

More than 100 items are on the list, according to a person who is knowledgeable about the project and who spoke on the condition of anonymity because the information is not public.

At the top of the list, Zients said, are the erroneous reports the system sends to insurance companies. Also of concern is that at times, three of 10 users are unable to complete the enrollment process, he said.

A look at the consumer's route through the HealthCare.gov website and the potential failure points.

“It will take a lot of work, and there are a lot of problems that need to be addressed,” he said. “But let me be clear: HealthCare.gov is fixable.”

The remarks by Zients are the most extensive public comments from the administration about the scope of the problems plaguing the Web site, established as a centerpiece of the president’s health-care law.

HealthCare.gov is the main portal for uninsured people in 36 states — the other states are running their own online insurance marketplaces — to buy coverage and get subsidies to help with their premiums. Starting next year, most Americans must carry health insurance or face a fine.

Insurers and consumer advocates say the Nov. 30 deadline for repairs is cutting it close, because people who want coverage that begins Jan. 1 must sign up by Dec. 15. The first of the year is when many of the health-care law’s benefits kick in, including a rule that bans insurance companies from rejecting people for preexisting conditions.

Even if the site is fixed, there could be a huge crush of people enrolling in those last few weeks, requiring insurers to generate bills and insurance cards in a short time frame.

“Most people who are going to change their insurance are going to want to do it by mid-December,” said Rep. Diana DeGette (D-Colo.), a supporter of the health-care law who has been critical of the way the Web site was handled. “Obviously, time is of the essence here.”

Those who do not sign up for coverage by March 31 could incur a penalty.

The site crashed shortly after its launch, preventing people from signing up for accounts — a prerequisite to shop for coverage. Zients said that initial problem is mostly fixed, with 90 percent of people now able to complete the account-creation process.

But more serious problems, such as the error-riddled reports to insurers, persist. Those errors make it hard for insurance companies to know who their new customers are.

The online marketplace is supposed to send each insurer a daily report listing people who have just enrolled. But several insurance industry officials have said the reports are sometimes confusing and duplicative.

In one case, an insurer received a report showing incorrectly that all enrollees that day were male, said Robert Moss, a health IT consultant who is working with five or six insurance companies offering plans on the exchange. “It could be that the gender information was stored as ‘m’ and ‘f,’ ” he said, while it should have been coded for the insurer as “1” and “2.” The error was quickly fixed, he said.

Other types of errors may be less obvious. Ferreting them out probably will take weeks, a time frame that is normal for enrollment systems, Moss said.

“If I have a family of five and one child doesn’t get enrolled, I may not know until July when a claim gets denied. Then it becomes much harder” to trace the root of the problem, he said.

Most of the insurance companies are checking enrollment information for errors before sending out official welcome letters, he said.

On Thursday, contractors suggested at a congressional hearing that the site’s problems could have been addressed earlier with more thorough testing. The Centers for Medicare and Medicaid Services (CMS), the agency within the Department of Health and Human Services responsible for the project, conducted the first full test of the site within two weeks of its launch. Ideally, such testing would have happened months in advance, the contractors said.

Zients said the administration now has a baseline of understanding about the problems and has come up with a “plan of attack.”

“Each week will get better, and by the end of November it will work smoothly for the vast majority of users,” he said.

Some critics have complained that a firm more expert at managing large information technology projects should have been in charge of coordination rather than CMS, the federal agency.

The selection of QSSI “is tacit recognition by the White House that ongoing management by folks at CMS is not going to be the most effective way to remedy the technical issues of HealthCare.gov,” said Bob Kocher, a former Obama health policy adviser.

Republicans complained that they should have learned of QSSI’s new role during Thursday’s House hearing. “It does not instill confidence that senior officials at QSSI who have been at the forefront of the HealthCare.gov mess are kept in the dark about being selected to be the savior for the project,” Energy and Commerce Committee Chairman Fred Upton (R-Mich.) said in a statement.

The attacks are not just coming from Republicans. Ten Democratic lawmakers have signed on to a letter from Sen. Jeanne Shaheen (D-N.H.) asking for an extension to the open enrollment period, which currently ends March 31.

QSSI, which was purchased by UnitedHealth Group in September 2012, faced questions from lawmakers a year ago about whether the sale posed a possible conflict of interest.

The company won an $85 million contract to work on HealthCare.gov, including building the online marketplace’s “data hub,” a complex network connecting the Web site with state, federal and insurance company databases. The data hub, which also serves the exchanges being run by the states, is working well, federal and QSSI officials have said.

The firm also built part of the account registration system and conducted some testing of the online system.

The bulk of the site was built by a different contractor, Fairfax-based CGI Federal.

On Friday, administration officials said it was not clear how much QSSI would earn for undertaking the new role.

“Working with CMS, QSSI will help monitor, assess, prioritize and manage the technical operations of HealthCare.gov to enhance the consumer experience,” a QSSI spokesman said in a statement.

The federal site is not the only marketplace trying to work out the kinks. On Friday, officials in Washington state announced they had fixed an error that caused 8,000 people to qualify for subsidies for which they were not eligible.

Juliet Eilperin, Sarah Kliff and Jia Lynn Yang contributed to this report.

Sandhya Somashekhar is a health reporter for the Washington Post.
Lena H. Sun is a national reporter for The Washington Post, focusing on health.
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