Sebelius: Enrollment up with improving HealthCare.gov; review of problems launched


U.S. Health and Human Services Secretary Kathleen Sebelius arrives to testify on Capitol Hill Wednesday. (GARY CAMERON/Reuters)

Health and Human Services Secretary Kathleen Sebelius said Wednesday that the ailing health insurance Web site was improving thanks to “relentless” efforts to work out the bugs, and she cited an uptick in enrollment as evidence that the program is back on track after a false start.

But she told a congressional panel she has launched an investigation into what policies and management failures may have contributed to the initial failures of HealthCare.gov, the main portal for people in 36 states to buy private insurance plans under the health-care law.

The administration announced Wednesday that about 365,000 Americans chose health plans during the first two months of the federal and state insurance marketplaces, bringing the total to more than triple the meager enrollment from October.

A report accompanying the announcement showed that the number of people who collectively signed up for coverage in the 14 states running their own insurance exchanges continued to outpace the total enrollment from the three dozen states relying on the federal marketplace.

Although federal health officials emphasized that they are encouraged that the enrollments quickened after the slow first month, the figures make clear that, through November, progress was still lagging behind the administration’s expectations.

The Congressional Budget Office has forecast that 7 million Americans will have gained health coverage by spring — a goal that the administration has embraced. In a telephone call with reporters, Michael Hash, director of HHS’s Office of Health Reform, adhered to that prediction.

“We think we are on track, and we will reach the total that we thought,” he said, noting that Americans have 3 1 / 2 months left to sign up for coverage during a six-month open-enrollment period that runs through March.

In a blog post published before the hearing, Sebelius said she has asked HHS Inspector General Dan Levinson to review the development of HealthCare.gov with a particular focus on the Centers for Medicare and Medicaid Services (CMS), the agency that oversaw the creation of the Web site, and the private firms that were contracted to work on the project.

She also announced the creation of a new position for a “chief risk officer” within CMS, who will report to the agency’s administrator, Marilyn Tavenner. The officer’s first task will be to review acquisition and contracting related to information technology.

“Now that the Web site is working more smoothly, I’ve determined it’s the right time to begin a process of better understanding the structural and managerial policies that led to the flawed launch so we can take action to avoid these problems in the future,” Sebelius told members of the House Energy and Commerce Committee.

It was Sebelius’s third appearance before Congress since the balky rollout of HealthCare.gov Oct. 1, which was plagued with technical troubles that left many Americans unable to shop for coverage despite a rule that most Americans must carry health insurance by early next year or face a fine.

Appearing before same committee Oct. 30 amid calls for her resignation, Sebelius apologized for the “debacle,” which dragged into November and only appeared to ease significantly by the administration’s self-imposed Dec. 1 deadline to improve the site for the vast majority of users.

But her tone was more upbeat Wednesday as she suggested the bulk of the Web site’s problems were in the past, and urged Americans who had been frustrated by the Web site’s problems to try again.

During the hearing, Sebelius disclosed that through the end of October, the administration had spent $319 million on information technology related to HealthCare.gov — up significantly from the $174 million figure she cited during her last appearance before the committee Oct. 30.

Asked by Rep. Fred Upton (R-Mich.), the committee chairman, whether she would have delayed the Oct. 1 launch date for HealthCare.gov, Sebelius responded: “On balance, I am not sure what the right answer is.”

“I would have done a slower launch, maybe with fewer people, and done some additional beta testing,” she said a little bit later.

Republicans’ complaints extended beyond the Web site. They cited stories of people whose health plans are being canceled despite assurances from President Obama that people who liked their insurance could keep it under his law, as well as reports that some people have not been able to keep their doctors as promised.

“My constituents do not trust the administration when it comes to the Affordable Care Act, and it is they who are suffering because of these broken promises,” said Rep. Joe Pitts (R-Pa.), chairman of the committee’s subcommittee on health.

But the uptick in enrollment provided fodder for Democratic lawmakers, who have struggled to defend the law’s poor rollout. They contended Wednesday that with a more fully functioning Web site the health law’s benefits were finally coming into focus.

“We’re beginning to hear the stories of people finally getting the security and peace of mind that comes with quality health insurance,” said Rep. Henry A. Waxman (D-Calif.). “And some of these stories are very powerful.”

Also on Wednesday, Rep. Darrell Issa (R-Calif.), chairman of the House Oversight Committee, which has also been probing HealthCare.gov, accused Sebelius of obstructing a congressional investigation because her department had sent at least one letter instructing a private firm on the project not to provide information requested by the committee.

In a statement, HHS spokeswoman Joanne Peters suggested the letters were an attempt to protect the privacy of consumers and the overall security of the health exchange. “We intend to continue to work with Committee staff to accommodate their requests in an appropriate manner and be cooperative with their oversight investigation,” she said.

But Issa had pointed words for Sebelius.

“Obstructing a Congressional investigation is a crime,” Issa said in a statement. “The federal obstruction laws reflect the fact that Congress’ right of access to information is constitutionally based and critical to the integrity and effectiveness of our oversight and investigative activities.”

Lena H. Sun contributed to this report.

Sandhya Somashekhar is the social change reporter for the Washington Post.
Amy Goldstein is a national reporter for The Washington Post focused on health-care policy.
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