Two key parts of online health insurance exchange will take longer to fix than expected

Video: Alex Howard explains how long it might take for the administration to get healthcare.gov working properly, and why the real test comes in December.

The Obama administration acknowledged Tuesday that two key parts of its online health insurance marketplace will take longer than expected to fix, even as it brought back a former senior White House official to help diagnose and correct the Web site’s flaws.

A senior health official said that the insurance exchange, HealthCare.gov, is still unable to perform one of its basic functions: making it easy for low-income Americans to enroll in Medicaid electronically. Days before the exchange opened three weeks ago, the administration said that feature was not ready but would be available by Nov. 1, at the latest.

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But in a phone call Tuesday with the nation’s state Medicaid directors, Marilyn Tavenner, director of the Centers for Medicare and Medicaid Services (CMS), the agency overseeing the exchange, said that this part was still not working and did not predict when it would be ready, said Matt Salo, executive director of the National Association of Medicaid Directors. In the meantime, the Web site simply tells low-income Americans whether they appear to be eligible and then advises them to contact their state’s Medicaid agencies, where they must start applications from scratch.

In a separate lingering problem, officials at the Health and Human Services Department, which oversees CMS, confirmed that the enrollment portion of the Spanish-language version of the online exchange was not working, despite assurances in September that it would be ready by this week. HHS spokesman Joanne Peters urged Spanish speakers to call a toll-free phone number to enroll.

As these fresh evidence of problems emerged, HHS Secretary Kathleen Sebelius announced in a blog post that the agency had enlisted Jeffrey Zients, a former acting director of the Office of Management and Budget, to help oversee the effort to fix the site’s assorted problems.

The decision to turn to Zients, who also served as the White House’s first chief performance officer, underscores the attention the exchange is receiving from President Obama and his deputies. On Sunday, the administration announced that it had brought in more computer experts, and on Monday, Obama said the problems angered him.

Zients, who had previously worked as part of a White House “SWAT” team to speed up G.I. Bill payments and improve the administration’s “Cash for Clunkers” program, left OMB in April and is slated to rejoin the administration as head of the National Economic Council in January.

In her blog post, Sebelius said that the experts tapped to work on the Web site include “veterans of top Silicon Valley companies” and a few “presidential innovation fellows” from the technology sector who work on federal projects for short stints.
On Friday night, four or five of the fellows showed up at the Herndon offices of CGI Federal, one of the main contractors for HealthCare.gov, according to a person familiar with the project. Another contractor, Terremark, a subsidiary of Verizon Communications, has added servers to spread out the processing load, said two people familiar with the project.

The Web site’s Medicaid problems matter because, under the health-care law, about half of the 32 million Americans who stand to gain insurance are expected to be covered through the state-federal health program for the poor and the disabled. The Web site is designed to tell people, depending on their income, whether they are likely to qualify for Medicaid or new federal tax credits to help them pay for private insurance. The site steers consumers in one direction or another after they enter information, including their family size and income . That part works.

Here’s the snag: If the Web site determines that a consumer probably qualifies for Medicaid, it cannot communicate with a state Medicaid program for quick enrollment. Instead, the site gives the person a message to contact the state’s Medicaid program. Then the person has to “start all over again,” said Salo, of the Medicaid directors association. He added that the malfunction is “a frustration. . . . It can turn [consumers] off and make them angry about how government works.”

An HHS spokesman did not explain why the Medicaid function is taking longer than expected to work, other than to say, “We are prioritizing fixes to the online application.” In the meantime, the spokesman said, federal health officials are sending to states lists of consumers who the Web site says may be eligible for Medicaid, along with their contact information.

Meanwhile, the fight over HealthCare.gov is heating up on Capitol Hill, where Republicans are seizing on the Web site’s defects as their latest line of attack on the health-care law and Democrats are rushing to defend the administration.

Republicans quickly began to challenge what administration officials have termed a “tech surge” to try to fix the exchange. Late Tuesday, Rep. Darrell Issa (R-Calif.), chairman of the House Oversight and Government Reform Committee, dispatched letters to five large high-tech firms, including Google and Microsoft, to try to find out whether they had been enlisted to help and, if so, what procurement processes were used to hire them.

Rep. Rob Andrews (N.J.), a leading House Democrat on the matter, said he has spoken to high-ranking White House officials three times since Friday about how to address issues lawmakers are hearing from constituents. Andrews said, for instance, that the administration has made sure community health centers in individual members’ districts are equipped to take insurance applications in person.

On Wednesday, Mike Hash, director of the HHS Office of Health Reform, will brief House Democrats about the health-care law’s implementation. But the real fireworks are likely to begin Thursday when House Republicans are set to hold the first of what probably will be several hearings in coming days. The hearings are designed to grill administration officials and contractors who worked on the Web site.

An HHS official who spoke on the condition of anonymity to discuss operations said agency officials “have been in regular contact with members of Congress of both parties and their staffs,” providing “numerous in-person briefings” as well as a hotline and an e-mail address for questions about the law.

As congressional Republicans criticized the Web site’s operations, David Simas, White House deputy senior adviser for communications and strategy, said in an interview that he and others remain confident that the initial problems will not affect Americans’ overall impression of the law.

“When American people are sitting at home thinking about these issues, what they want is fairly straightforward and simple: Does it work, and can I get what I’m looking for?” he said.

Lena H. Sun, Sandhya Somashekhar and Scott Wilson contributed to this report.

 
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