The Washington PostDemocracy Dies in Darkness

‘We’re not getting that reliable data:’ The most important moment of the Sebelius hearing

Health and Human Services Secretary Kathleen Sebelius testifies before the House Energy and Commerce Committee. (Karen Bleier/AFP/Getty Images)

Welcome to Health Reform Watch, Sarah Kliff’s regular look at how the Affordable Care Act is changing the American health-care system — and being changed by it. You can reach Sarah with questions, comments and suggestions here. Check back every Monday, Wednesday and Friday afternoon for the latest edition, and read previous columns here.

Housekeeping announcement: Starting this month, you can sign up to get Health Reform Watch straight to your inbox! Just enter your information here, and you'll be all set. 

Health and Human Services Secretary Kathleen Sebelius spent about three hours testifying before Congress this morning. From all of that, there is one sentence that was arguably the most important things she said. It was about health insurance plans, which are still not receiving accurate data from

"The system isn't functioning, so we're not getting that reliable data," Sebelius told legislators, answering a question about why the administration will not release enrollment data.

Sebelius reiterated what Jeff Zients told reporters late last week: that fixing data files sent to insurance companies, known as "834" files, is at the top of the administration's "punch list" for fixing the Web site

"We have prioritized that specific fix," Sebelius said.  "Believe me, insurance companies [want] to get reliable data."

There's a reason that this item is getting such high priority: Without a fix, insurance plans won't know who actually signed up for their health plans. That means they can't send out membership cards or start paying claims for doctor visits.

There are significant problems with the front-end of; during  Sebelius's testimony, shoppers were getting an error message when they tried to apply, noting that "the system is down at the moment." That means insurance plans aren't getting a ton of enrollments right now, since it's really hard to sign up.

This forces health insurance plans to check each enrollment file by hand, to see what inaccuracies turn up. Even with the trickle of enrollments coming in right now, this is a lot of work: I spoke with one insurance source last week, whose company was using some offshore contractors to do some of the work checking 834 files.

"We're having a lot of issues with duplicate files coming over," that source said. "We enter in address information that we can't validate, so then we've got to call you or go to the postal service to figure out what your address is. Things along those lines are what we're seeing."

This works when insurance enrollments are coming in at a trickle. But if the front-end issues are resolved — and insurers receive a surge of sign-ups — that could create huge problems for the companies that are supposed to begin providing coverage Jan.  1.

Kliff Notes: Top health policy reads from around the Web. 

Sebelius apologized for the health law's rollout. "Health and Human Services Secretary Kathleen Sebelius acknowledged “frustrating” problems Wednesday with the new health-care law’s Web site and pledged that they would be fixed “as soon as possible.” She offer an apology for the site’s troubled launch, while also attributing the breakdowns to private-sector contractors." William Branigan and Sandhya Somashekhar in the Washington Post.

A September memo shows worries about's security protocols.  "An internal government memo obtained by The Associated Press shows administration officials were concerned that a lack of testing posed a "high" security risk for President Barack Obama's new health insurance website. The Sept. 27 memo to Medicare chief Marylin Tavenner said a website contractor wasn't able to test all the security controls in one complete version of the system." Ricardo Alonso Zaldivar and Jack Gillum in the Associated Press.

The fight of the navigators. "As Republicans in Washington prepare to grill Health and Human Services Secretary Kathleen Sebelius on Wednesday over problems a broken website is creating for accessing Obamacare, their fellow party members in a dozen-and-a-half states have added complications for people trying to access those benefits through alternate means." Alex Seitz-Wald in National Journal