Thursday, October 24, 2013

Health care sign-up snags, fix-it efforts detailed

From left, Aetna CEO Mark Bertolini, Humana CEO Bruce Broussard, Blue Cross Blue Shield of Florida CEO Patrick Geraghty, and other health care chief executive officers arrive at the White House in Washington, Wednesday, Oct. 23, 2013, to meet with White House officials regarding President Barack Obama's health care law. (AP Photo/Charles Dharapak)







From left, Aetna CEO Mark Bertolini, Humana CEO Bruce Broussard, Blue Cross Blue Shield of Florida CEO Patrick Geraghty, and other health care chief executive officers arrive at the White House in Washington, Wednesday, Oct. 23, 2013, to meet with White House officials regarding President Barack Obama's health care law. (AP Photo/Charles Dharapak)







House Speaker John Boehner of Ohio speaks during a new conference following a meeting at the Republican National Committee offices on Capitol Hill in Washington, Wednesday, Oct. 23, 2013. (AP Photo/Susan Walsh)







House Minority Leader Nancy Pelosi of Calif. gestures as she speaks to reporters during a news conference on Capitol Hill in Washington, Wednesday, Oct. 23, 2013. (AP Photo/Manuel Balce Ceneta)







House Speaker John Boehner of Ohio, left, and House Majority Leader Eric Canton of Va., right, walk away from the microphones following a news conference after a meeting at the Republican National Committee offices on Capitol Hill in Washington, Wednesday, Oct. 23, 2013. (AP Photo/Susan Walsh)







From left, Tufts Health Plan President and CEO James Roosevelt, Aetna CEO Mark Bertolini, Humana CEO Bruce Broussard, Blue Cross Blue Shield of Florida CEO Patrick Geraghty, Kaiser Permanente CEO Bernard Tyson, and other health care chief executive officers arrive at the White House in Washington, Wednesday, Oct. 23, 2013, to meet with White House officials regarding President Barack Obama's health care law. (AP Photo/Charles Dharapak)







(AP) — On the defensive, the Obama administration acknowledged Wednesday its problem-plagued health insurance website didn't get enough testing before going live. It said technicians were deep into the job of fixing major computer snags but provided no timetable.

Democratic unhappiness with the situation began growing louder — including one call for President Barack Obama to "man up" and fire someone — as the president's allies began to fret about the political fallout. Democrats had hoped to run for re-election touting the benefits of the health care law for millions of uninsured Americans, but the computer problems are keeping many people from signing up.

The White House also signaled a change underway in the timeline for signing up for coverage. Consumers have until Dec. 15 to apply for coverage that's effective Jan. 1. Even though open enrollment lasts until March 31, people would face a penalty if they postpone buying coverage beyond mid-February. Calling that a "disconnect," the White House said officials will soon issue policy guidance so that if consumers sign up by the end of March they will not face a penalty. No action from Congress is needed to make that happen, the White House said.

Republican sniping about the website's flaws continued unabated, with House Speaker John Boehner declaring, "We've got the whole threat of Obamacare continuing to hang over our economy like a wet blanket."

Obama himself, though strongly defending the health care overhaul, has been increasingly willing to acknowledge extensive problems with the sign-up through online markets. Amid all that, the Health and Human Services Department on Wednesday provided its most specific accounting yet of the troubles with HealthCare.gov — an issue that is also about to get a lengthy, even-less-forgiving airing on Capitol Hill.

The first of several hearings is set for Thursday in the Republican-led House, with lawmakers ready to pounce on the contractors who built the balky online enrollment system.

Acknowledging what's been obvious to many outside experts, the administration said Wednesday that the system didn't get enough testing, especially at a high user volume. It blamed a compressed time frame for meeting the Oct. 1 deadline to open the insurance markets. Basic "alpha and user testing" are now completed, but that's supposed to happen before a launch, not after.

The Health and Human Services explanation identified some bugs that have gotten little outside attention.

For example, technical problems have surfaced that are making it hard for people to complete the application and plan-shopping functions. That's a big concern because those stages are further along in the signup process than the initial registration, where many consumers have been getting tripped up. The problems are being analyzed and fixes are planned, the department said.

The explanation, posted online in a department blog and accompanying graphic, identified other broad areas of problems and outlined fixes underway but in most cases incomplete:

— Unexpectedly high consumer interest that overwhelmed the system in its initial days. Equipment has been added to handle the load and system design has been improved. More fixes are in progress.

— Lack of a way for consumers to browse their health plan options without first having to set up a user account. A partial fix is in place.

— Incorrect or duplicate information in enrollments is being delivered to insurance companies. Some software fixes that should help address the issue have been completed, others are underway.

— Difficulties for consumers trying to create user accounts, including drop-down menus that didn't work. Design changes and software fixes should address the situation.

The new markets are supposed to be the portal to coverage for people who don't get health insurance on the job. Middle-class people are to pick from subsidized private insurance plans, while low-income people are steered to Medicaid in states that agreed to expand that safety-net program.

The federal government is running the online markets in 36 states, and its website has had more than its share of problems. As a result, even Obama has urged consumers to revert to low-tech approaches, by applying through the mail, telephoning federal call centers, or seeking in-person assistance.

On Thursday, the House Energy and Commerce Committee will line up contractors, including CGI Federal, the lead developer of the website, and QSSI, which designed a back-room operation known as the federal data services hub. The hub is integral to verifying applicants' personal information and income details, and the administration says it is working as designed.

Rep. Joe Pitts, R-Pa., chairman of the panel's health subcommittee, said he wants to focus on the administration's decision not to allow browsing, or window shopping. That's a standard feature of e-commerce sites, including Medicare.gov for seniors. Lack of a browsing capability forced all users to first go through the laborious process of creating accounts, overloading that part of the site.

"Who made that decision? When was it made? Why was it made?" said Pitts.

In prepared testimony, an executive of QSSI's parent company said the decision was made late in the game. It could have contributed to overloading the system, said the executive, Andy Slavitt.

CGI vice president Cheryl Campbell said the administration was the "quarterback" of the entire effort.

Meanwhile, Democrats are worrying aloud about persistent problems with the rollout. Rep. Richard Nolan of Minnesota emerged from a Wednesday morning meeting with administration health care officials on Capitol Hill and told The Associated Press the computer fiasco has "damaged the brand" of the health care law.

"The president needs to man up, find out who was responsible, and fire them," Nolan said. He did not name anyone.

Likewise in the Senate, Florida Democrat Bill Nelson said somebody should be fired over the computer problems. "That's the problem in government today," Nelson told ABC's Miami affiliate. "People are not held to account."

Obama says he's as frustrated as anyone and has promised a "tech surge" to fix the balky website. White House spokesman Jay Carney also said the administration will be more open about the problems. After more than 20 days without briefing the media, HHS will start regular sessions on Thursday, he said.

In light of the computer problems, some Democrats are saying Obama should consider extending open enrollment season beyond next March 31, and revisit the penalties for individuals who don't sign up and remain uninsured. Under the law virtually all Americans must carry health insurance starting next year or face fines.

House Democratic Leader Nancy Pelosi advised against the change.

"I think we should try to fix what we have, move forward with the deadline we have," the California Democrat told reporters. "What we want to do is fix it and go forward with it, not make policies that are predicated on its not working."

Even if the computer problems get ironed out, the Republicans are unlikely to end their criticism. Said Boehner on Wednesday: "When you look at the problems with Obamacare, all the focus here lately has been on the website. ... I would argue the problems go much further than that."

____

Associated Press writers Josh Lederman, Laurie Kellman and Julie Pace contributed to this report.

Associated PressSource: http://hosted2.ap.org/APDEFAULT/3d281c11a96b4ad082fe88aa0db04305/Article_2013-10-23-Health%20Overhaul-Problems/id-80d55e134e81402cac6ea237a8a863bb
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