When the Affordable Care Act passed in March 2010, HHS had three and a half years and $400 million to produce a web portal for individual-market consumers that would … pretty much do what the existing portal did for the Medicare Advantage program that ObamaCare raided to pay for its own operation. HHS rolled it out on time last October, whereupon it crashed repeatedly and had to be overhauled. A few months later, the Obama administration bragged about the system when it hit eight million signups, even though the back end couldn’t actually determine how many actually paid for their insurance. Last week, we found out that the part of the system that actually manages the government-run coverage may have screwed up two million or more of those signups.
The next open enrollment date is in mid-November, so now HHS will overhaul Healthcare.gov again with five months to get it functioning properly. What could go wrong? Er …
The Obama administration is revamping HealthCare.gov and scrapping significant parts of the federal health-insurance marketplace in an effort to avoid the problems that plagued the site’s launch last fall, according to presentations to health insurers and interviews with government officials and contractors.
But the makeover—and the tight timeline to accomplish it—are raising concerns that consumers could face another rocky rollout this fall when they return to the site to choose health plans. Some key back-end functions, including a system to automate payments to insurers, are running behind schedule, according to a presentation federal officials made to health insurers.
Adding to the pressure, HealthCare.gov is still in the midst of transitioning to new government contractors to manage basic functions.
Among the changes in the new version of HealthCare.gov: a revamp of the site’s consumer-facing portion including the application for coverage most people will use, as well as the comparison tool that lets them shop for plans, according to slides from a May 20 meeting for insurers held by the Centers for Medicare and Medicaid Services, which oversees HealthCare.gov.
Of course, HHS has a new boss in Sylvia Burwell, who sailed to confirmation this week on a 78-17 Senate vote. The former OMB official has no particular expertise in web-portal project management, but then again, neither did her predecessor … and look how well that went.
Presumably Burwell will keep a closer eye on progress than did Kathleen Sebelius, but this looks like a recipe for disaster even if Bill Gates was HHS Secretary and the late Steve Jobs the director of the Center for Medicare and Medicaid Services (CMS). HHS now plans to overhaul the front end again while the back-end systems are still in the late stages of development, including the connections to insurers. Just how will those integrations take place while rewriting software based on the existing and buggy platform that still can’t successfully verify enrollment even in the government’s own programs?
“We’re all going to be nervous until November 15,” one insurer told the WSJ. No kidding. This time HHS plans to test some of the changes before the rollout date, but not all of them:
They said they expected to begin testing some of the changes over the summer, but that other tests would likely take place closer to the start of the new enrollment season. Julie Bataille, a spokeswoman, also said the agency knew the identity-management component was a particular source of problems.
While meditating on this, note this development in healthcare costs that flew under the Bergdahl-for-5-Talibani swap story earlier this week. Hospitals began charging more across the board for their services in 2012, and the New York Times is mystified by the reason (via Instapundit):
Charges for some of the most common inpatient procedures surged at hospitals across the country in 2012 from a year earlier, some at more than four times the national rate of inflation, according to data released by Medicare officials on Monday.
While it has long been known that hospitals bill Medicare widely varying amounts — sometimes many multiples of what Medicare typically reimburses — for the same procedure, an analysis of the data by The New York Times shows how much the price of some procedures rose in just one year’s time. …
Charges for chest pain, for instance, rose 10 percent to an average of $18,505 in 2012, from $16,815 in 2011. Average hospital charges for digestive disorders climbed 8.5 percent to nearly $22,000, from $20,278 in 2011.
In 2012, hospitals charged more for every one of 98 common ailments that could be compared to the previous year. For all but seven, the increase in charges exceeded the nation’s 2 percent inflation rate for that year, according to The Times’s analysis.
Perhaps we should put Nancy Drew in charge of this mystery. She could start with all of the taxes imposed by ObamaCare on medical devices and drug manufacturers, add in all of the administrative costs created to service the law’s mandates, and then round up the usual “you can keep your plan” subjects for the Big Reveal on the next-to-last page.