Pitiful: Sebelius to blame contractors, not HHS, for Healthcare.gov problems in House testimony tomorrow

Not only is this an egregious understatement of her own culpability, it’s horrible politics. Everyone knows that when a political crisis strikes, the surest way to soothe public/media outrage is with a phony, half-hearted “the buck stops here” statement accepting responsibility.

Maybe it’s better this way. Why keep up a pretense of accountability at this point?

Health and Human Services Secretary Kathleen Sebelius will tell a House committee tomorrow the site’s botched rollout was the result of contractors failing to live up to expectations – not bad management at HHS, as the contractors suggested.

“CMS has a track record of successfully overseeing the many contractors our programs depend on to function. Unfortunately, a subset of those contracts for HealthCare.gov have not met expectations,” Sebelius said in prepared testimony for tomorrow’s hearing before the Energy and Commerce Committee.

The site’s contractors have blamed HealthCare.gov’s problems on CMS – the Centers for Medicare and Medicaid Services, which handled the Obamacare implementation effort within HHS. Testifying before the same committee last week, contractors faulted CMS for design changes that made the site harder to use.

Indeed they did blame CMS. It’s tempting to dismiss that and Sebelius’s testimony tomorrow as S.O.P. fingerpointing now that the fit’s hit the shan, but one of the most persistent criticisms among experts about the Healthcare.gov development process is that HHS decided to serve as manager on the project itself. That’s unusual, especially for a tech undertaking this ambitious. If you’re trying to integrate multiple complex data systems into one cohesive whole, you need a lead contractor who understands in granular detail what that requires in terms of deadlines, testing, etc. Why didn’t HHS realize that? No one knows — yet — but it had enormous consequences for the project:

Key work to create the website was given to CMS, which had experience running a site for Medicare drug plans. But the agency, which is overseen by Health and Human Services Secretary Kathleen Sebelius, had a siloed management structure, and no single unit was designed to pull off a mammoth task like HealthCare.gov.

In one camp were computer experts reporting to a veteran CMS official, Michelle Snyder, who were among the first to recognize the scale of the problems facing the website, current and former officials say, such as errors in the calculation of insurance prices and eligibility determinations.

But a separate policy arm built the road map for what the exchange needed to accomplish, with strained communication with its computer counterparts; that team reported to Gary Cohen, a former California lawyer…

While officials in the insurance office continued drafting the road map for the exchange, computer experts reporting to Ms. Snyder were given oversight of contractors hired to help carry it out. The CMS experts also were given the task of being the so-called systems integrator, an unusual job for the agency, acting as a sort of general contractor to cobble together the components of the site.

“It was like building a bridge by starting from both sides of the river. You hoped they met in the middle,” said one source to the WSJ. That’s the macro-level complaint against HHS, but there are micro-level complaints too. One largely unanswered question is how much extra work the agency dumped on the contractors down the home stretch before launch day by changing key parts of the site at the last second. Officials at CGI told Issa’s committee a few weeks ago that the site was designed initially to let people comparison-shop for plans without having to create an account first. That was changed at the eleventh hour in late August or early September; the decision to require accounts in order to shop is one of the reasons the system ended up being overloaded and inaccessible in the first few weeks. Beyond that, don’t forget Politico’s report on October 17 that HHS officials refused to bring in outside help to fix the site before it launched after they realized it was in grave trouble because they feared the GOP would subpoena the new contractors, potentially exposing the depth of the site’s problems and HHS’s mismanagement. It’s undoubtedly true that the talent working on the site at the contractor level was … not the best, but then whose fault is that? Bear all of it in mind tomorrow when Sebelius sits down and the buck starts passing.

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Ed Morrissey 10:01 AM on June 02, 2023