Health and Human Services Kathleen Sebelius will go before the House Energy and Commerce Committee Wednesday to testify on the problem-plagued rollout of the federal health insurance marketplace, HealthCare.gov.
She’s likely in for a grilling. Democrats and Republicans alike are unhappy with the website’s epically bad launch. The long wait times and other glitches have combined to create a colossal embarrassment for the Obama administration. President Barack Obama himself said that the problems were “unacceptable.”
Unsurprisingly, Republicans have been naked opportunists in the last few weeks. After overshadowing the glitchy launch with their doomed mission to stop Obamacare, they’ve been transparently gleeful about its problems and Democrats have called them out on it time and again. There’s also a dissonance between the GOP’s supposed concern about the site’s shortcomings and the fact that their recent political philosophy has been founded almost entirely on the existential danger in which Obamacare places America.
But the administration for its part has been remarkably diffident in providing information about the nature and scope of the problems, resistant to questions about who has been brought in to fix them, and unresponsive to such basic inquiries as what are the projected costs of the anticipated fixes.
So what are the legitimately tough questions the administration should have to answer? We surveyed several congressional aides and policy experts and came up with the seven most pressing questions Sebelius should address:
Who exactly is doing the work to fix the website?
The administration announced a “tech surge” last week to repair the glitches and get HealthCare.gov. But they’ve been loathe to provide many additional details about who’s doing that work beyond Jeff Zients, a top White House adviser, and QSSI, a contractor that is taking the lead in coordinating the surge.
Basic questions from reporters about who else is involved, how much it’s going to cost or even a figure of how many people are part of the surge have gone unanswered. The website’s construction was also shrouded in secrecy, and that hasn’t exactly gone as planned.
At what point do you have to consider delaying the individual mandate?
The deadline for enrolling for insurance under Obamacare is March 31, 2014. If you don’t have it by then, you’re subjected to the law’s mandate penalty. If the website is fixed soon, most experts agree, people should still have enough time to sign up for coverage. But what if problems linger into next year?
If people are having trouble with the website in February, for example, that places significantly more pressure on the administration to delay the penalty. But for now, it’s unclear when exactly that threshold would be crossed.
How will we know when the website is working properly?
The administration has pledged that HealthCare.gov will be fully functional for the “vast majority of users” by the end of November. But that isn’t a very specific metric by which to gauge success.
So are there specific numbers — like percentage of people able to access the site without any problems — that can be used to determine whether the administration has met its own goals for fixing the site?
What can be done for insurers if the website’s problems negatively affect their risk pools?
A big concern about long wait times and other user problems is that the people who will stick it out so they can sign up for coverage are more likely to have medical problems, which will yield a sicker insurance pool and mean higher costs to insurers. The law needs young and healthy people to sign up for insurance, too, in order for its finances to work.
There are some built-in protections in the law to help protect insurers if their projections about the new insurance pools aren’t accurate. But the worry is that those provisions weren’t structured to handle the kind of problems that could result if the website’s glitches significantly alter the make-up of the pools.
Is the administration working with insurers or outside vendors to give people other avenues for signing up for coverage?
Websites like ehealthinsurance.com already existed before the Affordable Care Act, and insurers have always been able to enroll people in their plans themselves. Those existing outlets could potentially offer alternative paths to coverage for people while simultaneously easing the burden on HealthCare.gov.
Some issues would have to be resolved — specifically, how would these other outlets determine and verify that people are eligible for financial help under the law? — but the upside for the administration could be significant.
What security measures are in place for the website?
It can be difficult to differentiate between scare tactics and genuine concerns, but, as Mother Jones reported last week, legitimate questions have been raised about the security of personal information that people enter into the site.
Those issues have come up during congressional oversight hearings in the last week. Following a troubled launch that might have amplified the public’s uncertainty about the law, detailed reassurances about what’s been done to keep the site secure could be in order.
Why did the launch go as poorly as it did?
The White House has been adamant that it’s not going to play the blame game, and administration officials have refused to provide any kind of picture of who knew what about the problems and when. Monday morning quarterbacking isn’t particularly useful, they say, when it comes to fixing the site as quickly as possible.
But that isn’t going to stop people from demanding answers. And to complicate things further, the only public statements from the administration and contractors have contradicted each other. The software companies during a congressional hearing last week blamed the feds for the management failures. But according to Sebelius’ prepared testimony, it seems she will attempt to shift the blame back to the contractors.