It’s been another busy couple of days for news on the Obamacare rollout.  Chief among those is a report from the Washington Post that private consultants warned of risks before HealthCare.gov’s Oct. 1 launch:

The Obama administration brought in a private consulting team to independently assess how the federal online health insurance enrollment system was developing, according to a newly disclosed document, and in late March received a clear warning that its Oct. 1 launch was fraught with risks.

The analysis by McKinsey & Co. foreshadowed many of the problems that have dogged HealthCare.gov since its rollout, including the facts that the call-in centers would not work properly if the online system was malfunctioning and that insufficient testing would make it difficult to fix problems after the launch.

Among the issues noted in the report were the lack of a single point of decision making authority, as well as evolving requirements.  In a large scale technology project such as this, these are two factors that in combination can present real challenges when clear guidance on requirements and business rules would be of significant importance.  From the Washington Post:

The consulting firm suggested that some of the project’s troubles occurred because there was “no single empowered decision-making authority,” or person in charge, who could make changes or define what constituted success.

One industry source close to the project, who spoke on the condition of anonymity to discuss the matter frankly, said this lack of an overarching project leader complicated the system’s development because contractors received “absolutely conflicting direction between the various entities within CMS.”

According to the document, McKinsey & Co reviewed 200 documents, interviewed about 40 people across various CMS and HHS offices and federal partners, and participated in various meetings in order to prepare its assessment.  The firm did not review code or conduct external interviews.

The document also describes that the development and implementation process was not necessarily ideal.  Among other potential issues noted were the decision to launch at full volume, insufficient time and scope with respect to end to end testing, and a significant dependency on outside contractors.

While dependency on outside contractors would not necessarily always present a problem in itself – many government and private sector projects rely on similar arrangements – any lack of communication or clear coordination of all of those moving parts across contractor assignments could certainly have become an issue.

Other potential issues flagged in the document however, such as the possibility of long wait times at call centers, seem to have largely improved since the site’s initial launch.

Obamacare Rollout Round-up

Meanwhile, other Obamacare related stories are making the rounds today.

NPR dives into more detail on one of the slides in the aforementioned report, in an article titled This Slide Shows Why HealthCare.gov Wouldn’t Work At Launch.  It describes the differences in how the project was managed versus ideal circumstances.

In a hearing before a House panel, a top IT official on the healthcare.gov project indicated that a portion of the payment system has still not yet been built, according to ABC News.

“Healthcare.gov, the online application, verification, determination, plan compare, getting enrolled, generating an enrollment transaction, that’s 100 percent there,” said Henry Chao, the Centers for Medicare and Medicaid Services project manager in charge of HealthCare.gov, told a House panel.

“There is the back office systems, the accounting systems, the payment systems. They still need to” be built, Chao said.

The Obama administration has said more than 100,000 Americans “selected health plans” through a state or federal insurance exchange in October, but it’s unclear how many of those have made their first premium payment.  Health insurers do not consider a consumer enrolled in a health plan until a first payment is received.

Some notable thoughts and questions on that topic also over at HotAir.

And then there was the story about an Affordable Care Act supporter whose enrollment success story had been cited by Obama.  It turns out that her experience soured after a series of errors and issues left her, in reality, priced out of the market.  From CNN:

[Jessica] Sanford reiterated her frustration in a post to the Washington HealthPlanFinder’s Facebook page last Friday.

“Wow. You guys really screwed me over,” Sanford wrote. “Now I have been priced out and will not be able to afford the plans you offer. But, I get to pay $95 and up for not having health insurance. I am so incredibly disappointed and saddened. You majorly screwed up.”

In the meantime, NBC News reports that left-leaning groups Moveon.org and Democracy for America are trying to rally progressives to step up and start fighting to save Obamacare.  A similar effort to try and rally supporters didn’t go very smoothly Monday evening, when an Organizing for Action website failed to work for some of those on the call, according to the NY Times.

(Featured image: CSPAN video; deputy CIO at CMS Henry Chao testifies before a House committee)