As the Obamacare website continues to struggle with issues since its rollout, more and more information is emerging that tells us the problems extend beyond “glitches.”
The NY Times published a lengthy article over the weekend, detailing more of the issues as viewed by various sources. It further emphasizes much of what has been written here at Legal Insurrection on the subject: in addition to the technical issues and contractor woes, this is a project that had many troubles from the start.
For the past 12 days, a system costing more than $400 million and billed as a one-stop click-and-go hub for citizens seeking health insurance has thwarted the efforts of millions to simply log in. The growing national outcry has deeply embarrassed the White House, which has refused to say how many people have enrolled through the federal exchange.
Even some supporters of the Affordable Care Act worry that the flaws in the system, if not quickly fixed, could threaten the fiscal health of the insurance initiative, which depends on throngs of customers to spread the risk and keep prices low.
“These are not glitches,” said an insurance executive who has participated in many conference calls on the federal exchange. Like many people interviewed for this article, the executive spoke on the condition of anonymity, saying he did not wish to alienate the federal officials with whom he works. “The extent of the problems is pretty enormous. At the end of our calls, people say, ‘It’s awful, just awful.’ ”
Interviews with two dozen contractors, current and former government officials, insurance executives and consumer advocates, as well as an examination of confidential administration documents, point to a series of missteps — financial, technical and managerial — that led to the troubles.
The Times article also notes that politics weighed heavily on the administration as the project moved along in the process. Some rules were put off until after the elections, funding was hampered by the House, and the project’s scope was increased when dozens of states declined to participate in the exchanges, leaving the federal site to pick up the slack.
Realistically, these are issues that also exist in a similar fashion in the corporate world. Even most large corporate IT projects fall victim to the demands of corporate politics and budget constraints in some way or another. The key is in how you manage those challenges when dealing with the constraints of scope, cost and time in project management. When one constraint is burdened, it affects the others and modifications often need to be made in order to keep the project in check.
All of that, especially when dealing with multiple contractors, can certainly be a challenging task. It takes regimented management to keep such a project on track. But as the Times revealed, even managing the project was an area of concern.
Deadline after deadline was missed. The biggest contractor, CGI Federal, was awarded its $94 million contract in December 2011. But the government was so slow in issuing specifications that the firm did not start writing software code until this spring, according to people familiar with the process. As late as the last week of September, officials were still changing features of the Web site, HealthCare.gov, and debating whether consumers should be required to register and create password-protected accounts before they could shop for health plans.
One highly unusual decision, reached early in the project, proved critical: the Medicare and Medicaid agency assumed the role of project quarterback, responsible for making sure each separately designed database and piece of software worked with the others, instead of assigning that task to a lead contractor.
Some people intimately involved in the project seriously doubted that the agency had the in-house capability to handle such a mammoth technical task of software engineering while simultaneously supervising 55 contractors. An internal government progress report in September 2011 identified a lack of employees “to manage the multiple activities and contractors happening concurrently” as a “major risk” to the whole project.
As we’ve written previously, there were warnings that things were not on track.
Despite those warnings, officials moved ahead. Even rolling out the project in stages was not an option, according to the Times, which notes that The White House specifically was calling the shots.
By early this year, people inside and outside the federal bureaucracy were raising red flags. “We foresee a train wreck,” an insurance executive working on information technology said in a February interview. “We don’t have the I.T. specifications. The level of angst in health plans is growing by leaps and bounds. The political people in the administration do not understand how far behind they are.”
The Government Accountability Office, an investigative arm of Congress, warned in June that many challenges had to be overcome before the Oct. 1 rollout.
“So much testing of the new system was so far behind schedule, I was not confident it would work well,” Richard S. Foster, who retired in January as chief actuary of the Medicare program, said in an interview last week.
But Mr. Chao’s superiors at the Department of Health and Human Services told him, in effect, that failure was not an option, according to people who have spoken with him. Nor was rolling out the system in stages or on a smaller scale, as companies like Google typically do so that problems can more easily and quietly be fixed. Former government officials say the White House, which was calling the shots, feared that any backtracking would further embolden Republican critics who were trying to repeal the health care law.
That last bit is also interesting when you consider that the administration blamed the lack of approved documentation of the federal exchange operations on the government shutdown.
While it’s clear that some are gearing up to lay blame on the Republicans, I have to inject another small dose of reality again here.
IT projects come with critics; this is part of managing such a project. In the end, it’s important to make smart project decisions and practice good planning, regardless. Instead, now even supporters are expressing their disappointment in the launch, let alone the critics.
As I’ve written previously, some of the contractors will certainly deserve their share of blame. And admittedly, government IT projects also come with their share of extra challenges. This will be further complicated in coming weeks as contractors scramble to fix the technical issues, which always stands the chance of breaking other technical components.
But the public simply wants to understand what is going on in the meantime, as the clock ticks on the individual mandate. As we’ve seen the responses from this administration, which repeatedly tells the public these are all just glitches due to the overwhelming demand for Obamacare – demand it claims was unexpected – it should be evident by now that no straightforward answers appear to be coming our way anytime soon.
Read the full NY Times article, it’s an informative read.
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