“Entire healthcare reform program is jeopardized:” White House

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The rampant issues surrounding HealthCare.gov’s financial management platform were the primary cause for the ousting of key IT contractor CGI Federal and the quick appointment of Accenture Federal Services, a 10-page CMS document reveals.

The “Justification for Other than Full and Open Competition” appeared on the CMS website this week, explaining why the government awarded Accenture a $90mn to fix the troubled exchange site without going through the typical six- to 12-month competitive procurement process.

HealthCare.gov “urgently requires” fixes to its “financial management platform,” the document said. The platform is required to provide “stable and predictable financial accounting and outlook for the entire program through administration or risk adjustment.”

The incomplete “back-end” of HealthCare.gov—the financial management platform—already caused an estimated 15,000 applications to disappear within the first three months of enrollment. The data never reached carriers, leaving consumers without proof of enrollment and producers without credit for their sales.

The effect of the debacle led CMS to comment in the document that “the entire healthcare reform program is jeopardized.”
White House spokesperson Jay Carney declined to comment on the document, saying he had not seen it himself, but producers who had client data lost or processed incorrectly can testify to the resulting headaches.

“It’s total chaos. HealthCare.gov has not fully transmitted data and subsidy eligibility to the insurance company,” producer Kelly Fristoe said of the system’s failing. “I’ve been fielding phone calls all day long.”

Sanjay Singh, CEO of hCentive—the IT contractor responsible for building successful state exchanges like those in Kentucky and Colorado—told Insurance Business HealthCare.gov suffered from a lack of thorough testing.

“When you buy on our state exchanges, the exchange is able to send the enrollment data back to the payer whose product was chosen. We enabled that connectivity,” Singh said. “With HealthCare.gov, the backend systems were built but not tested. The first thing that should have happened a long time back was delayed, and by Oct. 1, there was no time to test the backend.”

Singh said he believed HealthCare.gov general contractor QSSI “has done the heavy lifting already” in terms of improving the site, and expressed confidence in Accenture’s ability to make further positive repairs.

Accenture was responsible for the building and launch of Covered California, an exchange Singh rates highly.

“I think they’re operating very well,” he said. “We process their transactions for our carrier clients, and we’re seeing connections flowing at an upward clip. My sense is that it’s one of the more successful state exchanges.”

Larkspur, Calif.-based producer Susan Lundy was less effusive in her praise for Covered California, but admitted it was one of the better exchanges she has worked with.

“Covered California may have blame to be assigned to it, but to be honest, it’s better than some of the others,” Lundy said. “I sell in Oregon and they’re so messed up, you can’t even believe it.”

“Of course, I’m damning with faint praise to say that a really bad website is better than the others, but it pretty much is,” she added.
  • Clay Durstoff on 1/24/2014 7:58:57 AM

    This is an impeachable offense. Thanks Obama.

  • LBW on 1/24/2014 9:34:42 AM

    Being a 2nd generation agency, with a 3rd generation in line, perhaps I expect more out of the industry than I should. We provide insurance to help our clients live their lives with a little peace of mind . . . as agents, that is all we can do for them to set us apart. What could more important than affordable health care? New technology rarely works right from the start, but with time the kinks/glitches are corrected. Negative thoughts have a way destroying things that with a little time turn out to be exceptional.

  • Maria on 1/24/2014 12:54:42 PM

    There are still many Californians that have not received ID cards from the carriers and have not been able to pay their premium for 1/1/14. Upset for the delay.

  • JJ SMITH on 1/27/2014 8:48:54 AM

    LBW- I am 5th generation in our insurance agency. It's fine to expect good things from the insurance industry. Just don't expect good things from our government. Insurance companies that fail to deliver a quality product at a competative price get bought out, shut down, or otherwise driven out of the market. Unfortuneatly, we don't have that option for our government. Just remember and encourage everyone you know to remember this disaster when the next election comes around. Our government has forcefully taken over the health insurance business. What do we really expect?

  • Maria on 1/27/2014 9:27:40 AM

    Is everyone having the problem with BS of Ca as I am having?. They are not processing Covered Ca applications ON or OFF the exchange. Applicants are getting letters that they are not eligible after they have paid 2 months premium.

  • Jmo on 1/28/2014 3:10:52 AM

    My experience with Covered CA has been on the worse level possible. While it looks good, it is a junior high school-level website; easy to navigate, but with no real in-depth content, and no way to find out information when one needs help. It's taken months to enroll a couple of our customers, and when our offices finally reached them, and we asked 'why', their response was "I don't know" to both the answer to my question and who do we speak with. Covered CA is anti-agent, plain and simple. Hopeful that this stuff will get fixed over time.

    The much bigger issue is the quality and design of the product for Individuals and Small Group. They are very expensive overall (unless you happen to be poor and qualify for subsidies, but not so poor that you end up in Medicaid, another story), and there is little or no personalization available to get people designs that are best suited for them. Costs for coverage will bankrupt the carriers, and will slowly bail from the program until all that are left are quasi-governmental carriers. There is NO competition already. Not a good situation for consumers or agents.

    Further,

  • Carol on 1/28/2014 5:49:12 AM

    I agree with LBW. If we never expect good things from our govt. we will never get them. Its a huge bureaucracy and they struggle like many very large corporations. We need to make CGI Federal pay for their mistakes with the programming issues. If the health insurers want to stay in business they are going to have to work with the government to give access to affordable health care to all.

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