On Wednesday, the House Energy and Commerce Committee grilled Department of Health and Human Services (HHS) Secretary Kathleen Sebelius on ongoing issues with the implementation of the Affordable Care Act. Committee members questioned Sebelius on everything from the health law’s dysfunctional website to recent reports that thousands of insurers are discontinuing plans deemed inadequate by the health law’s standards. Here’s what you need to know about today’s hearing:
Sebelius took responsibility for Healthcare.gov’s woes and admitted the site required more extensive testing.
The secretary wasted no time in claiming responsibility for Healthcare.gov’s disastrous rollout during the oversight hearing. “I apologize,” said Sebelius in her opening remarks. “I’m accountable to you… I’m committed to earning your confidence back by fixing the site.” When several Republican committee members, demanded that Sebelius point to specific people within the Center for Medicare and Medicaid Services (CMS) who were responsible for the “debacle” of Healthcare.gov, Sebelius responded that she was.
Sebelius also admitted several times that the site should have been tested more extensively before its rollout. The contractors who built the Obamacare website testified last week that although the individual portions of the site they built worked, the system crashed when attempting to put it all together. They also said that months of integrated, end-to-end testing — and not just two weeks’ worth — should have been done to work out kinks in the program.
“We did not adequately do end-to-end testing,” the secretary said. She admitted that the site’s features were not “locked and loaded” until the 3rd week of September, a little more than a week before the launch. “Clearly, looking back, it would have been ideal to do it differently,” she said.
Sebelius made a huge admission about why we don’t know the number of people who have enrolled in Obamacare.
The hearing’s most important moment came when Sebelius was pressed to provide more accurate figures on the number of people who have actually enrolled in insurance plans through the federal Obamacare website. Although HHS has been saying that about 700,000 Americans have started applications, that provides little information on how many have actually completed the entire enrollment process — and Sebelius’ explanation for why there aren’t more accurate figures is troubling.
According to Sebelius, insurance companies are still receiving incomplete, duplicate, and inaccurate applications at the back end of the system. That’s made it impossible to know exactly how many people have enrolled in health plans since insurers are still sifting through garbled data to process applicants. “The system isn’t functioning, so we’re not getting that reliable data,” said Sebelius. She added that fixing that issue is at the top of the administration’s to-do list. “We have prioritized… that specific fix,” she said.
Sebelius’ admission suggests that problems on the back end of the website are more pervasive than contractors admitted in last week’s Obamacare hearing. Full enrollment figures in the federal marketplace from October are expected to be released in mid-November. State enrollment data is far more accessible.
The administration is lowering expectations for first month enrollment figures.
HHS may not be sure how many people have enrolled in an Obamacare plan so far — but don’t expect the first month’s numbers to be dazzling when they’re released next month. October enrollment figures will likely be “very small,” said Sebelius, especially considering the site’s many technical woes.
But health experts say that should be no cause for alarm. Massachusetts Institute of Technology economist Jonathan Gruber, who helped design the Massachusetts health care law that Obamacare is largely based on, said that Massachusetts saw just 123 enrollments in its first month. A full 20 percent of people who signed up in the first year didn’t do so until the very last month of the enrollment period.
“The fact that people aren’t signed up now is not at all interesting or important,” said Gruber on a conference call with reporters. “The success of health care reform has to be measured in months and years, not days and weeks.”