House panel looks for answers on exchange issues

Software contractors who built the Patient Protection and Affordable Care Act (PPACA) federal exchange system defended their work at a raucous, standing-room-only House hearing convened today to allow Republicans, who constitute a majority of the House, an opportunity to cast “Obamacare” in the most negative light possible.

The hearing was held to highlight the problems faced by the federal exchange. The federal exchange is mainly designed to serve the 34 states that have refused to open their own exchanges because their leadership is opposed to the basic concept of any federal involvement in regulation of health insurance.

The federal site, however, has faced severe complaints from potential users of inability to log in, lengthy delays, incorrect information relayed to insurance companies and other problems. The administration has acknowledged that it did not anticipate the huge response to the opening of the site, as well as design problems that are impeding people having access to it and signing up for it.

Republicans, none of whom voted for the law when it was passed by Congress in 2010, used their opening statements to point to the federal exchanges problems as justifying their opposition to PPACA.

For example, in his opening statement, Rep. Tim Murphy, R-Pa., called the federal exchanges the “ultimate ‘cash for clunkers’ program.”

Rep. Fred Upton, R-Mich., chairman of the panel, repeatedly sought to elicit from the contractors whether the Department of Health and Human Services (HHS), the parent agency, and the Centers for Medicare and Medicaid Services (CMS), which administers PPACA, approved launching of the site Oct. 1 even though the contractors expressed concern to them that the exchanges were not ready for prime time.

Upton said that in hearings held before Oct. 1, “Top administration officials and lead contractors appeared before this committee, looked us in the eye and assured us repeatedly that everything was ‘on track.’” Upton said. “Except that it wasn’t, as we now know all too well.

So why did they assure us the website would work? Did they not know? Or did they not disclose? That’s what we are looking to find out, with the contractors today, and with Secretary [Kathleen] Sebelius next week.”

Rep. Marsha Blackburn, R-Tenn., a ranking Republican on the committee and an outspoken critic of Obamacare, said in her opening statement that, “These past three weeks of exchange messiness demonstrate that no member of this body should be a blind cheerleader for the Affordable Care Act and ignore the problems before their very eyes.” She later raised the issue of whether the site complied with federal health privacy laws.

Republicans did win acknowledgement during questioning of the vendors that some of the source code for the exchange is being changed, although it is unclear if that is being done daily or regularly. Vendors also acknowledged that testing of the integrated system, put together by a number of vendors, was not done until the last minute, for example, the last several weeks before launching, although ideally, the vendors testified, that such a complex site would undergo months of intensive testing.

Rep. Michael Burgess, R-Texas, a doctor and outspoken opponent of PPACA, is founder and chairman of the Congressional Health Care Caucus. He asked the contractors, “When should we have comfort [that the federal site will be working]?” Texas, which has the largest number of people without health care insurance in the country, has adamantly refused to participate in the exchanges and also in the expanded Medicaid program, which launches next month.

Told by the contractors that CMS is responsible for getting the federal exchange in shape, Burgess said, “No one believes things will be fixed with answers like this.”

Officials of CGI and Optum/QSSI, two of the key vendors, admitted that “months of end-to-end testing,” not the days or last two weeks before launching, is the industry standard for the complex website being used to solicit applications for insurance policies purchased to comply with PPACA.

But Democrats on the panel defended the Obama administration.

For example, Rep. Jan Schakowsky, D-Ill., said, “Let’s work together to fix it, not mix it — as we did on Medicare Part D under [President George W.] Bush.” 

Rep. Henry Waxman, D-Calif., outspoken ranking minority member of the committee and its former chairman, criticized the Republicans for convening the hearing. He said Republicans “have not shown us that they are trying to make this law work so far.”

Waxman called PPACA “an enormous success” even as he admitted it has “a poorly designed website.”

He said that Americans have already saved thousands of dollars because of the law, although he agreed early performance of the website has caused “notable frustration and anxiety.”