Nation/World

First full test of health website came 2 weeks before opening

WASHINGTON -- Federal officials did not fully test the online health insurance marketplace until two weeks before it opened to the public on Oct. 1, contractors told Congress on Thursday.

While individual components of the system were tested earlier, they said, the government did not conduct "end-to-end testing" of the whole system from start to finish until late September.

The disclosure came at a hearing of the House Energy and Commerce Committee, which is investigating problems plaguing the federal marketplace, or exchange, a central pillar of President Barack Obama's health care overhaul.

Cheryl R. Campbell, a senior vice president of CGI Federal, a unit of the CGI Group, the main contractor on the federal exchange, said that end-to-end testing of the full integrated system first occurred "in the last two weeks of September."

Another witness, Andrew M. Slavitt of UnitedHealth Group, said: "We didn't see end-to-end testing until a couple days leading up to the launch" of the federal marketplace on Oct. 1.

UnitedHealth, one of the nation's largest insurers, owns Quality Software Services, which was in charge of "identity management," including the use of password-protected accounts, in the federal marketplace.

Campbell and Slavitt said they would have preferred to have months of testing, as required by industry standards for a project of such immense complexity. The federal exchange must communicate with other contractors and with databases of numerous federal agencies and more than 170 insurance carriers.

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The rollout of the Affordable Care Act has been tarnished by technical problems that have made it difficult for consumers to shop in the federal marketplace serving 36 states.

Campbell said that CGI continually reported to top officials at the federal Centers for Medicare and Medicaid Services, including Michelle Snyder, the chief operating officer of the agency, and Henry Chao, the deputy chief information officer. Those officials made critical decisions about the federal exchange, Campbell said.

In response to questions, Campbell said: "We were not responsible for end-to-end testing" of the whole system. The Medicare agency, known as CMS, was responsible, she said.

Slavitt said that his company had tested computer code for the federal marketplace and had found problems. "We informed CMS that more testing was necessary," he testified.

Lawmakers from both parties expressed anger during the hearing at the performance of contractors hired to build the online health insurance marketplace, which is still limping along after three weeks.

Lawmakers said they were dismayed because the contractors assured the committee on Sept. 10 that they, their computer systems and the online federal marketplace were ready to enroll millions of Americans eager to buy insurance, subsidized by the government.

"Why did they assure us that the website would work?" asked Rep. Fred Upton, R-Mich., chairman of the committee. "Did they not know? Or did they not disclose?"

"This is more than a website problem," Upton said. "The website should have been the easy part. I'm also concerned about what happens next. Will enrollment glitches become provider payment glitches? Will patients show up at their doctor's office or hospital only to be told that they aren't covered, or even in the system?"

The hearing room was packed with spectators eager to witness the confrontation between lawmakers and business executives whose companies have received tens of millions of dollars to build the federal marketplace, or exchange.

Politics pervaded the session. Republicans said that technical problems crippling the federal website epitomized fundamental flaws in the 2010 health care law, Obama's most significant legislative achievement.

Democrats said that the law was fundamentally sound, but that the website needed to be fixed immediately so people could get the insurance promised to them.

Rep. Diana DeGette, D-Colo., said: "Three weeks after the website went live, we are still hearing reports of significant problems. These problems need to be fixed, and they need to be fixed fast."

Rep. John D. Dingell, D-Mich., lamented the sorry state of the website and said: "This is unacceptable. It needs to be fixed."

But Rep. Frank Pallone Jr., D-N.J., said the hearing was part of "a cynical Republican effort to delay, defund or repeal the Affordable Care Act."

Rep. Tim Murphy, R-Pa., said the contractors "were shockingly unaware of what was happening or deliberately misleading our committee and the public" when they testified last month that their components of the exchange would be ready on time.

Campbell said all of CGI's work had been done "under the direction and supervision" of CMS.

"We acknowledge that issues arising in the federal exchange have made the process for selecting and enrolling in qualified insurance plans difficult to navigate for too many individuals," Campbell said. "Unfortunately, in systems this complex with so many concurrent users, it is not unusual to discover problems that need to be addressed once the software goes into a live production environment."

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She blamed Quality Software Services for problems that consumers have had creating password-protected accounts. These problems "created a bottleneck that prevented the vast majority of users" from gaining access to the federal exchange, Campbell said.

The exchange, she said, is "not a standard consumer website," but "a complex transaction processor" that must simultaneously help millions of Americans shop for insurance and enroll in health plans. It must communicate instantaneously with computer systems developed by other contractors and with databases of numerous federal agencies and more than 170 insurance carriers qualified to do business in the 36 states where the federal marketplace operates, she said.

Slavitt said its identity verification tool was just one part of "the federal marketplace's registration and access management system, which involves multiple vendors and pieces of technology."

These were overwhelmed by people trying to use the site, Slavitt said. One reason for the logjam, he suggested, is that the administration made "a late decision requiring consumers to register for an account before they could browse for insurance products."

John Lau, a program director for Serco, another contractor, said his company was seeing an increase in paper applications. Serco is supposed to enter data from those applications into the government's computerized eligibility system, but problems in that system have created challenges for Serco, as they have for consumers, Lau said.

The same contractors, testifying before the committee on Sept. 10, assured lawmakers that they were ready to handle a surge of users when the federal exchange opened on Oct. 1.

Trying to catch up with problems still plaguing the federal exchange, Obama's chief of staff, Denis R. McDonough, and Valerie Jarrett, a senior adviser to the president, met at the White House on Wednesday with top executives from insurance companies, including Aetna, Humana, Kaiser Permanente, WellPoint and several Blue Cross and Blue Shield plans.

The White House said technology experts from government and industry were working together "to iron out kinks" that had provided insurers with incomplete and inaccurate information about people trying to enroll.

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By ROBERT PEAR

The New York Times

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