Officials knew that Healthcare.gov faced a high risk of failure and continued implementation of the website despite multiple warnings, according to an audit by the Inspector General of the Department of Health and Human Services.
The report evaluated all factors that led to the website’s shortcomings, reviewing events from before its widely-criticized launch in 2013 through the second open enrollment period in 2015.
Despite warnings from multiple sources that there were potential problems with the launch, the audit found that officials ignored the advice and continued with implementation.
There were 18 documented warnings about the project’s shortcomings from the Centers for Medicare and Medicaid Services, the Department of Health and Human Services, and two consulting firms that expressed concerns about the project’s during 2011 and 2013.
Despite these concerns, leadership at the Centers for Medicare and Medicaid Services remained positive about the launch, failing to develop contingency plans in case things went awry.
Immediately after launch, the website experienced problems ranging from system outages to login issues. Only six individuals were able to select a plan and submit an application on the first day of enrollment.
According to the audit, efforts to resolve problems were obstructed because of the agency’s organizational structure, which led to a lack of coordination between the policy and technical workers.
The report found that the departments spent too much time on policymaking instead of focusing on the development of the website, a move that led to poor technical decisions.
"The development of Healthcare.gov faced a high risk of failure, given the technical complexity required, the fixed deadline, and a high degree of uncertainty about mission, scope and funding," the audit states. "Most critical was the absence of clear leadership, which caused delays in decision making, lack of clarity in project tasks, and the inability of [the agency] to recognize the magnitude of problems as the project deteriorated."
Critics of the president’s health care law say they are not surprised by the results of the audit.
"The findings of this report are not surprising and they validate conservatives’ repeated warnings in the fall of 2013 that Healthcare.gov was not ready for primetime," Rep. Diane Black (R., Tenn.) said.
"The Obama Administration’s decision to move forward with a broken website is the height of arrogance, particularly when we now know very clearly that they had every reason to wait until needed improvements could be made," Black said. "While I hope the Administration will heed the recommendations in this report, the fact remains that Healthcare.gov is simply an extension of a deeply broken law – something no amount of technical changes can fix."
A spokesman for the Centers for Medicare and Medicaid Services defended the organization’s actions.
"The lessons learned from the initial problems in 2013 and CMS’ subsequent improvements to the website have also been applied throughout the organization in order to improve management with a clear focus on leadership, accountability, and prioritization of deliverables," said Aaron Albright, the spokesman. "CMS has put the consumer at the center, making enrollment quicker and smoother for both returning and new customers coming to HealthCare.gov, and during this most recent Open Enrollment period, millions of consumers signed up for quality, affordable health coverage."