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Healthcare.gov Still Unfinished Year After Feds Issued Dire Warning

CMS January 2014: Incomplete website puts ‘entire health insurance industry at risk’ (Updated)

Healthcare.gov / AP
February 27, 2015

More than a year after the federal government issued an emergency contract and deadline to fix Healthcare.gov, the back-end of the website is still not finished.

The Centers for Medicare and Medicaid Services (CMS) issued an "urgent" contract to Accenture Federal Services to complete the back end of Healthcare.gov in January 2014, warning that a failure to do so by March of that year put "the entire health insurance industry at risk."

The no-bid contract was valued at $91.1 million for one year, and was issued outside of the normal competitive process because any delay "would cause the financial harm to the Government," CMS said.

At the time, the website had no "Financial Management platform" to account for enrollments, tax credits, and payments to insurance plans. HHS said without such a system the "entire healthcare reform program is jeopardized."

The website remains unfinished. Politico reported last week that the back end of Healthcare.gov "still isn’t properly wired to the health insurance companies." Problems persist with subsidy payments, and information verification, resulting in roughly 800,000 enrollees receiving inaccurate subsidy information.

"Even though consumers had a largely smooth enrollment experience this year, the fact that these gaps persist behind the scenes 18 months after HealthCare.gov launched shows that the system is still not working as intended," Politico said. "Instead of a swift process, health plans use clunky workarounds and manual spreadsheets. It takes time and it costs money."

Kevin Counihan, the chief executive officer of Healthcare.gov who previously ran the Connecticut health insurance marketplace, recently told insurance brokers that "CMS is spending a lot of time focusing on how to improve the federal exchange’s back-end functions and that the agency meets at least weekly with a group of insurance officials from large companies to discuss its two-year development plan," Politco Pro reported.

"We’re taking this very, very seriously," Counihan said. "It’s not going to be as fast as everybody wants, but we’re going to get there. We’re going to make good progress this year and even more progress next year."

The House Energy and Commerce Committee said on that timeline, the back end of Healthcare.gov would not be completed by the time President Obama leaves the White House.

"The committee first uncovered that the backend of the health care exchange was not built in November 2013," the committee said on Tuesday. "The following month, [the]then-Health and Human Services Secretary told the committee, ‘The financial management system, which is getting the insurance companies their money for accelerated tax credits and cost-sharing, is due to go into effect in mid-January.’ That was ‘mid-January’ of last year." (Emphasis in original.)

"Now, two open enrollment periods and more than 16 months after the exchanges first went live, the HealthCare.gov CEO reveals the backend will still not be complete for two more years," they said.

Accenture replaced the Canadian-based CGI Federal, which was responsible for the initial botched rollout of Healthcare.gov, to oversee the website’s development. However, the Daily Caller reported that CGI received an additional $4.46 million IT contract last August to work on the website until the summer of 2015.

On Dec. 23, Accenture received a $563.6 million contract to continue running Healthcare.gov for another five years.

Aaron Albright, director of media relations group for CMS, told the Washington Free Beacon that the agency will continue to work on the website for "the next couple years."

"With the close of a successful second open enrollment period, the Marketplace is currently supporting more than 8 million consumers, 50 states and the District of Columbia, hundreds of health plans and interactions with other trusted partners that allow us to verify eligibility," he said. "Our priority in 2015 is completing our payment systems that allow for the calculation of policy level payments and of the premium stabilization payments, which we are beginning to test with issuers."

"Over the next couple of years, we will continue to improve the efficiency of the Marketplace," Albright said.

Albright also pointed to a statement from CMS in March 2014, saying that the agency had "adjusted timeframes" for when Healthcare.gov needs to be complete.

UPDATE: 10:45 A.M.: This story has been updated to include comment from the Centers for Medicare and Medicaid Services.