The Obama Administration Insisted that Obamacare’s Exchanges Would Be Ready and Working on Time. They Weren’t.

Healthcare.govHealthcare.govSome Democrats have attempted to downplay the significant, widespread problems with Obamacare’s federally run insurance exchanges by noting that President Obama warned that “glitches and bumps” were inevitable. But the federal exchange system that covers 36 states has been plagued by problems more severe than glitches and bumps. As Daniel Mendelson, the head of influential health consultancy Avalere Health, told The New York Times, “the federal exchange has, for all practical purposes, been impenetrable. Systems problems are preventing any sort of meaningful engagement.”

That’s not what the administration told people to expect. Despite numerous warnings about technical difficulties associated with the implementation process and questions about the administration’s preparedness, the official line throughout the year—repeated at multiple Hill hearings—was that, for the most part, the executive branch had everything under control. The exchanges would be ready to launch on time, and the system would be basically functional.

A letter released yesterday evening by Sen. Lamar Alexander (R-Tn.) and Darrell Issa (R-Ca.), the top Republicans on the Senate health committee and and the House oversight committee, does a nice job of documenting the administration’s reassurances:

Two top HHS officials, Marilyn Tavenner, the Administrator of the Centers for Medicare and Medicaid Services (CMS), and Gary Cohen, the Director for the Center for Consumer Information and Insurance Oversight, provided testimony to the House Committee on Oversight and Government Reform within the past few months suggesting that HHS would be ready for implementation on October 1, 2013.  On July 17, 2013, Ms. Tavenner testified that she was “feeling pretty comfortable about the ability [of CMS] to be ready on October 1st.”  She further stated that “I want to assure you that [on] October 1, 2013, the health insurance marketplace will be open for business.  Consumers will be able to log onto healthcare.gov, fill out an application and find out what coverage and benefits they qualify for.” At a hearing on May 21, 2013, Mr. Cohen testified “I think we are very much on schedule; we are moving forward.  We are going to be ready October 1st for open enrollment to begin.” Mr. Cohen also testified that there would not be “any problems with [the] massive amount of data sharing.”

Now, of course, we know that the site has serious enough problems that the administration is reportedly considering replacing a major chunk of the code over the weekend. 

So what happened? Did federal officials really not know about the extent of the problems? Or were they misleading the public and legislators about the readiness of the system?

The Alexander/Issa letter asks Health and Human Services Secretary Kathleen Sebelius for answers about the administration’s dodgy assurances and a variety of other exchange-related issues. Sebelius doesn’t seem to be very good at fielding questions about problems with the exchanges, but I’ll be curious to see what, if anything, the GOP queries here come up with. 

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  • ||

    So what happened? Did federal officials really not know about the extent of the problems? Or were they misleading the public and legislators about the readiness of the system?

    Yes.

    You seem to be failing to understand how incompetent these people are, combined with the usual executive/management complete failure to understand what the technical requirements and hurdles are. This was tailor-made to be this fucked up. Anyone with any experience with IT and software could have predicted this a mile away. They are scrambling right now, because it's a total disaster behind the curtain.

  • Pro Libertate||

    Do you think those is power think they can just make a pronouncement, and it will happen? Are they that fucked in the head?

  • Pro Libertate||

    Those in power, that is.

  • ||

    Well, yes. Remember that this is going to operate like a big company's rollout of some new thing, think, say, Diablo 3. The management, who often is comprised of business people who know jack and shit about the nuts and bolts of major software implementation, either asks or tells the programmers what the deadline is going to be. Depending on the level of stupidity and delusion of the management (which in this case, being government, is higher than Mount Everest), the amount that it gets fucked can be extremely high.

    In the case of Diablo 3, there was a lot of initial fuckups that got people pissed off, and this was from a for-profit private company that has every reason to make its customers happy. What do you think happens when there is no such incentive, and the staff is not the cream of the crop but instead the dregs that will work for the government, and the management is composed of delusional egomaniacal power monger scum who think they are infallible?

  • Scruffy Nerfherder||

    Windows Vista?

  • Almanian!||

    #WINNING

    *mic drop*

  • ||

    Actually, us using public-facing examples isn't really a good analogy. A better analogy is internal software. Who has worked at a large company which has significant internal software/websites that tend to be absolutely horrible, bug ridden, take forever to implement or change, don't respond to feedback, and are sometimes completely down even though they are required to get anything done?

    The healthcare exchanges are like that. They're monopolistic. What are your employees going to do, use somebody else's internal software?

  • Scruffy Nerfherder||

    Oh, so you mean your average ERP implementation.

  • ||

    Yup. If you think about it that way, except make the IT department even worse than one at a big company, it all makes "sense".

  • Scruffy Nerfherder||

    Anecdote. Years ago, I was in manufacturing engineering when our company decided to bring all of our subsidiaries (13 of them) onto the same ERP system, and upgrade to the next version, and implement a new part numbering scheme, all at the same time, on a four month schedule.

    There were 130,000 part numbers that got converted and thousands of BOMs that got put into the system. On top of that, it was Baan, the Enron of ERP and SAP's less well documented competitor.

    You can only imagine the unholy mess it was when I asked the question (the day before turn-on) if anyone had double-checked the data.

  • SugarFree||

    Based on my experience, everyone involved in the creation of SAP should be drowned in the blood and excrement of their loved ones.

  • R C Dean||

    Hospitals tend to have enormously expensive and complicated electronic medical records systems that are purely internal.

    However, because people die if they don't work, they tend to work.

  • Almanian!||

    A thousand-year Reich Brave, New World?

    FORWARD!

  • Pro Libertate||

    Okay, then, I'm not buying this new MMO the administration has launched.

  • The Last American Hero||

    You will when they launch the Single Payer Expansion Pack.

  • Pro Libertate||

    Wonder what black market doctors will charge?

  • Len Bias||

    Yes, I honestly do.

    When he said that 2010 was going to be the summer of recovery, he honestly believed that the economy would cooperate with him and that it would suddenly heal.

    He honestly believed that Syria, Russia, et al would fall into line and he would be a hero.

    He honestly believes that he can micromanage the entire health care system without a glitch.

    This is why he is really dangerous. Not necessarily because he is ill intentioned, but because he has no concept about any limits to his ability to manage a situation.

  • Scarecrow Repair||

    It's also because of the contempt they have for anyone who doesn't agree with them. With that ideological contempt comes competency contempt, the idea that anything touched by anybody else failed because their opponents are so incompetent. And since their own side has the right ideological thoughts, they must also have the competency chops to make things work.

    It's the flip side of celebrities who think their competency at being well known somehow carries over into ideological competency too.

  • Hyperion||

    Yeah, but some people are actually saying that there were syntax errors in some of the code. WTF? Did they test anything at any stage of development? Syntax errors can't even make it from development into Staging, let alone into production. Did they compile the code, or are they running uncompiled code in production?

    Ye Gawds, these really are government employees doing this, aren't they?

    This code should have been tested for months in a staging environment before being released. Everyone on this project should be fired and never work in IT again.

  • ||

    They're using open source, presumably scripting languages, which are not pre-compiled. It's not like they are using Visual Studio and can't even build if there is a syntax error. It's totally unsurprising that they have syntax errors, especially if their QA procedures were shitty/limited/incompetent. And especially so considering the kind of programmers that work for the government.

    There is a reason Visual Studio costs a lot of money.

  • Pro Libertate||

    They should make the whole thing open source, letting us code it for them. Then we can rewrite it so that it actually points people to free market solutions.

  • Hyperion||

    600 million and they can't afford VS?

  • Ruckus||

    Even if it was Javasript or any other scripting language, syntax errors could/should have easily been caught.

    I do a lot of work with VS and since our products are mainly web based applications, a lot of JS work as well. How a syntax error could leave a developers desk is beyond me.

    The loop to 50 instead of the array length, I could see that (I can't understand how someone coded the error, just how once it was there how it was not caught in staging/testing/QA).

  • Scruffy Nerfherder||

    But it went beyond that. The comment indicated that someone knew it was a problem, yet left it.

  • Ruckus||

    Good point.

    I know I have saw something in an old piece of legacy code that probably could be rewritten and improved, but just left a comment saying otherwise; either because of time constraints or out of fear of breaking old functionality.

    Of course the array length comment instead of a static value is not rewriting entire routines. It's intro to c++ level stuff.

  • Jordan||

    No kidding. And Eclipse is free, if for some unknown reason they can't get the government to shower them with cash to buy VS.

  • R C Dean||

    The best description I've seen is that the HIEs appear to be a mockup, not an actual functioning system.

    Which makes perfect sense, given that to a politician, appearances are everything and substance is nothing. The important thing wasn't to have fully functioning system, well, ever. It was to have a webpage that the DemOp media could put on a screen while they gushed about the fabulousness of Obama.

  • ||

    I would not surprise me if the entire site was just a form collection system that then outputs to an army of drone workers who then hand input what was submitted on the site in order to enroll people in various systems. It would not surprise me at all if they were not actually hooked up to anything.

    Like I have said many times, I think what's going on behind the scenes is even more horrible and incompetent than we, who already have the lowest opinion of government, can conceive.

  • Ruckus||

    You are probably both right.

    If anyone here has ever done any software work for a government contact, mock ups, change requests, and documents are their favorite things EVAR!! It's almost like there is a small army of useless bureaucrats that have to justify their existence by making your job more difficult.

    I thought they were just joking with us at first, just playing to the stereotype and bad things you hear. I wish that was the case. No matter how negative your opinion of gov. workers / managers are, there is still a fuck load of room for them to surprise you with their incompetence.

  • John Thacker||

    And then the mock up ends up being the real site, even though you made a bunch of stupid compromises since it wasn't important since it was only a demo.

    Don't forget the armies of SETA contractors sitting in the room trying to justify their existence.

  • Pro Libertate||

    Sneakernet. There was some fairly well-known dot com business that was run like that--basically no back-end, just people running around with paper.

  • R C Dean||

    I am now basking in my reputation as some sort of prophet/sage, due to my consistent predictions that this would be pretty much the complete cock-up that it is.

    And, yes, anyone with any experience at all with IT, even third-hand (like myself) could see this coming from miles and years away.

  • BuSab Agent||

    Only the right words matter.

  • Fist of Etiquette||

    While hardly the worst thing about Obamacare, it is a good reminder of what happens when you trust your shit to government bureaucracy.

  • Pro Libertate||

    Say, if I'm the hearer of the 10,000th lie of this administration's, what do I win?

  • The Rt. Hon. Serious Man, Visc||

    A personal "because fuck you, that's why" call from Obama.

  • Pro Libertate||

    Really? Oh, I'm not ready. What do I say? Is it "my lord" or "your majestic awesomeness?" I'm all afluster.

  • The Rt. Hon. Serious Man, Visc||

    Don't worry, you won't be able to speak. I suggest you put it on speaker phone because your hand will shake as though palsied and the majesty of Obama will make you dismiss all thoughts of speaking.

  • Pro Libertate||

    I plan to cower in the corner, my eyes averted from the speaker from which his holy dulcet tones will emanate.

  • fish_remote||

    So....? Isn't this every government IT project? Californias family court and child support tracking system. Canadas gun control registry?

    Sounds like it's a problem in search of additional appropriations.

  • ||

    Basically, yes.

  • ||

    "reportedly considering replacing a major chunk of the code"

    Paywall. But has to be complete bullshit. What, they had all of the good code just waiting on standby? Bullshit. A system this big and fucked up will take years to get right.

  • johnl||

    The replacement code will have replacement bugs.

  • John Thacker||

    Favorite Healthcare.gov bug so far:

    You've got a 51 member array variable named StateData that stores state names and abbreviations (includes DC).

    You've got a function getStateCodeFromState that takes in the state name and returns the abbreviation. It hardcodes the array length as 50 (oops, forgot DC) including a comment above the function that "Technically, we should be using StateData.length here."

    Took more time to write that comment than to just replace the "50" in the loop with "StateData.length."

  • John Thacker||

    However, unlike the other bugs, at least that one can be fixed easily.

  • ||

    Oh really? Real process control requires that a change request be created, followed by the change, then a review, then the development of a test case, then a documentation update, and finally sign off for inclusion into the next build.

    Once code has been released to the wild, it's assumed to be good and you have to prove it. Of course, small companies operate fast and loose without such process control and that's why they get shit done (until they grow to a size that they've created an unmanageable pile of spaghetti code which known on can maintain because all the original hires left).

  • Jordan||

    That assumes that the a) the bug was not found until after release (looks very unlikely) and b) they are following the waterfall model.

  • John Thacker||

    That particular piece of JavaScript is still live at the site.

  • Jordan||

    Right, but if someone put a comment in about it, then it was found prior to release.

  • John Thacker||

    Not necessarily, the guy doing it could have put in the comment even knowing he was doing it wrong, but still thought that 50 was the right value.

    "Technically, I should be using stateData.length instead of 50 here" is a comment he could have written still thinking that 50 was correct. (And faster, being a constant.)

  • John Thacker||

    Yeah, you're right there is all that with the change request and so forth. But at least the technical side isn't a lot of hours.

    Probably wouldn't need a documentation change for this.

  • Hyperion||

    We test everything in development, move to staging, it gets tested there, by clients and testers, signed off on, and only then moved to prod. That's the short of it. No major bugs make it into production, ever. If they do, people start to disappear.

  • John Thacker||

    But what were the odds that someone would live in Wyoming and want health insurance? No need to test *every* state.

  • tarran||

    I am so reminded of the dysfunctional environment within which YT's mom and the other FedGov programmers slaved away in SnowCrash.

  • Scruffy Nerfherder||

    Holy fuck. Why in god's name would that persist?

    Only explanation I can come with is that government programmers are just like government bureaucrats. Fixing the problem means taking responsibility for the problem. And taking responsibility for a problem is the only way you can get fired.

  • ||

    If you are a good programmer, you can expect quick advancement, good pay, and a hands-off approach from your manager(s) in a private company. You can expect none of those things when working for the government. What good programmer would ever work for the government?

    Of course their programmers are terrible.

  • John||

    Here is the other thing. You have to be a good programer to be able to recognize another good programer. The idiots in charge of this thing are not programers. So they were of course easily taken in by the first young, hip looking, prog bullshit artist. It is no surprise at all that they hired idiot programers. It would have been remarkable if they hadn't.

  • Hyperion||

    That's why, around here, guess who interviews potential developer hires? I have to sit in on one next week, and there won't be one person in that room who is not a developer.

  • Sevo||

    Doesn't matter. Just a supposed glitch. And Bush made him do it. Obo can do no wrong.

  • Almanian!||

    But - seriously - how could anyone have foreseen this problem? The government's so complex, how could a President possibly know what's going on everywhere, or have the ability to control the bureaucracy?

    Cause - complexity?

    That's why we need to give the President MORE power. So he can manage all this complexity. Cause - FORWARD!

  • Michael Price||

    The real complexity comes from automating the subsidy system, something that has never been tried before anywhere. Trying to get a computer to automatically decide how to interpret 1,000 pages (or however much it is) of regulations is insane.

  • Hyperion||

    If you think this is screwed up, wait until the government is actually managing the healthcare of a nation with over 300 million people, all the while expanding into every other thing possible. It's going to be a blast.

  • entropy||

    Oh yeah. These really are the launch day glitches.

    It gets worse. Wait till you see what the catastrophic failures look like.

  • John||

    If you ever want to read something funny, do a google search and read some of the media puff pieces from 12 and 13 about the team of top men who were building these exchanges. They were young and so amazing they could apparently do anything. In light of this train wreck, those puff pieces are hysterical to read now.

  • Hyperion||

    In government, anyone can magically become anything they want to, just by virtue of kissing the right persons butt for long enough. Once you've kissed the right amount of butt, you can be an expert on anything, and when you fail miserably at that, you just magically become an expert at the next available top job.

  • John Thacker||

    The one in the Atlantic was priceless.

  • Red Rocks Rockin||

  • John Thacker||

    Yeah, that's the one. Credulous doesn't even begin to describe it.

  • Red Rocks Rockin||

    The before and after comments are a hoot.

  • Ruckus||

    So I read that whole thing for some stupid fucking reason. The entire time I just kept wondering why there was no conversation about the actual registration, communication with dozens of other systems, ya know the actual fucking marketplace.

    I get to the end and thankfully the author is there replying to all the recent comments. That entire fucking article was about the front end, "brochure", entirely static web site. Basically it was a long winded way of saying we created a functioning modern CMS with publishing abilities to update static resources and put the source code in a public repository. That's news? Help us.

    This is the money comment from the author himself:

    That adopted modern methods of development and design were so notable should give you some insight into the state of government IT and website design.

    Yet it's good policy to continue giving these people more IT responsibility.

  • Zoobs||

    Did a little investigating of CGI, the Canadian company that got the job. Acquired American Management Systems in 2004. There are a bunch of ex-government types in key positions. Another example of cronyism at work. Connected people got rich and the US taxpayer got screwed, again. They'll drop another $500M to fix it which will be 10x the original estimate. Why am I surprised?

  • Jose Chung||

    And that's just the cost of the website. Wait until the subsidies start rolling out, then we'll see the costs really explode.

  • Michael Price||

    Is the $500M your estimate and is it based on anything but a "x10 cost to fix anything" rule of thumb?
    Personally I think it could well be that much or more, but I just want to see your math on it.

  • Jose Chung||

    I'd love for someone to ask the President or Sebilius:

    "So were you lying or are you just incompetent?"

  • albeit||

    Contracts awarded to build California's Obamacare exchange add up to more than $450 million. Accenture alone got $327 million.

    http://www.healthexchange.ca.g.....ations.pdf

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