Journalism in the Public Interest

Sebelius Testifies: Four Things to Know About Today’s Obamacare Hearing

Among the proferred questions for HHS Secretary Kathleen Sebelius: Why has no one been fired?


HHS Secretary Kathleen Sebelius arrives to listen to Obama speak about the error-plagued launch of at the White House on Oct. 21. Today she'll face lawmakers on Capitol Hill. (Mark Wilson/Getty Images)

Health and Human Services Secretary Kathleen Sebelius will testify before the House Energy and Commerce Committee this morning.

Her appearance comes the week after contractors testified before the same committee and a day after the head of the Centers for Medicare and Medicaid Services testified before a different House committee.

Here’s what you need to know:

1. Where to watch the hearing, which begins at 9 a.m. EST:

Live streaming video by Ustream

2. Read Sebelius’ prepared testimony. Politico calls it more of the same:

Sebelius’s eight pages of prepared testimony for the House Energy and Commerce Committee matches nearly word-for-word testimony delivered by CMS Administrator Marilyn Tavenner to Ways and Means on Tuesday.

In both written statements, the officials acknowledge that the website hasn’t met expectations but say the administration is taking major steps to improve it.

Neither testimony includes an apology for the bungled launch—but Tavenner apologized in person at the hearing Tuesday morning.

Clay Johnson (@cjoh), who advocates for open source information in the federal government, annotated the testimony on Rap Genius, with questions and comments.

3. Get familiar with the background.

Sebelius gave an interview to CNN’s Sanjay Gupta last week in which she had this memorable exchange:

GUPTA: The president did say that he was angry about this. I mean do you know when he first knew that there was a problem?

SEBELIUS: Well, I think it became clear fairly early on. The first couple of days, that —

GUPTA: So not before that, though? Not before October 1st?

SEBELIUS: No, sir.

GUPTA: There was no concern at that point here in the White House or at HHS?

SEBELIUS: I think that we talked about having — testing, going forward. And if we had an ideal situation and could have built the product in, you know, a five-year period of time, we probably would have taken five years. But we didn’t have five years. And certainly Americans who rely on health coverage didn’t have five years for us to wait. We wanted to make sure we made good on this final implementation of the law. And, again, people can sign up. The call center is open for business. We’ve had 1,100,000 calls. We’ve had 19 million people visit the Web site, 500,000 accounts created. And people are shopping every day. So people are signing up and there’s help in neighborhoods around the country, that people can have a one-on-one visit with a trained navigator and figure out how to sign up. So people are able to sign up.

I wondered at the time if Sebelius’ answer left a little wiggle room. I expect Republicans on the committee will pursue this.

4. Digest media reports.

You can definitely expect that Sebelius will be asked about a CNN report yesterday that’s lead contractor warned the administrator well before the Oct. 1 launch of major problems. Read the documents.

CNBC suggests these six questions for her:

  • What did you know, when did you know it, and who told you?
  • Did you ever consider not launching Oct. 1?
  • Why has no one been fired?
  • What does all this cost?
  • What contingency plans do you have?
  • What are the enrollment numbers?

TPM also offers what it calls seven legitimate questions for her. And the Washington Post says that “the embattled secretary of health and human services will submit to a quintessential station of the Washington deathwatch.”

Gotta love Washington.

Putting on a management hat, here’s what I’d ask if minions had a similar problem or what I’d expect to have to answer if I was involved in this sort of fiasco:

1.  Was a schedule drafted and can it be distributed?  This is important to understand the context this happened in.
2.  How and how frequently were contractors made accountable for their work?  If they weren’t held responsible for many milestones, then this was designed to fail.
3.  How much time on the schedule was allocated to testing?  If it’s not at least as long as development time, just as a rule of thumb, the schedule was wildly optimistic.
3a.  Bonus points, how much time on the schedule was allocated to design.  Without a good design and without feedback on the design, it’s basically a shot in the dark.
4.  When did the team fall behind the schedule?  If we have answers to the previous questions, this should be easy.
5.  Were there contingency plans for complete failure?  If so, what?  If not, what led to such confidence in the contractors?  Software does fail frequently enough that every back-up plan should have a back-up plan.

I’m also still very curious as to why the site violates the Paperwork Reduction Act, and if that was forgotten and if there was an oversight in giving credit to libraries in use, then what other laws and standards (HIPAA is very big, for example) might we have accidentally violated?  There may be a whole line of questioning on whether or not the project was audited and how it might have been handled.

Asking why nobody has been fired is very…Stalin, and a waste of everybody’s time.  We also know why they didn’t consider delaying the launch, we know how much this costs, and enrollment numbers are irrelevant when people can’t enroll.  The CNBC crew is clearly trying to boost advertising numbers, not solve the problem…

4 things Propublica wants you to know about the Obamacare debacle

1. Its not Obama’s fault
2. It only has problems because its so popular
3. Its not Obama’s fault
4. Its the fault of the Republicans.

Mike H:  You left out ‘It’s all Bush’s fault.’

Just tried the site and got right in. Seems to be working. GOP seems to be a very sociopathic group of folks with an agenda of promoting fear and hate to their largely uneducated base.

Mike H and Dave F:

You got lost on your way to
Next time take a hard right at Il Duce Avenue.

They’re talking about how many signed up. That’s not how many have enrolled. That number of enrollees needs to hit 1 million just to keep up with the number of people who have been cancelled - primarily because their existing “you can keep your current policy” didn’t satisfy the new law.

Only 500,000 accounts have been created - that’s fewer accounts created than the number of people who have already received notice that their insurance policies will be cancelled.

How many have enrolled? “We’ll have those numbers by mid-November” the previous witness testified repeatedly to Congress yesterday morning. Those responsible for the live launch of the biggest online private purchasing mandate in U.S. history claim they don’t know how many “conversions” their site generated until six weeks after launch. That to me sounds like a lie in contempt of Congress.Otherwise it’s gross negligence. No private-sector contractor would let any site - much less a multi-million-dollar site - go live without real time tracking of conversions e.g. “enrollments.”

All of this obfuscation hides from we the public details of what has been falsely billed as a requirement that we purchase health insurance. The only real requirement is that we pay a tax that will be waived if we purchase insurance. Any reasonable decision to purchase or pay the tax will be informed by insurance rates. Neither proPublica nor anyone has a clearly stated list of requirements and exemptions - including the one that matters to many of us older pre-medicaid persons whose rates are the highest.

If our rates exceed 8 percent of our income, are we exempt from the tax?
What is annual window to purchase this product?
What will be the range of possible rates next year?
Is the tax $700 or 2.5 percent of my income?

These simple facts inform any intelligent decision on my part to purchase or not.  They inform my decisions to ask for a raise and how much to ask of my employer. Maybe I could save my company and me money by paying the tax and keeping my income lower. I don’t need maternity care, I don’t plan to go to a rush-job doctor for “preventive” care that I can otherwise enjoy by spending on gym fees and dental costs.

ProPublica, do your job and quit pandering to your left wing donors. And lefties - get your government out of my body.

EVERY new national program had rollout problems: SS, Medicare, Medicare D.
I recall having to give my Medicare D card to the pharmacy FIVE times because we “got lost in the computer”.
That doesn’t make it any less frustrating, but it will get ironed out.

As someone whose company has completed websites for dozens of public and private sector clients, I can only ask: what were they thinking?  The time allotted to create such a site was ample—but destined to fail, perhaps, because of insufficient design direction on the front end, and destined to fail, for sure, because of little to no apparent testing before launch.

Carl D'Agostino

Oct. 30, 2013, 2:08 p.m.

Ah the age of technology. When I got my first Florida teaching certificate in 1971(when they kept records on 5x7 index cards in folders) it took 3 weeks. Now 42 years later with tech advancement it takes 6-7 weeks.

I would believe the problems in the designing of the website are moreso due to the typical practice of letting contracts to the “Lowest Bidder”, and then expecting a quality product at the lowest price. Then things go wrong and you expect the contractor to immediately make it all right. The citizens of Indiana have seen this same happen when the state let a contract to an out-of-state web design company contracted to set up testing for the ISTEP program. Almost immediately there were various problems with so many students trying to sign-on or even to complete the tests. The contractor was notified of the problems, attempted to repair or reconfigure, failed that, and the contract was nullified. After all that, the DOE of Indiana is still attempting to calculate the results of those tests, at least the results that are verifiable, and then to rate the schools to determine funding. Internal operations to make those ratings are delayed, thereby creating confusion amongst school systems and their funding. So, is the theory of letting contracts to the “Lowest Bidder” always the best? That depends on your expectations.

Sebelius claims in the CNN interview “the ideal situation would have taken 5 years, but we did not have 5 years” Really, where was the time line crisis ? The Americans without health insurance have not had coverage for the past 50 years, what does another 6 months or 1 year or 2 matter ? It was a self imposed deadline ! Like EVERYTHING to government does, it will be HIGH COST,LOW QUALITY ! Postal System, Housing, Welfare, SS, same crap sucking money out of our pockets

abinico warez

Oct. 30, 2013, 3:18 p.m.

Obamacare is all about health - unfortunately it’s more about medical industry profits’ health than your health. Obamacare does nothing to replace GMO food with organic; does nothing to get artificial ingredients out of food; does nothing to address possible Fukushima contamination of the US food chain; does nothing to make sure food is nutritious; ignores rocket fuel contamination of the Colorado River whose water irrigate a huge section of America’s farms. So there you have it - Obamacare, as superficial and specious as the guy whose name it carries.

Nothing new here. Jerry S, your comment made me LOL.

Bruce J Fernandes

Oct. 30, 2013, 5:47 p.m.

Just look at this as a pure business issue and take a pass on the politics for a change.

I completed the application for my private ACA-approved plan in less than five minutes.  Before I completed my application I went through the insurance company’s offerings which included the four required levels (Platinum, gold, silver, bronze).  That took a good 30 minutes just to make sure I understood the plans as I had read about them from a variety of other sources.

If the structure of the federal exchange plan had been set up the way private sector companies set things up I suspect there would not be as many problems.  The presumption that everyone must register before they can look at the plans… Pelosi told us at time of passage we couldn’t see the plan before it was passed by congress. 

Did I misunderstand and we were never supposed to see the plan… register for a pig in a poke… and then pay for it?

Simple story, they screwed up…. the political problem is the screw ups fit right into the republican argument for delay.  Obama did not do himself much service today in Mass speech.

EVERYONE needs to get their eye on the ball which is the co-pays and deductibles.  Sure the insurance with subsidy is affordable but can cash-strapped people perhaps never having health insurance before be willing to go to the doctor’s office and pay $30 and then maybe an Xray for another $35 and then maybe a antibiotic for a third $30.  These are all bronze plan copays…..

Not many consumers who previously did not have insurance have that kind of money for one simple visit that requires this outgo.  Anyone who thinks the newly insured have any clue what is coming at them in terms of co-pays and deductibles is deluding themselves.  Obama took care to talk about insurance premiums; nothing about co-pays and deductibles.

The Republicans should accept the label “Health Care Deniers.” Their actions are obstructing progress. The moral panic over the rollout of the ACA is ridiculous.

of all the prop;e questioning Sibelius only Bachman asked questions that were relevant.  The rest were just clowns.

How many decisions actually came out of the White House and did Ms. Sibelius have to fall on her sword for Obama’s negligence?

My friend the web designer, who has been doing it for 15 or so years, albeit not at this level, said that all websites fail in the beginning.

Bruce Fernandes: “EVERYONE needs to get their eye on the ball which is the co-pays and deductibles.  Sure the insurance with subsidy is affordable but can cash-strapped people perhaps never having health insurance before be willing to go to the doctor’s office and pay $30 and then maybe an Xray for another $35 and then maybe a antibiotic for a third $30.  These are all bronze plan copays…..”

But it’s the annual deductible in the $thousands that will make the insured succumb to their “optimism bias,” and pay the tax penalty.  Ergo, only the very sick will enroll in greater numbers, the formula for failure.

This article is part of an ongoing investigation:
Obamacare and You

Obamacare and You

The Rollout of the Affordable Care Act has been marred by glitches and political opposition.

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