Saturday, December 28, 2013

$50M Obamacare-Fix: 'Literally a Life-or-Death Situation'

    As the full breadth of the Healthcare.gov debacle became apparent, the Department of Health and Human Services (HHS) turned to the architect of the Federal Data Hub to lead the team of contractors to fix the woefully inadequate website that had disastrously launched just weeks before. As announced on October 25, Quality Software Services Inc. (QSSI), whose Data Hub turned out to be one of the better functioning systems of the Obamacare Marketplace, was named as the general contractor for the rescue effort.  According to the Washington Post at the time, "details on the size of the contract were still being worked out."
    Recently, more details on that contract (treated as an extension to a 2007 Enterprise System Development contract) have become available and shed more light on HHS's own assessment of the situation less than one month after the website launch.  The documents paint a devastating picture of stunning incompetence three and a half weeks into the most ambitious domestic policy program in recent memory: 
During Healthcare.gov's first weeks of open enrollment, many Americans attempted to access the Marketplace and enroll in health insurance.  Due to numerous technical issues, such as hundreds of software bugs, inadequate hardware and infrastructure, and a general lack of system monitoring and incident response capabilities, the Marketplace could only support a fraction of all those who tried to register, apply, and enroll in a health plan.
    The estimated value to QSSI of the one-year contract extension is $50 million:

     Since the situation was deemed to be an emergency by HHS, the contract was awarded without the usual competition, as explained by the Justification and Approval document which cited the likelihood of "unacceptable delays."  A process that normally takes three months was accomplished in less than a day. QSSI's previous work with HHS on Healthcare.gov, as well as experience with "problematic program start-ups" such as the Medicare Part-D Prescription Drug program seven years ago.  HHS foresaw dire consequences if Healthcare.gov was not repaired in a timely manner, warning of "literally a life-or-death situation":
Timely availability of the Marketplace is critical for [uninsured] individuals to be able to obtain coverage by January 1st, 2014, as was specified within the [Affordable Care Act] legislation. For many of them, access to affordable healthcare is literally a life-or-death situation. 
    The contract specifies ten tasks to be performed by QSSI, including "Baseline Current Architecture and Code for all FFM [Federal Facilitated Marketplaces] Systems", "Establish Flexible Testing and Performance Testing Environments", and designing, establishing and maintaining a Healthcare.gov "dashboard" as a real-time tool to track the performance of Marketplace systems and subsystems.
    The Justification and Approval document was signed by nine different HHS officials up the chain of command, including the Chief Operating Officer of the Centers for Medicare and Medicaid Services, A. Michelle Snyder.  Snyder was the last to add her signature on December 20, which likely explains why the document was not posted online until December 23.

Note: A version of this article first appeared at The Weekly Standard.

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