Did the U.S. Government Learn Anything From the ACA Website Failure?

Healthcare.gov, the website designed to help consumers compare and purchase health insurance as a part of President Obama’s Affordable Care Act, officially launched on October 1, 2013. The site was immediately plagued by serious problems that made it difficult for many users to navigate. In the months that followed, the Obama administration fought hard to get the site running smoothly and to mend the damage the website’s failure inflicted on the President’s deeply dwindling approval ratings.

Over the course of this past year, journalists have investigated the events leading up to and immediately following the launch, and government officials have held hearings in an attempt to uncover exactly where things went wrong. While it can often be difficult to separate facts from political posturing, it appears clear that the web project was plagued by inefficiency and a lack of communication from its inception. It remains to be seen whether the government or primary contractor will change their ways in the wake of this disaster.

A “Burdensome” Prospect

The firm initially chosen as the primary contractor responsible for building healthcare.gov was CGI Federal. CGI Federal is an American subsidiary of CGI Group, a Canadian company that employs almost 70,000 people who are spread around the globe.
Despite CGI’s experience working with the military, the F.B.I., and over 40 state governments, they were less suited for creating a project of this magnitude than many of the country’s flashier Silicon Valley tech firms. Silicon Valley has little interest in pursuing government contracts, largely because they don’t consider the extra work required to qualify to be worth the effort. As Stan Soloway, the C.E.O. of an organization that represents government contractors explains, “it is very burdensome, and the rules make it very unattractive.”

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The extensive requirements that must be met before a company can be considered for government contracts were designed to keep businesses from profiting too much off the American taxpayer. Unfortunately, they also exclude talented firms who are unwilling to slog through the details. As a result, the government often has few choices. The Centers for Medicare and Medicaid Services (CMS), the government agency that the Obama administration charged with implementing its Affordable Care Act and by extension the online healthcare marketplace, chose CGI Federal from a pool of only four pre-qualified contractors.
By early 2014, Federal officials concluded that despite the improvements CGI made to its original designs, the firm was too ineffective and ill equipped to trust with completing the project. CGI was fired and replaced by Accenture, another contractor with more direct experience building large websites for government organizations. Following the July 2014 release of a nonpartisan government investigation into the problems surrounding healthcare.gov, CMS spokesperson Aaron Albright admitted his agency’s poor choice of contractor. Albright stated, “CMS takes its responsibility for contracting oversight seriously and has already implemented contracting reforms…including ending its contract with CGI and moving to a new type of contract with Accenture that rewards performance.” If there were more incentives for qualified companies to seek government work, the Obama administration would have had a larger pool of initial applicants from which to choose and many of the problems that arose could have been avoided.

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Lack of Leadership
Perhaps the most consistently cited factor contributing to the failure of healthcare.gov has been a lack of leadership. In a congressional hearing held only weeks after the site’s initial failure, CGI Federal Vice President Cheryl Campbell was one of the first people involved in the project to directly place blame on the government, not its contractors. In a prepared statement, Campbell claimed that CMS “serves the important role of systems integrator or `quarterback’ on this project and is the ultimate responsible party for the end-to-end performance.” Subsequent testimony supported her statement and congress sanctioned CMS’s failure to hire a qualified company to act as systems integrator. A designated systems integrator would have been responsible for making sure that the many different aspects of the website worked smoothly with one another. Because no one firm was specifically given this task, problems arose when it came time to put the pieces together.
Some people attribute this critical oversight to a general lack of knowledge within government agencies when it comes to technology. They suggest that CMS may not have realized in time just how important a systems integrator was to the project’s success. As its name suggests, CMS is primarily tasked with administering medical social services, not web development. It seems likely that they simply did not recognize their mistake until it was too late.
CMS relinquished their role as systems integrator shortly after Campbell’s testimony, and the website has continued to improve since then. Problems still exist, particularly surrounding the ways that insurers receive participant information. These problems serve to further highlight the importance of strong leadership, particularly when building a project that connects so many different businesses to potential consumers.

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Practice Makes Perfect

In the year since healthcare.gov first launched, hundreds of government officials have worked extremely hard to determine what went wrong and to fix the problems. For the most part, they have corrected their mistakes and they have done so quickly considering the vast scope of the site. While these decisive actions suggest that the government has learned from its failure, many of the processes that contributed to that failure remain in place. Government contracts are still limited to the specialized companies willing to pursue them. The valuable lessons healthcare.gov taught both CGI Federal and the Obama administration about the importance of clear direction and leadership will however hopefully encourage the American government to better manage similar projects in the future.
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