The three hours of questioning that CMS Administrator Marilyn Tavenner faced before the House Ways and Means Committee could be described by some as "a dog and pony show"--just more of the same intense finger-pointing and arguing Americans have grown to expect from federal lawmakers around the Affordable Care Act.
The hearing Tuesday on the status of its implementation was intended to aid the committee in overseeing the ACA, or Obamacare. It provided a platform for majority Republican concerns over dropped healthcare coverage, administrative waste and more, as they tried to wrestle the answers they were seeking about the less than exemplary Oct. 1 launch of the federal health insurance marketplace, HealthCare.gov.
A number of committee members wanted to know why some of their constituents have received notices that their insurance policies will be dropped under Obamacare. Tavenner said that those who had previously purchased insurance plans on the individual market had plans that were grandfathered into Obamacare.
Insurers have chosen to change those plans in order to comply with required essential benefits and other provisions that improve coverage and protect consumers under ACA, and how insurers do that is out of the federal government's control, she said. Insurers, and Tavenner at the hearing, have referred those individuals to HealthCare.gov where they can buy insurance and may be eligible for subsidies.
Committee Chairman Dave Camp (R-Mich.) said the committee cannot begin to fix the problems with Obamacare until the administration reveals the extent of the problems.
"Instead of plowing forward with this unworkable law, the administration should, at a minimum, seriously consider delaying the law for families and individuals, just as it has done for big business," he said.
As head of the Center for Medicare & Medicaid Services, Tavenner told lawmakers that she was the one ultimately responsible for the problematic rollout.
She attributed the bungled launch to a major underestimation in the number of people who would come to the site to apply for coverage. The site was tested end-to-end before the launch, based on estimates derived from the Medicare Part D prescription drug site when it launched. The number of people who came to HealthCare.gov was many times over that number – something CMS and its contractors did not expect to happen, she said.
The technical problems, Tavenner explained, are located within the actual three-page application process, which determines whether an applicant is a candidate for the federal health insurance marketplace and federal assistance. Anyone coming to the website merely for information or to compare prices could still access that information on the main pages without any difficulty, Tavenner said.
GOP members of the committee wanted to know how many of the more than 700,000 applicants reported by CMS to have visited the site have now actually enrolled in healthcare coverage. Tavenner said those statistics would not be available until mid-November. She promised a Nov. 30 deadline for fixing the system, many now taking place on a daily basis.
Tavenner said that the data hub for HealthCare.gov has operated successfully since the launch and has helped states with their application processes in a timely fashion. The problems have come for states that did not opt to participate in the health insurance exchange program, and thus must use the federal marketplace to enroll their beneficiaries.
"It's working quite effectively in states that are running those sites," Tavenner said of the states that created their own marketplaces. "The irony is, the GOP has put hurdles in the way of states."
To remedy what ails HealthCare.gov, the federal government has designated one of the program's contractors, Quality Software Services Inc. (QSSI), to oversee the fixes and has bumped up the number of technicians working on the solutions. The site is getting faster every day, she assured. Individuals still have the option to use the call center, paper applications and in-person assistance to apply.
Tavenner said she fully expects there to be enough time from Nov. 30 to the March 31 deadline for uninsured Americans to access the marketplace and enroll.
"The flaw is the law, itself. Not the website," said Rep. Kevin Brady (R-Texas), summing up what most Republicans had implied all day.
Rep. Jim McDermott (D-Wash.) called for a little patience. "This is one of the biggest changes we have ever made, and we are only four weeks into it." Medicare and Part D were not without their glitches at the start, he said.