Obamacare crashes onths in coming not easily repaired - hCentive newsAlisha North
In the weeks before the start of Obamacare, officials failed to complete exhaustive testing of the program’s website in a push to begin signups by Oct. 1, according to people involved in the rollout.
Obamacare markets debut as early hurdles may slow signups - hCentive newsAlisha North
The three-year effort to open the Obamacare health-insurance exchanges culminates today, beset by logistical delays and a U.S. government shutdown borne of Republican opposition to the Affordable Care Act.
Obamacare crashes onths in coming not easily repaired - hCentive newsAlisha North
In the weeks before the start of Obamacare, officials failed to complete exhaustive testing of the program’s website in a push to begin signups by Oct. 1, according to people involved in the rollout.
Obamacare markets debut as early hurdles may slow signups - hCentive newsAlisha North
The three-year effort to open the Obamacare health-insurance exchanges culminates today, beset by logistical delays and a U.S. government shutdown borne of Republican opposition to the Affordable Care Act.
Hawaii- Leadership Under Fire - Balancing Governor's Emergency Powers and Gov...CliftonHasegawa1
LEADERSHIP is about making others better as a result of your presence and making sure that impact lasts in your absence.
- Sheryl Sandberg
Success is making a positive difference to other people, especially seeing others grow, succeed and thrive as a result of your own small contribution. - Azran Osman Rani
Success today requires the agility and drive to constantly rethink, reinvigorate, react, and reinvent. - Bill Gates
The rewards for those who persevere far exceed the pain that must precede the victory.
~ Ted Engstrom and R. Alec Mackenzie
Nothing splendid has ever been achieved except by those who dared believe that something inside of them was superior to circumstance.
~ Bruce Barton
Every job is a self-portrait of the person who did it. Autograph your work with excellence.
~ Motorola World Class Ambassador Club
This new publication, Cyber Claims Insight from Aon Benfield’s Cyber Practice Group, empowers readers with the resources and tools they need to understand the cyber landscape, including legal trends, claims and insurance coverage disputes.
Intermediary Accountability in the Digital AgeRichard Austin
Examination of the accountability of Internet Intermediaries with a focus on Online Reputation, Cambridge Analytica and Facebook and Competition issues
Tisski Ltd Freedom of Information White PaperKatie Weir
The public sector’s management of Freedom of Information (FOI) requests has come sharply into focus recently, with the new Information Commissioner threatening to vigorously pursue delays and poor treatment of FOI applications.
This white paper sets out to explore the challenges around maintaining compliance and what existing technology can deliver immediate improvements to FOI systems and processes.
It specifically looks at the power of Microsoft Dynamics 365 and will be useful to anyone operating in the public sector who wants to find a quick and effective means of ensuring compliance at a time of enhanced scrutiny.
Social Media for Lenders Webinar featuring Lee NegroniSmarsh
Record keeping rules for mortgage lenders weren’t written with social media in mind. Complying with these rules for loan-related tweets, Facebook messages and LinkedIn communications suggests the proverbial square peg and round hole. Some regulatory agencies mention social media communications but lack rules for it, while others are silent on the subject.
Is social media an unsupervised digital opportunity to advertise and originate mortgages, or a regulatory compliance risk?
A Shaky Start for Healthcare.govThe Patient Protection and Afforda.docxbartholomeocoombs
A Shaky Start for Healthcare.gov
The Patient Protection and Affordable Care Act, often called Obamacare, is considered the centerpiece of President Barack Obama’s legacy. Essential to Obama’s health care reform plan is Healthcare.gov, a health insurance exchange website that facilitates the sale of private health insurance plans to U.S. residents, assists people eligible to sign up for Medicaid, and has a separate marketplace for small businesses.
The site allows users to compare prices on health insurance plans in their states, to enroll in a plan they choose, and to find out whether they qualify for government health care subsidies. Users must sign up and create their own specific account first, providing some personal information, to receive detailed information about available health care plans in their area.
Healthcare.gov was launched on October 1, 2013, as promised, but visitors quickly encountered numerous technical problems. Software that assigned digital identities to enrollees and ensured that they saw only their own personal data was overwhelmed. Customers encountered cryptic error messages and could not log on to create accounts. Many users received quotes that were incorrect because the feature used prices based on just two age groups. It was estimated that only 1 percent of interested consumers were able to enroll through the site for the first week of operations, and many applications sent to insurers contained erroneous information. Thousands of enrollees for HealthCare.gov—at least one in five at the height of the problems—received inaccurate assignments to Medicaid or to private health plans. Some people were wrongly denied coverage.
Insurers received enrollment files from the federal exchange that were incomplete or inaccurate, as many as one in ten. The information includes who is enrolling and what subsidies they may receive. Some insurers reported being deluged with phone calls from people who believed they had signed up for a particular health plan, only to find that the company had no record of the enrollment. Enrollment problems with insurers persisted into November.
U.S. chief technology officer Todd Park stated on October 6 that Healthcare.gov’s glitches were caused by an unexpectedly high volume of users. Between 50,000 and 60,000 had been expected, but the site had to handle 250,000 simultaneous users. More than 8.1 million people visited Healthcare.gov between October 1, 2013, and October 4, 2013.
White House officials later admitted that Healthcare.gov’s problems were not just caused by high traffic volume but also by software and system design issues. Stress tests performed by contractors a day before the launch date revealed that the site slowed substantially with only 1100 simultaneous users, far fewer than the 50,000 to 60,000 that were anticipated. Technical experts found out that the site was riddled with hardware and software defects, amounting to more than 600 items that needed to be fixed.
A major cont.
Hawaii- Leadership Under Fire - Balancing Governor's Emergency Powers and Gov...CliftonHasegawa1
LEADERSHIP is about making others better as a result of your presence and making sure that impact lasts in your absence.
- Sheryl Sandberg
Success is making a positive difference to other people, especially seeing others grow, succeed and thrive as a result of your own small contribution. - Azran Osman Rani
Success today requires the agility and drive to constantly rethink, reinvigorate, react, and reinvent. - Bill Gates
The rewards for those who persevere far exceed the pain that must precede the victory.
~ Ted Engstrom and R. Alec Mackenzie
Nothing splendid has ever been achieved except by those who dared believe that something inside of them was superior to circumstance.
~ Bruce Barton
Every job is a self-portrait of the person who did it. Autograph your work with excellence.
~ Motorola World Class Ambassador Club
This new publication, Cyber Claims Insight from Aon Benfield’s Cyber Practice Group, empowers readers with the resources and tools they need to understand the cyber landscape, including legal trends, claims and insurance coverage disputes.
Intermediary Accountability in the Digital AgeRichard Austin
Examination of the accountability of Internet Intermediaries with a focus on Online Reputation, Cambridge Analytica and Facebook and Competition issues
Tisski Ltd Freedom of Information White PaperKatie Weir
The public sector’s management of Freedom of Information (FOI) requests has come sharply into focus recently, with the new Information Commissioner threatening to vigorously pursue delays and poor treatment of FOI applications.
This white paper sets out to explore the challenges around maintaining compliance and what existing technology can deliver immediate improvements to FOI systems and processes.
It specifically looks at the power of Microsoft Dynamics 365 and will be useful to anyone operating in the public sector who wants to find a quick and effective means of ensuring compliance at a time of enhanced scrutiny.
Social Media for Lenders Webinar featuring Lee NegroniSmarsh
Record keeping rules for mortgage lenders weren’t written with social media in mind. Complying with these rules for loan-related tweets, Facebook messages and LinkedIn communications suggests the proverbial square peg and round hole. Some regulatory agencies mention social media communications but lack rules for it, while others are silent on the subject.
Is social media an unsupervised digital opportunity to advertise and originate mortgages, or a regulatory compliance risk?
A Shaky Start for Healthcare.govThe Patient Protection and Afforda.docxbartholomeocoombs
A Shaky Start for Healthcare.gov
The Patient Protection and Affordable Care Act, often called Obamacare, is considered the centerpiece of President Barack Obama’s legacy. Essential to Obama’s health care reform plan is Healthcare.gov, a health insurance exchange website that facilitates the sale of private health insurance plans to U.S. residents, assists people eligible to sign up for Medicaid, and has a separate marketplace for small businesses.
The site allows users to compare prices on health insurance plans in their states, to enroll in a plan they choose, and to find out whether they qualify for government health care subsidies. Users must sign up and create their own specific account first, providing some personal information, to receive detailed information about available health care plans in their area.
Healthcare.gov was launched on October 1, 2013, as promised, but visitors quickly encountered numerous technical problems. Software that assigned digital identities to enrollees and ensured that they saw only their own personal data was overwhelmed. Customers encountered cryptic error messages and could not log on to create accounts. Many users received quotes that were incorrect because the feature used prices based on just two age groups. It was estimated that only 1 percent of interested consumers were able to enroll through the site for the first week of operations, and many applications sent to insurers contained erroneous information. Thousands of enrollees for HealthCare.gov—at least one in five at the height of the problems—received inaccurate assignments to Medicaid or to private health plans. Some people were wrongly denied coverage.
Insurers received enrollment files from the federal exchange that were incomplete or inaccurate, as many as one in ten. The information includes who is enrolling and what subsidies they may receive. Some insurers reported being deluged with phone calls from people who believed they had signed up for a particular health plan, only to find that the company had no record of the enrollment. Enrollment problems with insurers persisted into November.
U.S. chief technology officer Todd Park stated on October 6 that Healthcare.gov’s glitches were caused by an unexpectedly high volume of users. Between 50,000 and 60,000 had been expected, but the site had to handle 250,000 simultaneous users. More than 8.1 million people visited Healthcare.gov between October 1, 2013, and October 4, 2013.
White House officials later admitted that Healthcare.gov’s problems were not just caused by high traffic volume but also by software and system design issues. Stress tests performed by contractors a day before the launch date revealed that the site slowed substantially with only 1100 simultaneous users, far fewer than the 50,000 to 60,000 that were anticipated. Technical experts found out that the site was riddled with hardware and software defects, amounting to more than 600 items that needed to be fixed.
A major cont.
Back end errors at u.s. health website jeopardize sign-up-hCentive newsAlisha North
There’s no way to tell how many people who think they enrolled for health insurance through the U.S. Obamacare exchange actually have, after about 1 in 4 files sent to insurers had garbled and incomplete information.
Chapter 14 Managing Projects 569 A Shaky Start for Healthcare.Gov CAS.pdfprajeetjain
Chapter 14 Managing Projects 569 A Shaky Start for Healthcare.Gov CASE STUDY e
administration of President Barack Obama has made Patient Protection and Affordable October 6
that Healthcare.gov\'s glitches were caused Care Act, often called \'Obamacare*, its chief by an
unexpectedly high volume of users. About domestic accomplishment and the center 50,000-
60,000 had been expected, but the site had to U.S. chief technology officer Todd Park stated on
piece of Obama\'s legacy. Essential to Obama\'s health handle 250,000 simultaneous users. Over
8.1 million care reform plan is Healthcare.gov, a health insurance people visited Healthcare.gov
between October I and exchange Web site that facilitates the sale of private October, 2013.
health insurance plans to U.S residents, assists people White House officials later eligible to sign
up for Medicaid, and has a separate Healthcare.gov\'s problems were not just caused by White
House officials later admitted that marketplace for small businesses high traffic volume but also
by software and system design The site allows users to compare prices on health issues. Stress
tests performed by insurance plans in their states, to enroll in a plan they choose, and to find out
if they qualify for gow ernment health care subsidies. Users must sign up and create their own
specific account first, provid- ing some personal information, in order to receive detailed
information about available health care day before the launch date revealed the site slowed
substantially with only 1,100 simultaneous users, far fewer than the 50,000-60,000 that were
anticipated. Technical experts found out that the site was riddled with hardware and software
defects, amounting to more than 600 items that needed to be fixed A major contributor to these
problems was the part of the system\'s design that requires users to Healthcare.gov was launched
on October 1 2013, as promised, but visitors quickly encounteredcreate individual accounts
before shopping for health numerous technical problems. Software that assigned insurance. This
means that before users can shop digital identities to enrollees and ensured that they for
coverage, they must input personal data that only their own personal data was overwhelmed. are
exchanged among separate computer systems built or run by multiple vendors, including CGI
Customers encountered cryptic error messages andbuilt or run by multiple vendors, including cG
could not log in to create accounts. There was insuf- ficient computing capacity in the Herndon,
Virginia, data center housing the system for the site. Many users received quotes that Group,
developer of healthcare.gov, Quality Software in the Herndon, Virginia, Services, and credit-
checker Experian PL.C. If any Services, and part of this web of systems fails to work properly
users will be blocked from entering the exchange the feature used prices based on just two age
groups.marketplace. A bottleneck had been created where It was estimated that on.
1
John Charles Chasteen, Born in Blood and Fire, “Revolution”
KEYWORDS
populism Che Guevara Cuban Missile Crisis
Juan and Eva Perón Fidel Castro Liberation Theology
Pablo Neruda Bay of Pigs
Study Questions:
§ How did Latin American relations with the United States change after World War Two?
§ In particular, what high hopes of Latin American nationalists were disappointed in a postwar
world?
§ In what ways does the 1954 US intervention in Guatemala exemplify patterns of the emerging
Cold War in Latin America? What is to be learned by comparison with Bolivia?
§ What things made a Marxist view of history persuasive to many Latin Americans in the 1950s
and 1960s?
§ Did the triumph of the Cuban Revolution in 1959 present a plausible model for would-be
guerrillas around the region?
No response paper due this week.
The project/The Files/From the Start, Signs of Trouble at Health Portal.pdf
11/21/16, 5:01 PMFrom the Start, Signs of Trouble at Health Portal - The New York Times
Page 1 of 7http://www.nytimes.com/2013/10/13/us/politics/from-the-start-signs-of-trouble-at-health-portal.html
http://nyti.ms/1cJ1iaT
POLITICS
From the Start, Signs of Trouble at Health
Portal
By ROBERT PEAR, SHARON LaFRANIERE and IAN AUSTEN OCT. 12, 2013
WASHINGTON — In March, Henry Chao, the chief digital architect for the Obama
administration’s new online insurance marketplace, told industry executives that
he was deeply worried about the Web site’s debut. “Let’s just make sure it’s not a
third-world experience,” he told them.
Two weeks after the rollout, few would say his hopes were realized.
For the past 12 days, a system costing more than $400 million and billed as a
one-stop click-and-go hub for citizens seeking health insurance has thwarted the
efforts of millions to simply log in. The growing national outcry has deeply
embarrassed the White House, which has refused to say how many people have
enrolled through the federal exchange.
Even some supporters of the Affordable Care Act worry that the flaws in the
system, if not quickly fixed, could threaten the fiscal health of the insurance
initiative, which depends on throngs of customers to spread the risk and keep
prices low.
“These are not glitches,” said an insurance executive who has participated in
http://www.nytimes.com/
http://nyti.ms/1cJ1iaT
http://www.nytimes.com/pages/politics/index.html
http://topics.nytimes.com/top/reference/timestopics/people/p/robert_pear/index.html
http://www.nytimes.com/by/sharon-lafraniere
http://www.nytimes.com/by/ian-austen
11/21/16, 5:01 PMFrom the Start, Signs of Trouble at Health Portal - The New York Times
Page 2 of 7http://www.nytimes.com/2013/10/13/us/politics/from-the-start-signs-of-trouble-at-health-portal.html
many conference calls on the federal exchange. Like many people interviewed for
this article, the executive spoke on the condition of anonymity, saying he did not
wish to alienate the federal officials with whom he work ...
Federal Health Site HealthCare.gov Stymied By Lack of Direction as Obamacare Was Formulated
1. Federal Health Site HealthCare.gov Stymied By Lack of
Direction as Obamacare Was Formulated
Updated Oct. 28, 2013 10:43 a.m. ET
A team of young policy experts energized by President Barack Obama's health law toiled for three
years in a Bethesda, Md., office building to draw up specifications for the federally run insurance
marketplace.
Forty miles away at the Centers for Medicare & Medicaid Services' Baltimore headquarters,
longtime agency computer experts with different bosses oversaw building the site's software and
hardware components.
And in Washington, White House advisers worked to preserve the law through treacherous politics,
sometimes stalling final decisions about the site, HealthCare.gov, to avoid controversy ahead of the
2012 presidential election.
Find Your State's Health-Insurance Exchange
As it becomes clear that no single leader oversaw implementation of the health law's signature
online marketplace--a complex software project that would have been difficult under the best
circumstances--the accounts of more than a dozen current and former officials show how a disjointed
bureaucracy led to the site's disastrous Oct. 1 launch.
It has become clear that no single leader oversaw implementation of the health law's online
marketplace: the accounts of more than a dozen officials show how a disjointed bureaucracy led to
the site's disastrous launch. Christopher Weaver reports. Photo: Getty Images.
Problems persisted Sunday. A federal data hub that verifies the identity and income of people
applying for subsidized insurance from 14 state-run exchanges and 36 exchanges run by the federal
government failed when the company hosting the hub lost its network connectivity, the
administration said.
Divergent agency cultures, political directives that clashed with operational deadlines, a compressed
timeline and dispersed geography led to the federal site's technical failures, those people said. The
glitches have locked out millions of users, left insurers to sift through flawed data and given new
ammunition to Republican detractors of the health law.
A White House official said its experts were involved in policy making and some interagency
coordination. They were briefed on the website's development, but relied on the technical team of
CMS, as the Medicare and Medicaid agency is known, for operational decisions, the official said.
The administration last week named a single person to fix the exchange, veteran troubleshooter
Jeffrey Zients, and a single company, Quality Software Services Inc., a unit of UnitedHealth Group
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Your Value Your Change Short position that already held a contract to
build part of the site, to act as general contractor on the effort. Mr. Zients gave the government's
first specific estimate for when the site would have most problems repaired: the end of November.
Key work to create the website was given to CMS, which had experience running a site for Medicare
drug plans. But the agency, which is overseen by Health and Human Services Secretary Kathleen
Sebelius, had a siloed management structure, and no single unit was designed to pull off a mammoth
task like HealthCare.gov.
In one camp were computer experts reporting to a veteran CMS official, Michelle Snyder, who were
among the first to recognize the scale of the problems facing the website, current and former
officials say, such as errors in the calculation of insurance prices and eligibility determinations.
But a separate policy arm built the road map for what the exchange needed to accomplish, with
strained communication with its computer counterparts; that team reported to Gary Cohen, a former
California lawyer.
Word of the software problems was slow to reach Mr. Cohen, who testified to Congress on Sept. 19
that the exchange was on track even as the agency's computer experts were working around the
clock at a key contractor location to hammer out a host of unanticipated flaws.
Ms. Snyder and Mr. Cohen referred requests for comment to the CMS media office.
In a statement, Julie Bataille, the CMS communications director, said: "The CMS administrator,
Marilyn Tavenner is in charge of the agency's implementation of the Affordable Care Act." She said
delegating tasks to different arms of the agency is the norm and that "business and infrastructure
personnel have been, and continue to, work closely together to ensure improvements are rapidly
deployed."
When CMS presented HealthCare.gov to White House officials over the summer, they displayed a
demonstration version of the website composed of screen-shots of the real exchange and overlaid
with interactive features.
That version re-created the user interface, but didn't include the underlying mechanics--such as
identity verification and eligibility determinations--that have foiled the site's launch. Displaying such
versions for demonstration purposes is common in the computer industry. But it left senior officials
unaware of the more complicated and ultimately troubled workings of the exchange.
Meanwhile, critical deadlines to begin testing the real system were already slipping by, current and
former officials and insurance executives said.
The administration's most senior officials, including President Obama in a Rose Garden address last
week, have acknowledged they were unprepared for the depths of the exchange's flaws, which have
prompted some Republicans to call for Ms. Sebelius's resignation.
3. CMS agency didn't respond to specific questions, including about the test version of the website
presented to senior officials.
HealthCare.gov is the highest-profile experiment yet in the Obama administration's effort to
modernize government by using technology, with the site intended to become a user-friendly
pathway to new health insurance options for millions of uninsured Americans.
"This was the president's signature project and no one with the right technology experience was in
charge," said Bob Kocher, a former White House aide who helped draft the law.
The outcome--a partially finished product that, despite improvements, has allowed only a trickle of
users to enroll--also jeopardizes the core of the health overhaul. Sicker, older consumers who expect
to need health services are more likely to fight through the glitches to sign up for insurance plans,
insurers worry. Without enough healthier people to offset their costs, that could drive rates up next
year.
"The more time this goes on, it becomes more of an issue for all insurers," said Allan Einboden, chief
executive of Scott & White Health Plan in Temple, Texas, which so far has enrolled about 30
exchange customers, most over age 50, a potential early sign of trouble.
As the delays continue, congressional Republicans contend the requirement that people obtain
coverage or pay a fine, central to the law, should be abandoned for a full year, and the argument is
gaining some traction among Democrats.
The Obama administration's management troubles with the site trace to the first days after the law
cleared Congress in March 2010, people familiar with the matter say.
That April, a new Health and Human Services agency was formed to oversee the laundry list of
health-law provisions affecting private insurance. The new Office of Consumer Information and
Insurance Oversight attracted senior state-level officials, former insurance-industry experts and
enthusiastic staffers drawn to what appeared to be the center of the health-overhaul push, according
to people who worked there.
But the office cycled through four leaders in three years. Mr. Cohen, the current chief, was
appointed in August 2012.
Less than a year after its inception, the insurance office was subsumed by CMS in part to protect the
new office from congressional budget axes, then wielded by a new Republican House majority,
former officials familiar with the matter said.
4. The combination of the two agencies led to a culture clash as parts of exchange development were
assigned to career civil servants in other units of CMS, people from both sides say.
President Obama's advisers, including his most prominent health aide, Jeanne Lambrew, frequently
weighed in on regulations and website design carried out by the insurance office, but weren't
focused on computer issues, said former White House officials and others familiar with the matter.
Ms. Lambrew didn't respond to requests for comment.
While officials in the insurance office continued drafting the road map for the exchange, computer
experts reporting to Ms. Snyder were given oversight of contractors hired to help carry it out. The
CMS experts also were given the task of being the so-called systems integrator, an unusual job for
the agency, acting as a sort of general contractor to cobble together the components of the site.
Government contractors said the arrangement contributed to confusion over their roles. "It was like
building a bridge by starting from both sides of the river," one person familiar with the development
said. "You hoped they met in the middle."
The CMS computer arm was charged with setting deadlines for contractors, people familiar with the
matter said. These officials were expected to attend meetings called by policy makers to hammer out
details of the website specifications, the people said. One person said computer workers skipped
some of these sessions altogether. CMS declined to comment on the sessions.
Politics intervened, too, people familiar with the matter said. Key regulations stalled inside the White
House Office of Management and Budget for months while the Supreme Court weighed the
constitutionality of the law and the president campaigned for re-election in the 2012 contest.
In one case, a rule governing the design of plans to be sold on the exchange was completed and
signed by Ms. Tavenner, the CMS administrator, on May 15, 2012, approved by Ms. Sebelius that
Aug. 6 but not released publicly until Nov. 26, three weeks after the election, regulatory records
show.
HHS spokeswoman Joanne Peters said many of the law's major regulations were released before
November 2012.
As the launch neared, the exchange's managers were increasingly disconnected. By early
September, the CMS computer arm had sent personnel to work with contractors at a key site in
Herndon, Va., operated by CGI Group Inc., GIB.A.T +0.15% CGI Group Inc. Cl A SV Canada: Toronto
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Change Short position one of the main contractors.
Testing of the system by insurers that had been scheduled for July didn't begin until the third week
of September, said people familiar with the development and insurance executives who participated
in testing. Dozens of features of the site were behind schedule, they said.
On Oct. 1, nearly three million consumers stormed the site. It crashed as the first wave sought to
create accounts.
5. Write to Christopher Weaver at christopher.weaver@wsj.com and Louise Radnofsky at
louise.radnofsky@wsj.com
Corrections & Amplifications
Most insurance enrollees at Scott & White Health Plan are over age 50. An earlier version of this
article omitted the word "over."