The Conversation

Everyone but Obama Knew Healthcare.gov Was In Trouble

On Christmas Eve in the afternoon, Reuters dumped this story recapitulating the long history of Obamacare's IT failure. It's a technology failure that stemmed from management failure, one which the ultimate manager, the President himself, was completely unaware of until it happened.

The information in this story has been seen before but reading it here in collated form is clarifying. How are we to believe all this happened without the White House seeing the red flags? This questions seems especially apt in light of the fact that the red flags had ample opportunity to make themselves known from inside the White House:

Tavenner's anxiety - more than a year ahead of the planned launch of the exchanges - spurred concerns among industry and advocacy groups, which publicly questioned whether the multiple government agencies involved in the effort would be able to pull it off.

The White House was closely briefed on the issues. Tavenner was cleared to visit White House officials involved in the project 425 times from December 2009 to June 2013, including several meetings with Obama, visitor logs show. The White House said later that Obama knew only the broad picture, not details of the effort.

Tavenner had 425 visits and never expressed any doubt about what was happening? Even if that were true, there were voices who were not willing to offer happy talk as the train headed for a wreck. In April 2013 an outside consulting firm raised red flags about the development process [Emphasis added]:

The report by the consulting firm McKinsey & Co depicted a tangled, leaderless bureaucracy managing the effort and warned of possible system failures that materialized barely six months later. It blamed tight deadlines, insufficient testing and the absence of a "single, empowered decision-making authority."

The report sounded the alarm. Attendees at high-level briefings that followed included Todd Park, the White House chief technology officer, and Brian Sivak, the HHS technology whiz brought in to jumpstart health technology systems.

The consultants met with Tavenner and Jeanne Lambrew, Obama's healthcare adviser who, two decades earlier, had worked on a failed healthcare overhaul spearheaded by then-first lady Hillary Clinton.

Obama also was briefed on McKinsey's findings, White House press secretary Jay Carney later acknowledged. White House logs show two McKinsey consultants arriving for a meeting on April 8, but the company would not comment on the visit.

So a warning went directly to the White House six months before the launch yet. The President was briefed and yet, supposedly, the moment passed such that in September the President thought all was well.

From here the author of the Reuters piece skips ahead to the failed launch. That's a mistake in my estimation. He's overlooked another significant step in the development process. In mid-September, two weeks before the site went live, the White House began lowering expectations with the media.

Politico's story about the shift in tone was titled "Obamacare D-Day becomes a soft launch." For those unfamiliar with the term, a "soft launch" is a limited roll out of a project. It's not at all what was set to happen on October 1st. Politico's story reads:

Democrats -from President Barack Obama on down - say that hiccups are to be expected when the switch is flipped on the new state exchanges. It’s an intricate system that requires several complex government technology systems to successfully talk to each other — and to the consumer. A modest start to enrollment may reduce any start-up strain.

There are going to be some glitches. No doubt about it,” Obama said at a news conference last month. “There are going to be things where we say, you know what? We should have thought of that earlier, or this would work a little bit better or this needs an adjustment.”

This does not sound like a White House that expected a Kayak-like roll out. It sounds like a White House that expected the kind of problems CMS was seeing, the kind that actually happened on launch day.

Does it even seem plausible that the White House was aware of problems six months before the launch but not one month before? Of course the alternative is that the White House lied about not knowing what was coming. Is there any reason to think they would do something like that?


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