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Tavenner Predicts Another Hard Year for

By Rebecca Adams, CQ HealthBeat Associate Editor

September 18, 2014 -- The Centers for Medicare and Medicaid Services (CMS) will fully test the federal website that handles enrollment for most states, said Administrator Marilyn Tavenner at a hearing last week. But federal officials are not planning to take all of the recommendations put forward by the Government Accountability Office (GAO) in a report urging CMS to improve the security of the site.

GAO Director of Information Security Issues Greg Wilshusen testified at the House Oversight and Government Reform Committee hearing that the site remains vulnerable to disruptions and attacks.

The agency is hopeful that the second open enrollment season that starts Nov. 15 will go much more smoothly than last year's inaugural start to the new marketplace websites created under the health care law (PL 111-148, PL 111-152). This year, Tavenner said that federal officials will be handling enrollment for two additional states, Oregon and Nevada, but that she didn't expect the costs would increase significantly as a result.

Still, she acknowledged that the second year will be an equally hard year.

The sign-up period is half as long as last year's, and an additional five million people or so are expected to sign up.

"It won't be perfection," said Tavenner.

Tavenner said that CMS officials have already implemented 19 of 22 technical recommendations suggested by GAO and are working on the rest. Of six additional major findings, Tavenner said that the agency agreed in part with all of them but had disagreements about parts of three of them.

One of the recommendations that federal officials are accepting in part is the GAO's admonition that the agency should do comprehensive end-to-end testing, with all of the components in place, soon. Tavenner indicated in her testimony that the agency would do end-to-end testing in late September or October. But an administration official confirmed after the hearing that the agency is planning to test each of the parts of the website individually but not at one time as a single complete unit.

Health and Human Services (HHS) spokesman Kevin Griffis said that the scheduled testing fully complies with federal standards.

Some Democrats urged CMS officials to do all they can to avoid any more technical problems like the ones that plagued the website last year.

"Just do it, please," said Elijah E. Cummings of Maryland, the top Democrat on the committee.

Tavenner also said at the hearing that 7.3 million people were enrolled and paying their premiums as of Aug. 15. The information was based on payment data from insurers.

"I'm very pleased to know that we have payment levels of 90 percent," said Tavenner.

She said she did not have additional details about how many people dropped their coverage or why they did so. Possibilities include that some consumers may have realized they were eligible for job-related coverage, or they may have lost their jobs and become eligible for Medicaid. Their personal circumstances may have changed.

"By the end of '14, we'll understand the circumstances," she said, adding, "We'll only know that when we went look back and we're careful not to look back too early."

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