By John Reichard, CQ HealthBeat Editor
October 24, 2013 -- Almost 700,000 people have submitted initial applications for health care coverage on state and federal exchanges, a Centers for Medicare and Medicaid Services (CMS) official said last week.
The official also acknowledged that the agency had not done enough end-to-end testing of the computer system that supports the federal exchange site—healthcare.gov—prior to its Oct. 1 launch, blaming the "compressed time period" prior to the opening of the marketplace.
The comments by Julie Bataille, director of the CMS office of communications, were made in the first of what administration officials say will be regular briefings on the effort to correct malfunctions on the federal exchange that have badly damaged the full rollout of the health care law (PL 111-148, PL 111-152).
Lawmakers heard testimony at a recent House Energy and Commerce Committee hearing that the agency had not done sufficient testing prior to the launch. The witnesses included several of the contractors responsible for healthcare.gov. CMS did not send an official to testify, but Bataille didn't dispute the point in the telephone press briefing.
Asked why she termed the period available for testing "compressed" since the health law was passed in 2010, Bataille said "I think when you look at the complexity of the system and all of the pieces that are interrelated in order to work together, obviously we had to put all of those pieces in place over a period of time. I think it is no surprise to anyone that we're operating under a compressed time frame to get all of that done and in order to do the rigorous testing that was needed."
Bataille said she agreed with an assessment by one of the witnesses at the hearing that the application and enrollment functions would be working well enough to permit people to enroll by a Dec. 15 deadline for coverage that starts Jan. 1.
"We are working at this 24–7 and have a team that is looking at this around the clock," she said. "It is getting better every day."
Bataille added that "we know that we are early on into a full six-month open enrollment process and we are confident that consumers will be able to apply and enroll certainly by Dec. 15 for that first coverage that begins in January and then through the full duration of the open enrollment period."
Bataille said the nearly 700,000 applications shows "tremendous interest" among Americans in finding quality affordable health coverage. She clarified that the term "completed applications" means the applicant has submitted information and received a determination whether he or she is eligible for Medicaid, the Children's Health Insurance Program or a subsidy to buy coverage on an exchange, as well as the amount of any subsidy.
Having completed that process the consumer is then eligible to compare plans and pick one. A completed application does not mean a consumer has actually enrolled in a plan, however. CMS officials say they won't release enrollment totals until mid-November.
Bataille added, however, that technical problems are making the application and plan shopping process difficult to complete, "so we're analyzing healthcare.gov's issues and prioritizing fixes in real time."
Republicans at the hearing peppered witnesses with questions about why a "browse" function was not turned on for the launch that would have permitted visitors to get information on what plans are available and their prices without having to create accounts. A big question was whether the White House made the decision.
Bataille said "CMS obviously as we got closer to October 1st needed to prioritize the ability for us to launch live so that consumers could conduct the full online application process, understand what their eligibility determination was to get a tax credit, and then go on to enroll in a health plan. We made a business decision to prioritize resources so that that functionality would be live and available for consumers on October 1st."
Bataille would not shed light on who the administration has brought in from the outside to help fix the site. Her answer implied that they wouldn't be named so reporters wouldn't bother them. "These people are committed to being part of our 24–7 team and we have really asked them to hunker down and work with us to identify these issues moving forward so that is their current priority and certainly what we've asked them to focus on."