By Emily Ethridge, CQ Roll Call
October 30, 2013 -- Health and Human Services (HHS) Secretary Kathleen Sebelius apologized last week for the extensive problems that have marked the rollout of the federal health exchange website and said she accepted responsibility. But House Republicans, not fully satisfied with all her answers, said they would bring her back to testify.
Following a contentious three-hour hearing, House Energy and Commerce Committee Chairman Fred Upton, R-Mich., said that Sebelius had committed to testifying before the committee again during the first week of December. Although Upton said he had further questions for Sebelius, he demurred when asked whether she should be told to resign—unlike many other Republicans who have called for the secretary to step down.
Republicans, during the highly anticipated session, pushed Sebelius for answers about incomplete security for the site, delayed website functions and the numbers of Americans who have enrolled. They pressed her about whether President Barack Obama broke his word when he told Americans that if they like their health coverage, they can keep it. And Sebelius was confronted with a screenshot of healthcare.gov displaying an error message.
Yet the House hearing was less fiery than many had expected, with Sebelius staying mostly calm as she provided answers to several lines of questioning that Republicans have been pursuing for weeks.
There were, however, some touchy points, including the questions over the security testing of the federal health exchange website. Upton said the committee would send a letter requesting information by the end of the week.
Mike Rogers, R-Mich., grilled Sebelius on the risks of adding new code to the health care website without doing end-to-end testing to ensure there weren't any vulnerabilities throughout the system. He read from a Sept. 27 memo to Centers for Medicare and Medicaid Services Administrator Marilyn Tavenner that said the security control assessment was only partly completed.
"You have exposed millions of Americans because you all, according to your memo, believed it was an acceptable risk," said Rogers. "This is a completely unacceptable level of security."
Sebelius noted that the system is continually being tested, and that simultaneous testing is going on while the new code is loaded.
After the hearing, Rogers told reporters that "very low level attempts at hacking" have been successful in getting users' passwords. "The responsible thing to do is to shut this site down and do a complete security test," he said.
Sebelius will testify next before the Senate Finance Committee Nov. 6. By the December Energy and Commerce hearing, lawmakers are expected to have detailed figures on how many people have enrolled in the law's (PL 111-148, PL 111-152) exchanges. "Given our flawed launch of healthcare.gov, it will be a very small number," Sebelius predicted. She also said that even before the launch, officials predicted there would be a small number of initial enrollees.
During the hearing, Sebelius said she is the person ultimately responsible for the flawed rollout and apologized for its problems. The website, meant to help people enroll in the law's insurance exchanges, has been plagued with technical problems.
"Let me say directly to those Americans: You deserve better. I apologize. I'm accountable to you for fixing these problems, and I'm committing to earning your confidence back by fixing the site," said Sebelius. "We are working day and night and will continue until it's fixed."
She testified that senior officials in charge of the site never advised her to delay the Oct. 1 launch date for the websites, and the contractors never recommended delay either.
Although she accepted ultimate responsibility, Sebelius noted that some rollout decisions were made by other members of her team. She told Tennessee Republican Marsha Blackburn that Michelle Snyder, the chief operating officer for the Centers for Medicare and Medicaid Services (CMS), was in charge of overseeing the website program.
"Michelle Snyder is the one responsible for this debacle," said Blackburn, to boos from committee Democrats.
Sebelius disagreed, saying, "Hold me accountable for the debacle. I'm responsible."
In addition, she said that Tavenner, who testified Oct. 29 to another House committee, made the decision to turn off the website's "anonymous shopper" feature, the delay of which has been blamed for many of the initial problems. Users at first were required to fill out an application before they could view plan options.
"I wasn't aware of that particular decision that was made by the CMS team," said Sebelius. "I was aware that we were paring back some features to not put additional risk on the website, which is ironic at this point."
She said that Tavenner also decided to delay other parts of the website before the Oct. 1 start date for open enrollment, such as the online enrollment for the small business exchange and the Spanish-language website. Tavenner has said those parts would be functional by the end of November—the administration's goal for having most of the website running smoothly.
"We were anxious to get the website up and running and functional, which we clearly have failed to do to date, although I would suggest the website has never crashed," Sebelius said. "It is functional, but at a very slow speed and very low reliability, and has continued to function."
Committee Republicans, however, pointed out that the website was down when the hearing began and when it ended, posting screenshots of the error message to make the argument that it had crashed.
"You told us several hours ago when the hearing started, that the website was down. If you look at the screen several hours later, healthcare.gov is still down," Washington Republican Cathy McMorris Rodgers said to Sebelius. "You promised the system would be ready on October 1st. You're clearly wrong."
The website was unable to process individuals' applications all day on last Wednesday. People who hit a button to "apply online" were met with the news that they could go no further. "We are experiencing technical difficulties and hope to have them resolved soon," said a message on a gray screen that was still up in the late afternoon. "Please try again later."
The problems with the application process stemmed from an issue that first appeared over the weekend. The data center run by Verizon Terremark experienced a connectivity problem. Over the weekend, the federal hub was unable to transmit data from federal agencies such as the Internal Revenue Service to any of the state or federal marketplaces.
That glitch was fixed early last week, but a similar problem re-emerged later that same week. Centers for Medicare and Medicaid Services (CMS) spokeswoman Julie Bataille told reporters on a call that part of the problem had been fixed, so that the hub could transmit data, albeit slower than usual. That meant that websites for state-based marketplaces in areas that run their own exchanges could process applications - but not on the federal exchange.
Because of the ongoing problems, several Democrats have recommended extending the law's open enrollment period, which lasts through March 2014. Iowa Democrat Bruce Braley asked Sebelius if she would be willing to consider an extension, but Sebelius seemed to answer no, noting that the open enrollment period "is extraordinarily long" and that people can enroll via other methods besides the website.
In addition, Sebelius refused some lawmakers' requests to provide figures on enrollment so far. Those figures will come out in mid-November, she said.
"We do not have any reliable data on enrollment, which is why we haven't given it to date," she said. She said that insurance companies also don't have reliable numbers. "The system isn't functioning, which is why we're not getting reliable data," she added.
Along with questioning the website, Republicans also focused on another topic: constituents who are having their individual insurance policies cancelled. Several Republicans questioned whether Obama was breaking his word when he said people who liked their coverage could keep it.
Sebelius resisted criticism that Obama had not kept his promise. She explained that under the law, consumers who still have plans that were in effect before the law was passed can keep those plans, as they would be grandfathered in.
However, non-grandfathered plans are subject to the law's minimum benefit requirements and consumer protections, and insurance companies that change their plans in a significant way would have their plans subject to those requirements as well.
"Insurance companies cancel individual policies year in and year out," Sebelius said. She noted that there about 12 million individuals in the individual market, many of whom have grandfathered plans or plans that meet the law's requirements.
Democrats also defended the law, pointing out that all people will be able to receive coverage under it, and that coverage will be more comprehensive and include new consumer protections and minimum essential benefits.
In addition, Sebelius answered GOP lawmakers' questions about how much the website cost. She said HHS has spent about $118 million on the website itself and about $56 million on other IT to support the site.
She also said that contractor CGI has a contract for $197 million, which is to last through March 2014, and about $104 million has been expended of that amount. She said that the administration is negotiating how much QSSI, which has been tasked with being the systems' integrator, will receive for its new role.
When asked by California Democrat Anna G. Eshoo if contractors could be penalized for failing to do their work, Sebelius said, "There isn't a built-in penalty but I can tell you that paying for work that isn't complete is not something that we will do."
Meanwhile, House Republicans also had an opportunity to be briefed by Michael Hash, director of HHS' Office of Health Reform, on the implementation of the health care law. But not many attended the meeting.
John Fleming of Louisiana estimated that there were about 20 lawmakers in the room and that Hash spoke for about 10 minutes before answering questions. The inquiries were similar to those that came up at the morning hearing with Sebelius, Fleming said, and there wasn't really any new information covered.
Diane Black of Tennessee agreed. "I didn't learn much more than what I already know," she said.
Michael C. Burgess of Texas said that other meetings were going on when asked about the low attendance and also said he found the briefing useful.
"I think the agency would do itself a lot of good if it would come prepared to answer these kinds of questions in a more informal session, rather than making us go through the drama of a congressional hearing," Burgess said.