Healthcare.gov Insurance Exchange Website
Healthcare.gov Insurance Exchange Website Insurance Exchange Website Known as ACA. The exchange facilitates the sale of private health insurance plans to residents of the United States.
Healthcare.gov Insurance Exchange Website is a health insurance exchange website operated under the United States federal government under the provisions of the Patient Protection and Affordable Care Act (PPACA, often referred to simply as ‘ACA’ or ‘Obamacare’), which currently serves the residents of the U.S. states which have opted not to create their state exchanges.[better source needed] The exchange facilitates the sale of private health insurance plans to residents of the United States and offers subsidies to those who earn between one and four times the federal poverty line, but not to those earning less than the federal poverty line. The website also assists those persons who are eligible to sign up for Medicaid and has a separate marketplace for small businesses.
The October 1, 2013 roll-out of the Healthcare.gov Insurance Exchange Website went through as planned, despite the concurrent partial government shutdown. However, the launch was marred by serious technological problems, making it difficult for the public to sign up for health insurance. The deadline to sign up for coverage that would begin January 2014 was December 23, 2013, by which time the problems had largely been fixed. The open enrollment period for 2016 coverage ran from November 1, 2015, to January 31, 2016. State exchanges also have had the same deadlines; their performance has been varied.
The design of the website was overseen by the Centers for Medicare and Medicaid Services and built by several federal contractors, most prominently CGI Group of Canada. The original budget for CGI was $93.7 million, but this grew to $292 million before the launch of the website. While estimates that the overall cost for building the website had reached over $500 million before launch and in early 2014 HHS Secretary Sylvia Mathews Burwell said there would be “approximately $834 million on Marketplace-related IT contracts and interagency agreements,” the Office of Inspector General released a report in August 2014 finding that the total cost of the Healthcare.gov Insurance Exchange Website had reached $1.7 billion and a month later, including costs beyond “computer systems,” Bloomberg News estimated it at $2.1 billion. On July 30, 2014, the Government Accountability Office released a non-partisan study that concluded the administration did not provide “effective planning or oversight practices” in developing the Healthcare.gov Insurance Exchange Website website.
The site functions as a clearinghouse to allow Americans to compare prices on health insurance plans in their states, to begin enrollment in a chosen plan, and to simultaneously find out if they qualify for government healthcare subsidies. Visitors sign up and create their specific user account first, listing some personal information, before receiving detailed information about what is available in their area. Designed to assist the millions of uninsured Americans, the comparison shopping features involve a visual format somewhat analogous to websites such as Amazon.com and Etsy.
Healthcare.gov Insurance Exchange Website also details Medicaid options for individuals. This relates to an expansion of the long-running program undertaken as a joint effort under the PPACA. The Congressional Budget Office (CBO) projected that the exchange would be used by an estimated seven million Americans to obtain coverage during the first year after its launch; current estimates suggest that the combined figure is slightly above eight million.
President Barack Obama signed the Patient Protection and Affordable Care Act (PPACA) into law on March 23, 2010, in the East Room before a select audience of nearly 300. He stated that the health reform effort, designed after a long and acrimonious debate facing fierce opposition in the U.S. Congress to expand health insurance coverage, was based on “the core principle that everybody should have some basic security when it comes to their health care”. The primary purpose of the PPACA was to increase coverage to the American people either through public or private insurance and control healthcare costs. The Congressional Budget Office(CBO) estimated that the PPACA would reduce the number of uninsured by 32 million increasing coverage for the non-elderly citizens from 83 to 94 percent. Insurers were not allowed to deny insurance to applicants with pre-existing conditions. The Sunlight Foundation has stated that at least forty-seven private company contractors have been involved with the PPACA in some capacity as of fall 2013, with the measure causing a wide variety of policy changes. Journalists writing for The New York Times have called the PPACA “the most expansive social legislation enacted in decades”.
A report by Reuters described the Healthcare.gov Insurance Exchange Website itself as the “key” to the reform measure. Development of the website’s interface as well as its supporting back-end services, to make sure that the website could work to help people compare health insurance plans, were both outsourced to private companies. The front-end of the website was developed by the startup Development Seed. The back-end work was contracted out to CGI Federal Inc., a subsidiary of the Canadian IT multinational CGI Group, which subcontracted the work to other companies as is common on large government contracts. CGI was also responsible for building some of the state-level healthcare exchanges, with varying levels of success (some did not open on schedule).
Specifically, aspects of the Healthcare.gov Insurance Exchange Website relating to digital identity authentication were assigned to Experian. Quality Software Services, Inc. (QSSI) also played a role. The total number of companies enlisted in the website’s creation, and their names, have not been disclosed by the Department of Health and Human Services. The whole effort was officially coordinated by the Centers for Medicare and Medicaid Services (CMS), an agency that commentators such as journalists David Perera and Sean Gallagher have speculated was ill-suited to that task. Social activist and technologist Clay Johnson later said that the federal government had issues come up given that it “leans towards a write-down-all-the-requirements-then-build-to-those-requirements type of methodology” not well suited to current IT especially when government contractors are focused on maximizing profits.
“The firms that typically get contracts are the firms that are good at getting contracts, not typically good at executing on them,” Alex Howard, a fellow at the Harvard Ash Center for Democratic Governance and Innovation, remarked to The Verge as he evaluated the back-end of the project. In contrast, the web magazine’s journalist Adrianne Jeffries praised the successful use of an “innovative” startup business for the front-end. However, she found the overall rollout “bone-headed”.
The Obama administration repeatedly modified regulations and policies until summer 2013, meaning contractors had to deal with changing requirements. However, changing requirements are by no means unusual in a large, expensive custom software project; they are a well-known factor in historical project failures, and methodologies such as agile software development have been developed to cope with them. Unfortunately, regulations about large government contracts in many countries, including the United States, are not a good match for agile accounting software development.