Casey Submits Questions to Tavenner on Health Care Implementation

Washington, DC- U.S. Senator Bob Casey (D-PA) submitted written testimony questioning Marilyn Tavenner, Administrator for the Centers for Medicare and Medicaid Services at HHS, on the online enrollment problems in the federal online health insurance marketplace.

“I am disturbed that the rollout of the health insurance marketplaces on healthcare.gov has been so rocky,” Senator Casey stated. “I do not believe the problems are indicative of flaws in the law, but I do think that they are indicative of flaws in implementation.

Too many people have experienced problems with healthcare.gov since October 1.  They have had problems creating accounts, logging in, determining eligibility for premium assistance tax credits, and selecting plans.  Insurers are having problems getting the information they need from healthcare.gov, so that they can appropriately bill new enrollees for the coverage they have selected.” 

Testimony as submitted for the record is below. 

Note: Senator Casey was unable to attend today's HELP hearing because his wife, Terese, is having surgery today to repair a heart valve. While the procedure itself is very common, the recovery may take several weeks. He is expected to be with her most of this week. We will advise any additional changes to his schedule as appropriate.

Statement for the Record

Chairman Harkin, thank you for convening this important oversight hearing into the implementation of the Affordable Care Act.  I appreciate your leadership in overseeing the implementation of this law, following the passing of Senator Kennedy, who was the chair of the committee when we drafted the bill that was the basis of the Affordable Care Act.  I would also like to thank Administrator Tavenner for coming to the HELP Committee today.  I look forward to hearing your testimony.

I am disturbed that the rollout of the health insurance marketplaces on healthcare.gov has been so rocky.  I do not believe the problems are indicative of flaws in the law, but I do think that they are indicative of flaws in implementation.

Too many people have experienced problems with healthcare.gov since October 1.  They have had problems creating accounts, logging in, determining eligibility for premium assistance tax credits, and selecting plans.  Insurers are having problems getting the information they need from healthcare.gov, so that they can appropriately bill new enrollees for the coverage they have selected.

Pennsylvania is one of the 36 states with a federally-facilitated marketplace, that is, one being run by CMS.  These states are entirely dependent on the federally-created infrastructure; individuals in those states must use healthcare.gov from start to finish if they wish to be able to see and compare all the available plans in their area.

One constituent from Philadelphia wrote to me regarding her troubles with the website: “Some time ago I created an account on healthcare.gov with all of our personal information. The data was scrambled badly the next time I logged in. I called and was told to delete the bad data and correct it. Bad advice. A consumer cannot do that.  For the last three days the site indicates that I don't have an account.”

These problems are unacceptable.  I am grateful that the Administration has taken steps to address these issues, and I understand that the account creation process has been significantly improved, but I believe we need a clearer accounting of what happened: where the breakdowns occurred, what problems were predictable and could have been avoided or mitigated earlier, whether there were unusual factors that led to unpredictable results.

That being said, there is evidence that when the system works as intended, consumers are pleased.  I have heard from another constituent from Palmyra, PA, who said “Since I moved here 4 plus years ago my rates have gone up 9.9% per year, I do not qualify for a subsidy with the ACA, but even so ---because of the ACA going into effect I will be saving approximately $135 per month on my new private insurance starting in January.”

These examples demonstrate that the intent of the law, to provide consumers with an easy way to compare and select from affordable health insurance options, is achievable.  Now we need to figure out how everyone who needs to purchase health insurance has the same experience, and I am looking to Administrator Tavenner to provide insight on when the fixes to healthcare.gov will enable the website to live up to its promise.

I have never claimed that the Affordable Care Act is perfect, and I am open to reasonable improvements to the law.  However, it is the law, and it has been upheld by the Supreme Court.  Millions of Americans are eagerly awaiting its benefits: health insurance that doesn’t cost more because you’re a woman, or that excludes treatment for a preexisting condition, or charges outrageous rates without any guarantee of renewability at the end of the year.  October 1 was an eagerly-awaited date, but January 1, 2014 is even more eagerly awaited by so many people who have struggled for many years to access the health insurance they need to get the health care they need for themselves and their families.

Administrator Tavenner, thank you again for appearing before the Committee today.  I hope that your testimony will be helpful, and that we will be able to work together to ensure that the Affordable Care Act is a success.

Questions for the Record

1. Please detail the steps CMS intends to undertake to assist people who may have begun the enrollment process at healthcare.gov, but not completed it (due to problems with the website or other reasons).  Will there be outreach targeted to these individuals to find out why they did not complete the enrollment process, and provide extra assistance if they need it?
2. Similarly, one of the complaints I have heard is that individuals who had difficulty creating accounts ended up creating, intentionally or otherwise, multiple accounts on the site.  Has CMS taken steps to improve the system specifically to address this problem?  For example, many consumer websites require you to use your email address as your username, or to include that in the registration process.  If an individual already has an account, they are then prompted to enter their password or given the option to reset the password.  While healthcare.gov appears to have this feature, it clearly was not working as intended.
3. Please provide an overview of the core teams that have been established with QSSI to address the “punch list” of work that needs to be done, and how each team is prioritizing its work.
4. Can you describe the security measures in place to protect consumer data submitted by individuals applying for health insurance through healthcare.gov, and how those protections compare to similar protections for other federal programs like Medicare Part D?
5. I have heard that many individuals are turning to paper applications due to frustrations with the website, but I also understand that these paper applications will be processed using the same computer systems causing problems at healthcare.gov.  Does CMS, or the appropriate contractor, have the ability to ensure that these applications are processed in a timely fashion?

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