Stanley Feld M.D., FACP,MACE

 I cannot believe it.

President Obama continues to deceive the America public about his "Accountable Care Act" (ACA or Obamacare). Our elected officials continue to do nothing to stop him. Unelected administrative officials are making spending decisions that neither congress nor the public is aware of until after the fact. A case in point is www.healthcare.gov.

William T. Woods, a senior official at the Government Accountability Office in testimony prepared for a House hearing on Thursday, warned of “significant risks in the next open enrollment period, which begins Nov. 15.”

He said, “the marketplace and its website,HealthCare.gov, were over budget and behind schedule because of “new and changing requirements” imposed by administration officials.”

This is in direct contrast to what Sylvia Mathews Burwell, the secretary of Health and Human Services told the congress and the American people a few weeks ago. She said the problems were mostly solved.

The American people have still not gotten an accurate accounting of how many people have signed up legally through the health exchanges. My best estimate it is less than 3 million and not 8 million.

About 80% are getting subsidies by signing up on the federal government health insurance exchanges. It is also against the law according to the definition for subsidy eligibility as written the law. President Obama said the administration did did not mean what the law says.

Let us concentrate on the costs of the website until this point. Initially it was supposed to cost $56 million dollars.

The cost rose from $56 million dollars to $209 million dollars from September 2011 to February 2014. The Obama administration launched the disastrous web site in October 2013 without having a quality assurance surveillance plan to monitor the work of the main contractor CGI. A principle in CGI was a college buddy of Michelle Obama. A linkage of their friendship and the contract with CGI has never been proven.

On October 1, 2013 the disaster of the web site became apparent. There was confusion within the Obama administration about who had the authority to approve contractor request to expend funds for additional work.

Mr. Woods said,“In 40 instances, the staff members of the federal exchange inappropriately authorized contractors to expend funds, totaling over $30 million.”

Mr. Wood also said, “As the Oct. 1 deadline approached, federal officials identified significant performance problems in computer systems developed by CGI Federal, but “took only limited steps to hold the contractor accountable.”

The administration withheld only $267,000, or 2 percent of CGI’s $12.5 million fee. There is no indication of the profit CGI made on the work done that cost the government $209 million dollars.

It gets more complicated and bizarre.

In January 2014 the Center for Medicare and Medicaid Services (CMS) awarded a contract valued at $91 million to Accenture Federal Services to continue work on the project.

“Accenture Federal Services costs have ballooned to more than $175 million and the marketplace is still unable to perform essential computer functions needed to pay insurers and update information on consumers.”

The question that must be asked is what in the world is going on?

James E. McAvoy, a spokesman for Accenture said that another “task order” had increased the total to $190 million.

Accenture said, “It is helping the government develop an insurance exchange for small businesses, is expanding the federal exchange to serve additional states and is adding new features to verify the income of people seeking federal subsidies.”

The Government Accountability Office, an investigative arm of Congress, said that through March of this year the administration had made formal commitments to spend $840 million on the federal health insurance exchange and marketplace.

The $840 million dollars is a long way from the original $56 million dollar in the original Obamacare budget.

 The plot thickens.

Andrew M. Slavitt the No. 2 official at the Centers for Medicare and Medicaid Services told Congress that the agency was changing requirements for its contracts to expand the scope of work that must be done.

Mr. Slavitt said that the administration was making improvements in the federal health insurance exchange’s software , but that the second round of open enrollment, starting in November 2014, would not be perfect. “There will certainly be bumps,” he testified at a House hearing.

Mr. Slavitt avoided answering how much the website should cost. 

 Mr. Slavitt said, “That’s a really good question.” He did not specify the proper cost, but he said the nation was getting invaluable results, including new insurance coverage for millions of people.

Mr. Slavitt, who joined the government three weeks ago. A congressional panel has questioned his credibility.

Mr. Andrew Slavitt, a former executive at Optum, the technology company tasked with “saving” HealthCare.gov,ran into sharp questions from a House panel about a potential conflict of interest in his new role.

Rep. Morgan Griffith, R-Va., pressed Mr. Slavitt on his previous job at OptumInsight/QSSI.  Optum, and its parent company, UnitedHealth Group. UnitedHealth Group, one of the nation’s largest insurers, offers health plans on the federal health insurance exchanges. Optum had a large role in the creation of HealthCare.gov and built the data hub, The data hub is still not working properly.

The Obama administration granted an ethics waiver to Mr. Slavitt so that he could participate in decisions affecting his former employer, Optum, and its parent company, the UnitedHealth Group.  

Optum is the tech firm the Department of Health and Human Services picked in October 2013 to straighten out HealthCare.gov. It was awarded an $84.5 million contract with HHS’s Centers for Medicare and Medicaid Services in January 2012 to build the part of HealthCare.gov known as the federal data hub.

The purpose of the data hub is to connect multiple government agencies to streamline verification of crucial consumer information—including Social Security number and immigration status when Americans log into the federal and state exchanges and apply for Obamacare subsidies.

Doesn’t this sound fishy? Can we trust the Obama administration to decide what treatment American should get and what treatment Americans cannot get access to?

It looks like the VA all over again?

Let the buyers beware!

 The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.

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