Action Sports with Leigh Roche

A top federal health reform official acknowledged Thursday “there will clearly be bumps” in the second Obamacare enrollment season but said a management overhaul created a better “early warning system” and far more testing for HealthCare.gov.

Andy Slavitt, principal deputy administrator at CMS , who has been in his job for just three weeks, testified before a House panel Thursday one day after a blistering nonpartisan Government Accountability Office report summed up rampant mismanagement, mistakes, and cost overruns that contributed to the HealthCare.gov meltdown last year. The report warned that the second insurance sign-up season starting Nov. 15 faces risks if oversight isn’t improved.

Republicans opened the Energy and Commerce oversight subcommittee session with reminders of just how much of a disaster HealthCare.gov’s launch had been and how, at this time last year, CMS officials were blithely predicting that Affordable Care Act implementation was on track.

Slavitt, who worked on the Obamacare website in the private sector before being brought to HHS by new Secretary Sylvia Matthews, told the panel that CMS has streamlined management and is doing more testing than last year. He said the agency is “expecting to have a good open enrollment” but added that “I expect it won’t be perfect.”

“Fortunately or unfortunately, the GAO report wasn’t news to people at CMS,” he said. The staff have “lived through that nightmare and don’t want to go through it again.”

Slavitt said that the website is secure, with no confidential information breached. But he also acknowledged that the site’s back end, the portion that insurers rely on, is still not complete. Health plans are being paid, but based on enrollment estimates. Completing the business end will go into next year, he said.

He also said that the new lead HealthCare.gov contractor, Accenture, can be held accountable for poor performance, unlike its predecessor, CGI.

“Importantly, Accenture has skin in the game to make sure the work is delivered,” he said, referring to how the contract is structured.

But Rep. Phil Gingrey (R-Ga.) challenged Slavitt on why, if everything was being managed so well, the Accenture contract had nearly doubled since it began in January — rising from $91 million to more than $175 million.

Slavitt responded that the scope of the contract, which was quickly awarded as CGI was fired, had expanded since then. “I wouldn’t characterize that cost as ballooning,” he said. “I would say the proper scope was determined after they got going.”

The subcommittee didn’t ask Slavitt what the broader scope entailed.

Slavitt said CMS agrees with the GAO recommendations on management improvement and has already made numerous changes. The agency now has clear policies on which personnel can order new work and how it is done, he noted. GAO had identified $30 million worth of improper work orders.

The Obama administration is still on defense about the spectacular failure of the HealthCare.gov launch but is trying to move ahead. The “tech surge” repair effort last fall and massive surge of millions of Americans enrolling in Obamacare plans this spring mean the initial failure of the website could become a footnote to a belatedly successful push to sign people up for the new health care plans.

The GAO report focused on the many failings that have been reported in the run-up to the launch of HealthCare.gov; it added details about the mismanagement of contractors and the cost overruns that resulted — the lack of a clear chain of command, a failure of coordination among vendors, inadequate accountability testing of the systems that came too late, if at all.

Slavitt declined to answer whether the twice-delayed employer mandate will go into effect late this year, saying that was a question for Treasury or IRS, not CMS. Rep. Michael Burgess (R-Texas), who asked the question, then replied, “My personal belief is that we’ll never see the employer mandate.”...