The troubles with the initial rollout of Healthcare.gov on October 1, 2013 are well-documented. A site so unresponsive that only nine people enrolled in coverage on day one and a site torn apart by both supporters and opponents of the law, alike. So how did it get back to working and enroll more than 8 million people?
The Department of Health and Human Services turned to IT experts and specialists drawn from within government, contractors, and industry, according to an October 23rd HHS blog post. One of those brought in was Paul Smith, a serial tech entrepreneur and founder of EveryBlock.com, which was sold to MSNBC in 2009.
Speaking Tuesday at a conference sponsored by Enroll America, a multistate grassroots campaign to help enroll millions of uninsured Americans, Smith said “we all know that Healthcare.gov almost blew up on the launch pad, but I’m here to tell my story about how [we] got it to launch.”
Smith was visiting San Francisco on October 16,2013 and received a phone call saying “your country needs you.” He agreed to help and said he initially thought the project would take a few weeks.
On day one, he and his fellow team members found a site that was really failing and inoperative more than half the time. “The error rate was very high, [there were] a lot of serious, serious problems with the site and one of the first things we realized was there wasn’t good information,” he said. “We had to discover all that ourselves.” That included examining average load times of pages and error rates.
They also found a very intricate website with dozens of contractors and vendors, multiple government agencies and internal services. “It was a complicated ... website and had all the challenges those projects have,” Smith said, but adds that his team realized they could fix the technology.
A few weeks in, the White House was determining when the fixes would be ready and asked the team if it would be fixed in two weeks, four weeks, or ever. “We had to dig deep and think about those questions,” Smith said.
To overcome all the challenges, the team set up a war room, which was permanently staffed by representatives of all entities involved with Healthcare.gov and a place for real-time decision making. Smith said that was the first time many contractors and vendors had talked to each other directly. “We put all that (chain of command) nonsense aside and solve[d] problems together because it was critical,” he explained.
The site was re-launched on December 1, ahead of the initial Dec. 15 deadline for Jan. 1 coverage which was later extended until Dec. 23.
Looking toward 2015 open enrollment, Smith said Healthcare.gov is a vastly better place but work continues on some back end functionality, including payment information and the small business health options, or SHOP, exchange. However, he says the Healthcare.gov that you saw on the official close of open enrollment will largely be the same site for 2015.
“If you think about the time open enrollment ended April 1, and the next one starts November 15, that is not a long runway to do a lot of big changes,” he said.
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