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If you would like to help our coverage grow, consider <a href="/Ballotpedia:Donate" title="Ballotpedia:Donate">donating</a> to Ballotpedia.</i> </p> <hr /><div class="floatright"><a href="/File:Welcome_to_the_Marketplace.PNG" class="image" title="Image from the Healthcare.gov sign-up page"><img alt="Image from the Healthcare.gov sign-up page" src="https://ballotpedia.s3.amazonaws.com/images/thumb/4/43/Welcome_to_the_Marketplace.PNG/300px-Welcome_to_the_Marketplace.PNG" decoding="async" width="300" height="175" srcset="https://ballotpedia.s3.amazonaws.com/images/4/43/Welcome_to_the_Marketplace.PNG 1.5x" data-file-width="428" data-file-height="249" /></a></div><div class="floatleft"><a href="/Executive_Branch" title="Executive Branch"><img alt="Executive-Branch-Logo.png" src="https://ballotpedia.s3.amazonaws.com/images/thumb/0/0a/Executive-Branch-Logo.png/200px-Executive-Branch-Logo.png" decoding="async" width="200" height="200" srcset="https://ballotpedia.s3.amazonaws.com/images/thumb/0/0a/Executive-Branch-Logo.png/300px-Executive-Branch-Logo.png 1.5x, https://ballotpedia.s3.amazonaws.com/images/thumb/0/0a/Executive-Branch-Logo.png/400px-Executive-Branch-Logo.png 2x" data-file-width="900" data-file-height="900" /></a></div><p><b>Healthcare.gov</b> is the website published by the federal government that is intended to serve as the central online hub for the rollout of the federal government's <a href="/Obamacare_overview" class="mw-redirect" title="Obamacare overview">Patient Protection and Affordable Care Act</a> (ACA or commonly referred to as Obamacare). The federal website is intended to provide insurance options and administer government subsidies for residents of 36 states.<sup id="cite_ref-1" class="reference"><a href="#cite_note-1">[1]</a></sup> </p><p>The English-language version of <i>Healthcare.gov</i> website went live on October 1, 2013. The launch of a Spanish-language version was delayed.<sup id="cite_ref-rockystart_2-0" class="reference"><a href="#cite_note-rockystart-2">[2]</a></sup> </p><p>The website exists in order to enable users to shop for health insurance plans online and determine eligibility for subsidies (or for <a href="/Medicaid" title="Medicaid">Medicaid</a> enrollment at lower income levels). The enrollment period opened October 1, 2013, the same day the government shut down over the <a href="/United_States_budget_debate,_2013" title="United States budget debate, 2013">budget debate</a>. </p><p>The open enrollment period ended on March 31, 2014. The penalty, payable to the federal government, for not being enrolled in a health insurance plan by March 31 was either $95 or 1 percent of income, whichever was greater.<sup id="cite_ref-mccardle_3-0" class="reference"><a href="#cite_note-mccardle-3">[3]</a></sup> The White House stated anyone selecting a plan before the deadline would not be subject to the penalty.<sup id="cite_ref-nbcdeadline_4-0" class="reference"><a href="#cite_note-nbcdeadline-4">[4]</a></sup> In March 2014, however, the administration announced that uninsured people were allowed to enroll in plans into April as long as they had a plan selected on the website by March 31.<sup id="cite_ref-foxdelay_5-0" class="reference"><a href="#cite_note-foxdelay-5">[5]</a></sup> </p> <div style="float:right; margin-left: 15px; margin-right: 0.4em; margin-top: 0.5em; margin-bottom: 0.8em; ; max-width:200px;" class="toclimit-3"> <div id="toc" class="toc" role="navigation" aria-labelledby="mw-toc-heading"><input type="checkbox" role="button" id="toctogglecheckbox" class="toctogglecheckbox" style="display:none" /><div class="toctitle" lang="en" dir="ltr"><h2 id="mw-toc-heading">Contents</h2><span class="toctogglespan"><label class="toctogglelabel" for="toctogglecheckbox"></label></span></div> <ul> <li class="toclevel-1 tocsection-1"><a href="#Website_usage"><span class="tocnumber">1</span> <span class="toctext">Website usage</span></a> <ul> <li class="toclevel-2 tocsection-2"><a href="#Number_of_website_visitors"><span class="tocnumber">1.1</span> <span class="toctext">Number of website visitors</span></a></li> <li class="toclevel-2 tocsection-3"><a href="#Number_of_enrollees"><span class="tocnumber">1.2</span> <span class="toctext">Number of enrollees</span></a> <ul> <li class="toclevel-3 tocsection-4"><a href="#March/April_enrollment_official_report"><span class="tocnumber">1.2.1</span> <span class="toctext">March/April enrollment official report</span></a></li> <li class="toclevel-3 tocsection-5"><a href="#February_enrollment_official_report"><span class="tocnumber">1.2.2</span> <span class="toctext">February enrollment official report</span></a></li> <li class="toclevel-3 tocsection-6"><a href="#January_enrollment_official_report"><span class="tocnumber">1.2.3</span> <span class="toctext">January enrollment official report</span></a></li> <li class="toclevel-3 tocsection-7"><a href="#December_enrollment_official_report"><span class="tocnumber">1.2.4</span> <span class="toctext">December enrollment official report</span></a></li> <li class="toclevel-3 tocsection-8"><a href="#November_enrollment_official_report"><span class="tocnumber">1.2.5</span> <span class="toctext">November enrollment official report</span></a></li> <li class="toclevel-3 tocsection-9"><a href="#October_enrollment_official_report"><span class="tocnumber">1.2.6</span> <span class="toctext">October enrollment official report</span></a></li> <li class="toclevel-3 tocsection-10"><a href="#Early_enrollment_estimates"><span class="tocnumber">1.2.7</span> <span class="toctext">Early enrollment estimates</span></a></li> <li class="toclevel-3 tocsection-11"><a href="#Enrollment_goals"><span class="tocnumber">1.2.8</span> <span class="toctext">Enrollment goals</span></a></li> <li class="toclevel-3 tocsection-12"><a href="#FOIA_request_filed_by_media_outlets"><span class="tocnumber">1.2.9</span> <span class="toctext">FOIA request filed by media outlets</span></a></li> <li class="toclevel-3 tocsection-13"><a href="#Increased_funding_for_minority_enrollment"><span class="tocnumber">1.2.10</span> <span class="toctext">Increased funding for minority enrollment</span></a></li> </ul> </li> <li class="toclevel-2 tocsection-14"><a href="#Type_of_enrollees"><span class="tocnumber">1.3</span> <span class="toctext">Type of enrollees</span></a> <ul> <li class="toclevel-3 tocsection-15"><a href="#Awareness_polling"><span class="tocnumber">1.3.1</span> <span class="toctext">Awareness polling</span></a></li> </ul> </li> </ul> </li> <li class="toclevel-1 tocsection-16"><a href="#Project_benchmarks"><span class="tocnumber">2</span> <span class="toctext">Project benchmarks</span></a></li> <li class="toclevel-1 tocsection-17"><a href="#Pre-launch_testing"><span class="tocnumber">3</span> <span class="toctext">Pre-launch testing</span></a> <ul> <li class="toclevel-2 tocsection-18"><a href="#Problems_were_known"><span class="tocnumber">3.1</span> <span class="toctext">Problems were known</span></a></li> <li class="toclevel-2 tocsection-19"><a href="#Independent_pre-launch_assessment"><span class="tocnumber">3.2</span> <span class="toctext">Independent pre-launch assessment</span></a></li> </ul> </li> <li class="toclevel-1 tocsection-20"><a href="#Issues_with_rollout"><span class="tocnumber">4</span> <span class="toctext">Issues with rollout</span></a> <ul> <li class="toclevel-2 tocsection-21"><a href="#Eligibility_verification"><span class="tocnumber">4.1</span> <span class="toctext">Eligibility verification</span></a></li> <li class="toclevel-2 tocsection-22"><a href="#New_accounts_and_logging_in"><span class="tocnumber">4.2</span> <span class="toctext">New accounts and logging in</span></a></li> <li class="toclevel-2 tocsection-23"><a href="#Data_transfer_problems"><span class="tocnumber">4.3</span> <span class="toctext">Data transfer problems</span></a></li> <li class="toclevel-2 tocsection-24"><a href="#Errors_in_price_quotes"><span class="tocnumber">4.4</span> <span class="toctext">Errors in price quotes</span></a></li> <li class="toclevel-2 tocsection-25"><a href="#Direct_enrollment"><span class="tocnumber">4.5</span> <span class="toctext">Direct enrollment</span></a></li> <li class="toclevel-2 tocsection-26"><a href="#Transfers_from_Medicaid"><span class="tocnumber">4.6</span> <span class="toctext">Transfers from Medicaid</span></a></li> <li class="toclevel-2 tocsection-27"><a href="#Data_hub_outages"><span class="tocnumber">4.7</span> <span class="toctext">Data hub outages</span></a> <ul> <li class="toclevel-3 tocsection-28"><a href="#Post-enrollment_period_data_inconsistencies"><span class="tocnumber">4.7.1</span> <span class="toctext">Post-enrollment period data inconsistencies</span></a></li> </ul> </li> <li class="toclevel-2 tocsection-29"><a href="#Website_outages"><span class="tocnumber">4.8</span> <span class="toctext">Website outages</span></a></li> <li class="toclevel-2 tocsection-30"><a href="#Security_concerns"><span class="tocnumber">4.9</span> <span class="toctext">Security concerns</span></a></li> <li class="toclevel-2 tocsection-31"><a href="#Manual_back-up_systems"><span class="tocnumber">4.10</span> <span class="toctext">Manual back-up systems</span></a></li> <li class="toclevel-2 tocsection-32"><a href="#State_exchange_enrollment_problems"><span class="tocnumber">4.11</span> <span class="toctext">State exchange enrollment problems</span></a></li> </ul> </li> <li class="toclevel-1 tocsection-33"><a href="#Analysis_of_website_problems"><span class="tocnumber">5</span> <span class="toctext">Analysis of website problems</span></a> <ul> <li class="toclevel-2 tocsection-34"><a href="#Outdated_technology"><span class="tocnumber">5.1</span> <span class="toctext">Outdated technology</span></a></li> <li class="toclevel-2 tocsection-35"><a href="#CMS_level_of_expertise"><span class="tocnumber">5.2</span> <span class="toctext">CMS level of expertise</span></a></li> <li class="toclevel-2 tocsection-36"><a href="#Lines_of_code"><span class="tocnumber">5.3</span> <span class="toctext">Lines of code</span></a></li> <li class="toclevel-2 tocsection-37"><a href="#Size_of_project"><span class="tocnumber">5.4</span> <span class="toctext">Size of project</span></a></li> <li class="toclevel-2 tocsection-38"><a href="#Rigid_deadline"><span class="tocnumber">5.5</span> <span class="toctext">Rigid deadline</span></a></li> <li class="toclevel-2 tocsection-39"><a href="#Last-minute_design_changes"><span class="tocnumber">5.6</span> <span class="toctext">Last-minute design changes</span></a></li> <li class="toclevel-2 tocsection-40"><a href="#Lack_of_funds"><span class="tocnumber">5.7</span> <span class="toctext">Lack of funds</span></a></li> <li class="toclevel-2 tocsection-41"><a href="#Insularity"><span class="tocnumber">5.8</span> <span class="toctext">Insularity</span></a></li> <li class="toclevel-2 tocsection-42"><a href="#Fragmented_construction"><span class="tocnumber">5.9</span> <span class="toctext">Fragmented construction</span></a></li> <li class="toclevel-2 tocsection-43"><a href="#High-level_meeting_attendance"><span class="tocnumber">5.10</span> <span class="toctext">High-level meeting attendance</span></a></li> <li class="toclevel-2 tocsection-44"><a href="#Political_pressure"><span class="tocnumber">5.11</span> <span class="toctext">Political pressure</span></a></li> </ul> </li> <li class="toclevel-1 tocsection-45"><a href="#Efforts_to_fix"><span class="tocnumber">6</span> <span class="toctext">Efforts to fix</span></a> <ul> <li class="toclevel-2 tocsection-46"><a href="#Proposed_fixes"><span class="tocnumber">6.1</span> <span class="toctext">Proposed fixes</span></a></li> <li class="toclevel-2 tocsection-47"><a href="#Change_the_sign-up_deadline"><span class="tocnumber">6.2</span> <span class="toctext">Change the sign-up deadline</span></a></li> <li class="toclevel-2 tocsection-48"><a href="#Estimated_time_to_fix"><span class="tocnumber">6.3</span> <span class="toctext">Estimated time to fix</span></a></li> <li class="toclevel-2 tocsection-49"><a href="#Tech_surge_to_fix"><span class="tocnumber">6.4</span> <span class="toctext">Tech surge to fix</span></a> <ul> <li class="toclevel-3 tocsection-50"><a href="#Head_of_surge"><span class="tocnumber">6.4.1</span> <span class="toctext">Head of surge</span></a></li> <li class="toclevel-3 tocsection-51"><a href="#Team_members"><span class="tocnumber">6.4.2</span> <span class="toctext">Team members</span></a></li> <li class="toclevel-3 tocsection-52"><a href="#Website_daily_down_time"><span class="tocnumber">6.4.3</span> <span class="toctext">Website daily down time</span></a></li> </ul> </li> <li class="toclevel-2 tocsection-53"><a href="#Fix_results"><span class="tocnumber">6.5</span> <span class="toctext">Fix results</span></a></li> </ul> </li> <li class="toclevel-1 tocsection-54"><a href="#Post-rollout_issues"><span class="tocnumber">7</span> <span class="toctext">Post-rollout issues</span></a> <ul> <li class="toclevel-2 tocsection-55"><a href="#July_2014_hacker"><span class="tocnumber">7.1</span> <span class="toctext">July 2014 hacker</span></a></li> <li class="toclevel-2 tocsection-56"><a href="#CEO_appointed"><span class="tocnumber">7.2</span> <span class="toctext">CEO appointed</span></a></li> </ul> </li> <li class="toclevel-1 tocsection-57"><a href="#Penalties"><span class="tocnumber">8</span> <span class="toctext">Penalties</span></a></li> <li class="toclevel-1 tocsection-58"><a href="#Costs"><span class="tocnumber">9</span> <span class="toctext">Costs</span></a> <ul> <li class="toclevel-2 tocsection-59"><a href="#GAO_investigation_results"><span class="tocnumber">9.1</span> <span class="toctext">GAO investigation results</span></a></li> <li class="toclevel-2 tocsection-60"><a href="#Project_estimates"><span class="tocnumber">9.2</span> <span class="toctext">Project estimates</span></a></li> </ul> </li> <li class="toclevel-1 tocsection-61"><a href="#Contractors"><span class="tocnumber">10</span> <span class="toctext">Contractors</span></a> <ul> <li class="toclevel-2 tocsection-62"><a href="#Quality_Software_Services,_Inc."><span class="tocnumber">10.1</span> <span class="toctext">Quality Software Services, Inc.</span></a> <ul> <li class="toclevel-3 tocsection-63"><a href="#Connections_to_the_administration"><span class="tocnumber">10.1.1</span> <span class="toctext">Connections to the administration</span></a></li> </ul> </li> <li class="toclevel-2 tocsection-64"><a href="#CGI_Group"><span class="tocnumber">10.2</span> <span class="toctext">CGI Group</span></a> <ul> <li class="toclevel-3 tocsection-65"><a href="#Pre-flight_checklist"><span class="tocnumber">10.2.1</span> <span class="toctext">Pre-flight checklist</span></a></li> <li class="toclevel-3 tocsection-66"><a href="#Past_government_contracts"><span class="tocnumber">10.2.2</span> <span class="toctext">Past government contracts</span></a></li> <li class="toclevel-3 tocsection-67"><a href="#Connections_to_the_administration_2"><span class="tocnumber">10.2.3</span> <span class="toctext">Connections to the administration</span></a></li> </ul> </li> <li class="toclevel-2 tocsection-68"><a href="#Serco"><span class="tocnumber">10.3</span> <span class="toctext">Serco</span></a> <ul> <li class="toclevel-3 tocsection-69"><a href="#Scandals"><span class="tocnumber">10.3.1</span> <span class="toctext">Scandals</span></a></li> </ul> </li> <li class="toclevel-2 tocsection-70"><a href="#Contracting_practices_investigation"><span class="tocnumber">10.4</span> <span class="toctext">Contracting practices investigation</span></a></li> <li class="toclevel-2 tocsection-71"><a href="#New_contractor_search"><span class="tocnumber">10.5</span> <span class="toctext">New contractor search</span></a></li> </ul> </li> <li class="toclevel-1 tocsection-72"><a href="#Public_opinion"><span class="tocnumber">11</span> <span class="toctext">Public opinion</span></a></li> <li class="toclevel-1 tocsection-73"><a href="#Congressional_hearings"><span class="tocnumber">12</span> <span class="toctext">Congressional hearings</span></a> <ul> <li class="toclevel-2 tocsection-74"><a href="#Contractor_hearings"><span class="tocnumber">12.1</span> <span class="toctext">Contractor hearings</span></a></li> <li class="toclevel-2 tocsection-75"><a href="#Marilyn_Tavenner_hearing"><span class="tocnumber">12.2</span> <span class="toctext">Marilyn Tavenner hearing</span></a></li> <li class="toclevel-2 tocsection-76"><a href="#Kathleen_Sebelius_hearing"><span class="tocnumber">12.3</span> <span class="toctext">Kathleen Sebelius hearing</span></a></li> <li class="toclevel-2 tocsection-77"><a href="#IT_specialist_hearing"><span class="tocnumber">12.4</span> <span class="toctext">IT specialist hearing</span></a></li> </ul> </li> <li class="toclevel-1 tocsection-78"><a href="#Sebelius_resignation"><span class="tocnumber">13</span> <span class="toctext">Sebelius resignation</span></a></li> <li class="toclevel-1 tocsection-79"><a href="#Possible_ramifications"><span class="tocnumber">14</span> <span class="toctext">Possible ramifications</span></a> <ul> <li class="toclevel-2 tocsection-80"><a href="#Miscalculated_eligibility_frustrations"><span class="tocnumber">14.1</span> <span class="toctext">Miscalculated eligibility frustrations</span></a></li> <li class="toclevel-2 tocsection-81"><a href="#Popular_media_blowback"><span class="tocnumber">14.2</span> <span class="toctext">Popular media blowback</span></a></li> <li class="toclevel-2 tocsection-82"><a href="#Supporter_morale"><span class="tocnumber">14.3</span> <span class="toctext">Supporter morale</span></a></li> <li class="toclevel-2 tocsection-83"><a href="#Congressional_pushback"><span class="tocnumber">14.4</span> <span class="toctext">Congressional pushback</span></a> <ul> <li class="toclevel-3 tocsection-84"><a href="#Direct_enrollment_letters"><span class="tocnumber">14.4.1</span> <span class="toctext">Direct enrollment letters</span></a></li> <li class="toclevel-3 tocsection-85"><a href="#Investigation_into_Healthcare.gov_rollout_failure"><span class="tocnumber">14.4.2</span> <span class="toctext">Investigation into Healthcare.gov rollout failure</span></a></li> <li class="toclevel-3 tocsection-86"><a href="#Individual_mandate_extension_letter"><span class="tocnumber">14.4.3</span> <span class="toctext">Individual mandate extension letter</span></a></li> <li class="toclevel-3 tocsection-87"><a href="#Letter_for_Sebelius'_resignation"><span class="tocnumber">14.4.4</span> <span class="toctext">Letter for Sebelius' resignation</span></a></li> </ul> </li> </ul> </li> <li class="toclevel-1 tocsection-88"><a href="#International_government-run_healthcare_IT_comparisons"><span class="tocnumber">15</span> <span class="toctext">International government-run healthcare IT comparisons</span></a> <ul> <li class="toclevel-2 tocsection-89"><a href="#England"><span class="tocnumber">15.1</span> <span class="toctext">England</span></a></li> <li class="toclevel-2 tocsection-90"><a href="#Canada"><span class="tocnumber">15.2</span> <span class="toctext">Canada</span></a></li> </ul> </li> <li class="toclevel-1 tocsection-91"><a href="#Alternatives_to_Healthcare.gov_for_insurance"><span class="tocnumber">16</span> <span class="toctext">Alternatives to Healthcare.gov for insurance</span></a> <ul> <li class="toclevel-2 tocsection-92"><a href="#Health_Sherpa"><span class="tocnumber">16.1</span> <span class="toctext">Health Sherpa</span></a></li> </ul> </li> <li class="toclevel-1 tocsection-93"><a href="#Reactions"><span class="tocnumber">17</span> <span class="toctext">Reactions</span></a> <ul> <li class="toclevel-2 tocsection-94"><a href="#Executive_branch"><span class="tocnumber">17.1</span> <span class="toctext">Executive branch</span></a></li> <li class="toclevel-2 tocsection-95"><a href="#Congress"><span class="tocnumber">17.2</span> <span class="toctext">Congress</span></a> <ul> <li class="toclevel-3 tocsection-96"><a href="#Republicans"><span class="tocnumber">17.2.1</span> <span class="toctext">Republicans</span></a></li> <li class="toclevel-3 tocsection-97"><a href="#Democrats"><span class="tocnumber">17.2.2</span> <span class="toctext">Democrats</span></a></li> </ul> </li> <li class="toclevel-2 tocsection-98"><a href="#Media"><span class="tocnumber">17.3</span> <span class="toctext">Media</span></a></li> </ul> </li> <li class="toclevel-1 tocsection-99"><a href="#Recent_news"><span class="tocnumber">18</span> <span class="toctext">Recent news</span></a></li> <li class="toclevel-1 tocsection-100"><a href="#See_also"><span class="tocnumber">19</span> <span class="toctext">See also</span></a></li> <li class="toclevel-1 tocsection-101"><a href="#External_links"><span class="tocnumber">20</span> <span class="toctext">External links</span></a></li> <li class="toclevel-1 tocsection-102"><a href="#Footnotes"><span class="tocnumber">21</span> <span class="toctext">Footnotes</span></a></li> </ul> </div> </div> <p><br /> The rollout date was met with high demand for the website, both by those seeking insurance and those curious to see how the site worked. Attempts to use the website resulted in errors, including: </p> <ul><li>Error messages while creating an account and trying to log in</li> <li>Data transfer problems from the exchange to healthcare providers</li> <li>Errors in price quotes when not logged in</li> <li>Lack of ability to sign up directly through individual insurance providers</li></ul> <p>In an October 30, 2013, hearing before the <a href="/United_States_House_of_Representatives" title="United States House of Representatives">House</a> <a href="/United_States_House_Committee_on_Energy_and_Commerce" class="mw-redirect" title="United States House Committee on Energy and Commerce">Energy and Commerce Committee</a>, <a href="/U.S._Department_of_Health_and_Human_Services" title="U.S. Department of Health and Human Services">Health and Human Services Secretary</a> <a href="/Kathleen_Sebelius" title="Kathleen Sebelius">Kathleen Sebelius</a> stated, "Hold me accountable for the debacle. I’m responsible."<sup id="cite_ref-wapoSebelius_6-0" class="reference"><a href="#cite_note-wapoSebelius-6">[6]</a></sup> </p><p>The first official report from the Obama administration was released November 13, 2013, covering October enrollment numbers. The report stated 26,794 users completed enrollment through the <i>Healthcare.gov</i> federal exchange. Another 79,391 users were able to enroll in the 15 state exchanges, bringing the total enrollment to 106,185 in October. Prior to rollout, the administration estimated 500,000 would sign up in the first month.<sup id="cite_ref-njoctenrollment_7-0" class="reference"><a href="#cite_note-njoctenrollment-7">[7]</a></sup><sup id="cite_ref-Octofficialreport_8-0" class="reference"><a href="#cite_note-Octofficialreport-8">[8]</a></sup> </p><p>On November 22, 2013, the Obama administration announced an eight-day extension on completing applications for coverage starting January 1, 2014. The deadline to complete the application was moved from December 15 to December 23, 2013. Additionally, the 2014 open enrollment period was pushed back from the original October 15 start date to November 15, 2014, just after midterm elections.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9">[9]</a></sup> On November 25, 2013, the administration announced the Small Business Health Options Program (SHOP) would be delayed by one year. The program was supposed to be rolled out in October 2013 but was delayed until November 2014. Employers seeking the tax credit before the federal exchange rolls out SHOP in 2014 had to use an insurance broker to sign up for eligible plans. The small business program delay did not impact states with <a href="/State_health_insurance_exchanges" class="mw-redirect" title="State health insurance exchanges">state-run exchanges</a>.<sup id="cite_ref-10" class="reference"><a href="#cite_note-10">[10]</a></sup> </p><p>On April 10, 2014, <a href="/Kathleen_Sebelius" title="Kathleen Sebelius">Kathleen Sebelius</a> resigned from her post as a result of the troubled rollout of Obamacare.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11">[11]</a></sup> </p> <h2><span class="mw-headline" id="Website_usage">Website usage</span></h2> <p>The federal government expected that seven million Americans who were previously uninsured would buy a health insurance plan by March 31, 2014. The White House hoped to have about 2.7 million of the enrollees be young adults in order to offset the costs of insuring those with pre-existing conditions.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12">[12]</a></sup><sup id="cite_ref-yahoo_13-0" class="reference"><a href="#cite_note-yahoo-13">[13]</a></sup> The administration expected about 500,000 enrollees by the end of October 2013, but only 106,185 were enrolled.<sup id="cite_ref-njoctenrollment_7-1" class="reference"><a href="#cite_note-njoctenrollment-7">[7]</a></sup> </p><p>According to Jeffrey Zients, the leader of the administration's "tech surge," on October 25, 2013, the success rate of those attempting to create an account was up to 90 percent, but there were still problems completing applications, where "[a]s few as three out of 10" were accepted.<sup id="cite_ref-politicoZients_14-0" class="reference"><a href="#cite_note-politicoZients-14">[14]</a></sup> </p> <h3><span class="mw-headline" id="Number_of_website_visitors">Number of website visitors</span></h3> <ul><li>The official HHS report released May 1, 2014, noted the number of unique visitors to the state and federal exchanges was 98.3 million. The number of calls to the call centers was 33.3 million.<sup id="cite_ref-Marchofficialreport_15-0" class="reference"><a href="#cite_note-Marchofficialreport-15">[15]</a></sup></li> <li>The official HHS report released March 11, 2014, noted the number of unique visitors to the state and federal exchanges was nearly 75 million. The number of calls to the call centers was over 19 million.<sup id="cite_ref-Febofficialreport_16-0" class="reference"><a href="#cite_note-Febofficialreport-16">[16]</a></sup></li> <li>The official HHS report released February 12, 2014, noted the number of unique visitors to the state and federal exchanges was nearly 64 million. The number of calls to the call centers was 16 million.<sup id="cite_ref-Janofficialreport_17-0" class="reference"><a href="#cite_note-Janofficialreport-17">[17]</a></sup></li> <li>The official HHS report released January 13, 2014, noted the number of unique visitors to the state and federal exchanges was 53.2 million. The number of calls to the call centers was 11.3 million.<sup id="cite_ref-Decofficialreport_18-0" class="reference"><a href="#cite_note-Decofficialreport-18">[18]</a></sup></li> <li>The official HHS report released December 11, 2013, noted the number of unique visitors to the state and federal exchanges was 39.1 million. The number of calls to the call centers was 5.2 million.<sup id="cite_ref-Novofficialreport_19-0" class="reference"><a href="#cite_note-Novofficialreport-19">[19]</a></sup></li> <li>The official HHS report released November 13, 2013, noted the number of unique visitors to the state and federal exchanges was 26.9 million. The number of calls to the call centers was 3.2 million.<sup id="cite_ref-Octofficialreport_8-1" class="reference"><a href="#cite_note-Octofficialreport-8">[8]</a></sup></li> <li>As of October 21, 2013, the website had had 20 million visits.<sup id="cite_ref-rockystart_2-1" class="reference"><a href="#cite_note-rockystart-2">[2]</a></sup></li></ul> <h3><span class="mw-headline" id="Number_of_enrollees">Number of enrollees</span></h3> <h4><span id="March.2FApril_enrollment_official_report"></span><span class="mw-headline" id="March/April_enrollment_official_report">March/April enrollment official report</span></h4> <p>The <a target="_blank" rel="noreferrer noopener" class="external text" href="http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Apr2014/ib_2014Apr_enrollment.pdf">official report</a> for the closing of the open enrollment period was released May 1, 2014. Below are some notes from the report: </p> <ul><li>At the conclusion of the open enrollment period, over 8 million users had selected a plan. Of those signups, 5.4 million signed up through the federal exchange.<sup id="cite_ref-Marchofficialreport_15-1" class="reference"><a href="#cite_note-Marchofficialreport-15">[15]</a></sup></li> <li>Of the signups, 34 percent were age 34 and under, while 48 percent were between the ages of 45 and 64.<sup id="cite_ref-Marchofficialreport_15-2" class="reference"><a href="#cite_note-Marchofficialreport-15">[15]</a></sup></li></ul> <h4><span class="mw-headline" id="February_enrollment_official_report">February enrollment official report</span></h4> <p>The <a target="_blank" rel="noreferrer noopener" class="external text" href="http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Mar2014/ib_2014mar_enrollment.pdf">official report for February enrollment</a> was released March 11, 2014. Below are some notes from the report: </p> <ul><li>Through the first five months of the six month enrollment period, 4.2 million users had selected a plan. Of those signups, 2.6 million signed up through the federal exchange.<sup id="cite_ref-Febofficialreport_16-1" class="reference"><a href="#cite_note-Febofficialreport-16">[16]</a></sup></li> <li>Of the signups, 31 percent were age 34 and under.<sup id="cite_ref-Febofficialreport_16-2" class="reference"><a href="#cite_note-Febofficialreport-16">[16]</a></sup></li></ul> <h4><span class="mw-headline" id="January_enrollment_official_report">January enrollment official report</span></h4> <p>The <a target="_blank" rel="noreferrer noopener" class="external text" href="http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Feb2014/ib_2014feb_enrollment.pdf">official report for January enrollment</a> was released February 12, 2014. Below are some notes from the report: </p> <ul><li>Through the first four months of the six month enrollment period, 3.3 million users had selected a plan. Of those signups, 1.9 million signed up through the federal exchange.<sup id="cite_ref-Janofficialreport_17-1" class="reference"><a href="#cite_note-Janofficialreport-17">[17]</a></sup></li> <li>Of the signups, 31 percent were under the age of 34, while 53 percent were between the ages of 45 and 64.<sup id="cite_ref-Janofficialreport_17-2" class="reference"><a href="#cite_note-Janofficialreport-17">[17]</a></sup></li></ul> <h4><span class="mw-headline" id="December_enrollment_official_report">December enrollment official report</span></h4> <p>The <a target="_blank" rel="noreferrer noopener" class="external text" href="http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Jan2014/ib_2014jan_enrollment.pdf">official report for December enrollment</a> was released January 13, 2014. Below are some notes from the report: </p> <ul><li>Through the first three months of the six month enrollment period, 2.1 million users had selected a plan. Of those signups, 1.2 million signed up through the federal exchange.<sup id="cite_ref-Decofficialreport_18-1" class="reference"><a href="#cite_note-Decofficialreport-18">[18]</a></sup></li> <li>Of those who signed up, 30 percent were age 34 and under, while 55 percent were between the ages of 45 and 64.<sup id="cite_ref-Decofficialreport_18-2" class="reference"><a href="#cite_note-Decofficialreport-18">[18]</a></sup></li></ul> <h4><span class="mw-headline" id="November_enrollment_official_report">November enrollment official report</span></h4> <p>The <a target="_blank" rel="noreferrer noopener" class="external text" href="http://aspe.hhs.gov/health/reports/2013/MarketPlaceEnrollment/Dec2013/ib_2013dec_enrollment.pdf">official report for November enrollment</a> was released December 11, 2013. Below are some notes from the report: </p> <ul><li>Through the first two months of the six month enrollment period, 365,000 users had selected a plan. Of those signups, 137,000 signed up through the federal exchange.<sup id="cite_ref-Novofficialreport_19-1" class="reference"><a href="#cite_note-Novofficialreport-19">[19]</a></sup></li> <li>The total applications filled out on state and federal exchanges totaled 1.8 million, which represented 3.7 million individuals.<sup id="cite_ref-Novofficialreport_19-2" class="reference"><a href="#cite_note-Novofficialreport-19">[19]</a></sup></li></ul> <h4><span class="mw-headline" id="October_enrollment_official_report">October enrollment official report</span></h4> <p>The <a target="_blank" rel="noreferrer noopener" class="external text" href="http://online.wsj.com/public/resources/documents/rpt_enrollment11132013.pdf">first official report</a> on <i>Healthcare.gov</i> enrollment was released November 13, 2013. According to a report by the <i>Washington Post</i>, the White House's definition of enrolled included not only those who have fully enrolled and paid a premium but also those who have an insurance plan selected in their online shopping cart. Generally, insurance companies only count people who have paid a premium in their official counts.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20">[20]</a></sup> The official report stated 106,000 people enrolled in plans through the state and federal exchanges.<sup id="cite_ref-njoctenrollment_7-2" class="reference"><a href="#cite_note-njoctenrollment-7">[7]</a></sup> Below are more notes from the report. </p> <ul><li>Through the first month of the six month enrollment period, 106,000 enrollees was 1.5% of the expected total by the end of the period. The enrollment figure included those who have "selected a plan by clicking a button on the website page" as well as those who have paid their premium.<sup id="cite_ref-Octofficialreport_8-2" class="reference"><a href="#cite_note-Octofficialreport-8">[8]</a></sup></li> <li>The total applications filled out on state and federal exchanges totaled 846,000 which represented 1.5 million individuals. Another 259,000 applications were submitted by paper or call centers.<sup id="cite_ref-Octofficialreport_8-3" class="reference"><a href="#cite_note-Octofficialreport-8">[8]</a></sup></li> <li>Based on the history of similar programs (Federal Employees Health Benefits Program, <a href="/Medicare" title="Medicare">Medicare</a> Part D, Massachusetts' Commonwealth Care and the <a href="/Children%27s_Health_Insurance_Program" title="Children's Health Insurance Program">Children's Health Insurance Program</a>), the report suggested enrollment spikes would follow "'action-forcing' events" such as the enrollment deadline and the start date for receiving benefits.<sup id="cite_ref-Octofficialreport_8-4" class="reference"><a href="#cite_note-Octofficialreport-8">[8]</a></sup></li> <li>The report stated 18,000 assisters "informally" reached 450,000 consumers in the federal marketplace states.<sup id="cite_ref-Octofficialreport_8-5" class="reference"><a href="#cite_note-Octofficialreport-8">[8]</a></sup></li> <li>Washington, D.C., Hawaii and Oregon enrollment numbers were not available in the report.<sup id="cite_ref-Octofficialreport_8-6" class="reference"><a href="#cite_note-Octofficialreport-8">[8]</a></sup></li></ul> <h4><span class="mw-headline" id="Early_enrollment_estimates">Early enrollment estimates</span></h4> <ul><li>Citing an anonymous source close to the website, a <i>Wall Street Journal</i> report suggested the enrollment numbers for the federal exchanges through the first week of November were fewer than 50,000. An HHS spokesperson would not comment on the numbers, but suggested most enrollees would join later in the process.<sup id="cite_ref-21" class="reference"><a href="#cite_note-21">[21]</a></sup></li></ul> <ul><li>CBS News reported on October 31 that only six people enrolled in the system on October 1, 2013, the first day the exchanges opened.<sup id="cite_ref-cbslittle_22-0" class="reference"><a href="#cite_note-cbslittle-22">[22]</a></sup> The "early day enrollment" figures were revealed in internal "war room" documents turned over in response to a subpoena from the <a href="/United_States_House_of_Representatives_Committee_on_Oversight_and_Government_Reform" class="mw-redirect" title="United States House of Representatives Committee on Oversight and Government Reform">House Oversight Committee</a>.<sup id="cite_ref-23" class="reference"><a href="#cite_note-23">[23]</a></sup></li></ul> <ul><li>To meet the goal of 7 million enrollees by March 2013, the system would have required an average of 39,000 enrollees each day.<sup id="cite_ref-cbslittle_22-1" class="reference"><a href="#cite_note-cbslittle-22">[22]</a></sup></li></ul> <ul><li>As of October 21, 2013, an <i>NPR</i> report estimated 129,000 people had enrolled between the federal and state exchanges, although the definition of "enrolled" by the state systems was debated.<sup id="cite_ref-npr_24-0" class="reference"><a href="#cite_note-npr-24">[24]</a></sup> "Enrolled" could refer to the number of people who have created accounts on the website but not yet signed up, or it could mean the number of people who have selected a plan.<sup id="cite_ref-mccardle_3-1" class="reference"><a href="#cite_note-mccardle-3">[3]</a></sup> The definition in some states for the official numbers was someone who had paid their premium, but premiums weren't due until December 15.<sup id="cite_ref-npr_24-1" class="reference"><a href="#cite_note-npr-24">[24]</a></sup> Meanwhile, also on October 21, senior Obama administration officials claimed 476,000 health insurance applications had been filed through the website.<sup id="cite_ref-NBC_25-0" class="reference"><a href="#cite_note-NBC-25">[25]</a></sup></li></ul> <h4><span class="mw-headline" id="Enrollment_goals">Enrollment goals</span></h4> <p>The federal government expected that 7 million Americans who were previously uninsured would buy a health insurance plan by the end of the first enrollment period on March 31, 2014. The White House hoped that about 2.7 million of the enrollees would be young adults in order to offset the costs of insuring those with pre-existing conditions. Ezra Klein of the <i>Washington Post</i>, wrote on November 26, 2013 that in order for the law to be successful, 39 percent of the new signups should be young, healthy people. If the number of young and healthy people did not reach that number, Klein suggested the premium costs for next year could be disastrous. However, in 2015 the RAND Corporation released an analysis showing that premiums would only increase by about 3 percent if the government failed to meet its enrollment goals for young adults.<sup id="cite_ref-26" class="reference"><a href="#cite_note-26">[26]</a></sup><sup id="cite_ref-27" class="reference"><a href="#cite_note-27">[27]</a></sup><sup id="cite_ref-28" class="reference"><a href="#cite_note-28">[28]</a></sup> </p> <h4><span class="mw-headline" id="FOIA_request_filed_by_media_outlets">FOIA request filed by media outlets</span></h4> <p>A number of media outlets, including CNN, ABC and MSNBC, filed <a href="/Freedom_of_Information_Act" title="Freedom of Information Act">Freedom of Information Act</a> (FOIA) requests in October and November 2013. Among these requests, MSNBC asked for "up to date number of people who have enrolled in the government's healthcare exchanges set up by the [Affordable Care Act]," while ABC News requested "the documents detailing and describing the actual and potential costs associated with addressing flaws in [the HealthCare.gov] website from Oct. 1, 2013 to Oct. 21, 2013."<br /> </p><p>President Obama had hinted that he was aware of enrollment figures, with speeches that allude to "thousands" having signed up since the launch of the website.<sup id="cite_ref-29" class="reference"><a href="#cite_note-29">[29]</a></sup> </p> <h4><span class="mw-headline" id="Increased_funding_for_minority_enrollment">Increased funding for minority enrollment</span></h4> <p>HHS announced the Partnership to Increase Coverage in Communities on September 11, 2014, which was established to disburse funding to organizations focused on helping minorities enroll in healthcare coverage. The <a href="/U.S._Centers_for_Disease_Control_and_Prevention" title="U.S. Centers for Disease Control and Prevention">Centers for Disease Control and Prevention</a> estimated that only 40 percent of Latinos and 25 percent of African Americans were enrolled following the first enrollment period. The director of the Office of Minority Health stated, "Racial and ethnic minorities have lower rates of health insurance coverage than the national average and stand to benefit greatly from the Affordable Care Act."<sup id="cite_ref-30" class="reference"><a href="#cite_note-30">[30]</a></sup> </p> <h3><span class="mw-headline" id="Type_of_enrollees">Type of enrollees</span></h3> <p>Ezra Klein of the <i>Washington Post</i>, wrote on November 26, 2013, that when asked what the measurement of success would be for enrollment on <i>Healthcare.gov</i>, the administration claimed the ratio for success would be having 39 percent of the signups be young, healthy people. If the number of young and healthy people did not reach that number, Klein suggested the premium costs for next year could be disastrous.<sup id="cite_ref-31" class="reference"><a href="#cite_note-31">[31]</a></sup> </p> <h4><span class="mw-headline" id="Awareness_polling">Awareness polling</span></h4> <ul><li>A Gallup poll released December 2, 2013, showed that 37 percent of people under the age of 30 were unfamiliar with the ACA, while 26 percent between ages 30-49 shared the same unfamiliarity. Only 22 percent of the ages of 50-64 were not familiar. The success of the law depends highly on younger, healthier people enrolling.<sup id="cite_ref-32" class="reference"><a href="#cite_note-32">[32]</a></sup></li></ul> <h2><span class="mw-headline" id="Project_benchmarks">Project benchmarks</span></h2> <p>According to a <i>Washington Post</i> report, no benchmarks were used during the development of the website. Contractor CGI Federal was not required to lay out performance benchmarks in their contract, a typical requirement for IT jobs. The administration did not set official goals until after launch, when they determined an internal goal of having the website be able to handle 80 percent of signups. The team of presidential innovation fellows assigned to help fix the site, noted that in order to meet the goal of 80 percent, the error rate for the website would need to be under 1 percent and the average load time needed to be less than half a second per page.<sup id="cite_ref-33" class="reference"><a href="#cite_note-33">[33]</a></sup> </p> <h2><span class="mw-headline" id="Pre-launch_testing">Pre-launch testing</span></h2> <ul><li>A month prior to Healthcare.gov going live, a test run was conducted on the parts of the website that were ready for testing. The problems found at that time led the test team to try to persuade the <a href="/Centers_for_Medicare_and_Medicaid_Services" title="Centers for Medicare and Medicaid Services">Centers for Medicare and Medicaid Services</a> (CMS), the agency in charge of the website, to push back the October 1, 2013 launch date to have time to resolve the identified problems.<sup id="cite_ref-wapo_34-0" class="reference"><a href="#cite_note-wapo-34">[34]</a></sup></li></ul> <ul><li>Testifying before <a href="/Congress" class="mw-redirect" title="Congress">Congress</a> on October 24, 2013, UnitedHealth Group's Andrew Slavitt and a CGI Federal senior vice president, Cheryl Campbell, stated they would have preferred months of testing instead of leaving only two weeks to test the entire system. CMS, not the contractors were responsible for testing, according to Campbell. Slavitt claimed, "We informed C.M.S. that more testing was necessary."<sup id="cite_ref-nythearings_35-0" class="reference"><a href="#cite_note-nythearings-35">[35]</a></sup></li></ul> <ul><li>A final test, days before launch, was conducted to test traffic volume. The objective of the volume test was to determine whether the website could handle "tens of thousands of consumers at the same time." During this test, the system crashed after a simulation that involved several hundred simultaneous users.<sup id="cite_ref-wapo_34-1" class="reference"><a href="#cite_note-wapo-34">[34]</a></sup></li></ul> <ul><li>According to a statement by White House press secretary <a href="/Jay_Carney" title="Jay Carney">Jay Carney</a> on October 22, "We did not know until the problems manifested themselves after the launch that they would be as significant” as they were.<sup id="cite_ref-carneynot_36-0" class="reference"><a href="#cite_note-carneynot-36">[36]</a></sup></li></ul> <ul><li><a href="/Kathleen_Sebelius" title="Kathleen Sebelius">Kathleen Sebelius</a> said on October 22 that President <a href="/Barack_Obama" title="Barack Obama">Barack Obama</a> was not aware of the scale of the problems prior to the October 1 launch.<sup id="cite_ref-carneynot_36-1" class="reference"><a href="#cite_note-carneynot-36">[36]</a></sup></li></ul> <h3><span class="mw-headline" id="Problems_were_known">Problems were known</span></h3> <p>According to a memo obtained by <i>CBS News</i>, in 2010 a top administration consultant, David Cutler, attempted to advise economic adviser Larry Summers of possible problems: "I do not believe the relevant members of the administration understand the president’s vision or have the capability to carry it out."<sup id="cite_ref-37" class="reference"><a href="#cite_note-37">[37]</a></sup> </p> <h3><span class="mw-headline" id="Independent_pre-launch_assessment">Independent pre-launch assessment</span></h3> <p>The private consulting firm, McKinsey & Co., assessed the progress of the website components in early 2013. The company noted the lack in sufficient time set aside for testing and revising, as well as the project not having one single leader and decision-maker. Some problems the McKinsey report covered were not problematic such as call center wait times and data hub liability. When asked about the report, a White House spokesman stated, "flags were definitely raised throughout the development of the Web site, as would be the case for any IT project this complex. . . . But nobody anticipated the size and scope of the problems we experienced once the site launched."<sup id="cite_ref-38" class="reference"><a href="#cite_note-38">[38]</a></sup> </p> <div id="div-gpt-ad-1610395138232-0"><script>googletag.cmd.push(function() { googletag.display("div-gpt-ad-1610395138232-0"); });</script></div><h2><span class="mw-headline" id="Issues_with_rollout">Issues with rollout</span></h2> <h3><span class="mw-headline" id="Eligibility_verification">Eligibility verification</span></h3> <p>The Government Accountability Office (GAO) conducted a sting operation on the verification system of the federal health insurance exchange in which they submitted fake account information while signing up. The verification system allowed 11 of the 18 fake accounts to sign up for subsidized health insurance. The GAO tried telephone, online, and in-person signups. The attempts at using in-person navigators failed. Several Republican members of Congress requested the operation prior to the <a class="mw-selflink selflink">Healthcare.gov website rollout</a>. Acting Director of Forensic Audits Seto Bagdoyan stated that the investigation was ongoing and members of Congress couldn't draw any conclusions from the small sample size. Bagdoyan admitted that the sample raised questions about the effectiveness of the verification program but did not suggest that the sting was any more than a small sample.<sup id="cite_ref-39" class="reference"><a href="#cite_note-39">[39]</a></sup><sup id="cite_ref-40" class="reference"><a href="#cite_note-40">[40]</a></sup> </p> <h3><span class="mw-headline" id="New_accounts_and_logging_in">New accounts and logging in</span></h3> <p>In its first week, the website attracted as many as 250,000 users at a time. This exceeded administration estimates of between 50,000 and 60,000 simultaneous users.<sup id="cite_ref-newaccount_41-0" class="reference"><a href="#cite_note-newaccount-41">[41]</a></sup> The website produced error messages to most users trying to register. Once logged in, other error messages greeted users informing them that the system was down or that their accounts "couldn't be created at this time." The ability to chat with agents online timed out in a number of reported instances. The call center wait list was at 30 minutes or more.<sup id="cite_ref-42" class="reference"><a href="#cite_note-42">[42]</a></sup> </p><p>U.S. Chief Technology Officer Todd Park said the high traffic to the website caused the site to get overloaded, and many predicted the issues in the software would be resolved within a few weeks.<sup id="cite_ref-newaccount_41-1" class="reference"><a href="#cite_note-newaccount-41">[41]</a></sup> In the first week, only 1 percent of the estimated 3.7 million people who tried to register actually enrolled in a plan.<sup id="cite_ref-43" class="reference"><a href="#cite_note-43">[43]</a></sup> </p><p>CNBC published a survey on October 17 conducted by uSamp, an online market research firm. This survey found that 20 percent of those surveyed were able to log onto Healthcare.gov without experiencing technical issues.<sup id="cite_ref-cnbc_44-0" class="reference"><a href="#cite_note-cnbc-44">[44]</a></sup> 830 people were surveyed: </p> <ul><li>50 percent received a message asking them to "wait/try again later."<sup id="cite_ref-cnbc_44-1" class="reference"><a href="#cite_note-cnbc-44">[44]</a></sup></li> <li>38 percent said they had "received an error message."<sup id="cite_ref-cnbc_44-2" class="reference"><a href="#cite_note-cnbc-44">[44]</a></sup></li> <li>31 percent were "informed that the system was unavailable."<sup id="cite_ref-cnbc_44-3" class="reference"><a href="#cite_note-cnbc-44">[44]</a></sup></li> <li>25 percent were "not able to create an account."<sup id="cite_ref-cnbc_44-4" class="reference"><a href="#cite_note-cnbc-44">[44]</a></sup></li></ul> <h3><span class="mw-headline" id="Data_transfer_problems">Data transfer problems</span></h3> <p>Once users enrolled in the process, <i>Bloomberg</i> reported insurance companies were receiving incorrect information from the Healthcare.gov exchanges. The information passed on to the insurance companies was often either in inoperable files or missing vital information.<sup id="cite_ref-bloombergdata_45-0" class="reference"><a href="#cite_note-bloombergdata-45">[45]</a></sup> Other issues included the exchanges sending multiple files for each enrollee, mixing enrollments and cancellations and reporting spouses as children.<sup id="cite_ref-politicoenrollment_46-0" class="reference"><a href="#cite_note-politicoenrollment-46">[46]</a></sup><sup id="cite_ref-47" class="reference"><a href="#cite_note-47">[47]</a></sup> Some companies resorted to re-entering data by hand to correct the errors. The companies feared that if the website was fixed, allowing all users to enroll, the flood of bad data could have lead to major problems.<sup id="cite_ref-bloombergdata_45-1" class="reference"><a href="#cite_note-bloombergdata-45">[45]</a></sup> </p> <h3><span class="mw-headline" id="Errors_in_price_quotes">Errors in price quotes</span></h3> <p>On October 20, 2013, the administration released the new "shop and browse" feature, allowing consumers to look at pricing without having to fully login to the system. While they hoped this would ease the traffic on the actual exchange, <i>CBS News</i> discovered the new feature was often misquoting people on what plans may cost. Instead of using consumers' birthdays to get an accurate price quote, they only gave the options of "Under 49" and "Over 50," meaning price quotes could be significantly different from the actual plan for a person's age. Insurance executives claimed the quotes were misleading and useless.<sup id="cite_ref-48" class="reference"><a href="#cite_note-48">[48]</a></sup> </p><p>In general, the Healthcare.gov website understated actual prices due to this system error. As an example of the error caused by this website feature, <i>CBS News</i> found that Healthcare.gov estimated that a 48-year-old resident of North Carolina who was not subsidy-eligible would have had to pay $231 a month for a silver-level plan. However, the actual price was $360 a month.<sup id="cite_ref-49" class="reference"><a href="#cite_note-49">[49]</a></sup> </p> <h3><span class="mw-headline" id="Direct_enrollment">Direct enrollment</span></h3> <p>Insurers and the federal exchanges were missing the link that would allow consumers to enroll in an insurance plan directly through individual companies and still receive federal subsidies, according to an October 21, 2013 report in <i>Politico</i>. Insurers were supposed to be able to accept an individual's application and tap into the federal hub to determine their subsidy eligibility, easing the traffic to Healthcare.gov. The <a href="/U.S._Department_of_Health_and_Human_Services" title="U.S. Department of Health and Human Services">Department of Health and Human Services</a> hoped to have the backdoor open by the end of October 2013.<sup id="cite_ref-politicoenrollment_46-1" class="reference"><a href="#cite_note-politicoenrollment-46">[46]</a></sup> </p><p>On November 22, 2013, the <a href="/Centers_for_Medicare_and_Medicaid_Services" title="Centers for Medicare and Medicaid Services">Centers for Medicare and Medicaid Services</a> (CMS) announced direct enrollment would begin to be rolled out in Ohio, Florida and Texas. A CMS spokeswoman acknowledged the option of direct enrollment has "been there from the start," but the site's problems were only recently fixed to the point that insurers could access premiums and tax credits for users.<sup id="cite_ref-50" class="reference"><a href="#cite_note-50">[50]</a></sup> </p> <h3><span class="mw-headline" id="Transfers_from_Medicaid">Transfers from Medicaid</span></h3> <p>On November 1, 2013, the federal exchange had to transfer <a href="/Medicaid" title="Medicaid">Medicaid</a> applications and beneficiaries to state agencies. Bobby Peterson, executive director of ABC for Health in <a href="/Madison,_Wisconsin" title="Madison, Wisconsin">Madison</a>, <a href="/Wisconsin" title="Wisconsin">Wisconsin</a>, said this date posed a test to the system: "If the marketplace isn’t working well by the first part of November, I think people are going to start raising major concerns."<sup id="cite_ref-politico_51-0" class="reference"><a href="#cite_note-politico-51">[51]</a></sup> </p> <h3><span class="mw-headline" id="Data_hub_outages">Data hub outages</span></h3> <div class="thumb tright"><div class="thumbinner" style="width:402px;"><a href="/File:Sebelius_hearing_website_down.jpg" class="image"><img alt="" src="https://ballotpedia.s3.amazonaws.com/images/thumb/8/8b/Sebelius_hearing_website_down.jpg/400px-Sebelius_hearing_website_down.jpg" decoding="async" width="400" height="297" class="thumbimage" srcset="https://ballotpedia.s3.amazonaws.com/images/thumb/8/8b/Sebelius_hearing_website_down.jpg/600px-Sebelius_hearing_website_down.jpg 1.5x, https://ballotpedia.s3.amazonaws.com/images/8/8b/Sebelius_hearing_website_down.jpg 2x" data-file-width="755" data-file-height="561" /></a> <div class="thumbcaption"><div class="magnify"><a href="/File:Sebelius_hearing_website_down.jpg" class="internal" title="Enlarge"></a></div>A tweet by @zbyronwolf captured Sebelius and the struggling website on <i>CNN</i> during her hearing October 30, 2013.</div></div></div> <p>On Sunday, October 27, 2013, the data hub for Healthcare.gov as well as exchanges for 14 states and the District of Columbia went down. The hub was operated by Verizon Communication Inc. and was down for about a day, blocking enrollment.<sup id="cite_ref-chitrib_52-0" class="reference"><a href="#cite_note-chitrib-52">[52]</a></sup> Verizon and the Department of Health and Human Services declined to comment.<sup id="cite_ref-53" class="reference"><a href="#cite_note-53">[53]</a></sup> </p><p>On Tuesday, October 29, 2013, the data hub experienced another outage. The outage was first noticed by the Connecticut state healthcare exchange, Access Health CT, which like the other 14 <a href="/State_health_insurance_exchanges" class="mw-redirect" title="State health insurance exchanges">state healthcare exchanges</a>, uses data from the hub to function. The Connecticut exchange issued a statement that said, "Access Health CT was informed by CMS (Center for Medicare and Medicaid Services) that the Federal Data Services Hub is currently experiencing an outage." An official from the Department of Health and Social Services acknowledged the problem, writing, "Tonight, Verizon Terremark again experienced network issues in their data center that caused a system outage impacting the federal data services hub and the Healthcare.gov marketplace application."<sup id="cite_ref-54" class="reference"><a href="#cite_note-54">[54]</a></sup> </p> <h4><span class="mw-headline" id="Post-enrollment_period_data_inconsistencies">Post-enrollment period data inconsistencies</span></h4> <p>The HHS inspector general released a report in June 2014 that from October to December 2013, 2.6 million data inconsistencies were not able to be resolved and pressured the <a href="/Centers_for_Medicare_and_Medicaid_Services" title="Centers for Medicare and Medicaid Services">Centers for Medicare and Medicaid Services</a> to establish a public plan for resolving the inconsistencies. The healthcare exchange's data hub was designed to fact check applications against federal information from the <a href="/Internal_Revenue_Service" title="Internal Revenue Service">Internal Revenue Service</a>, <a href="/Social_Security_Administration" class="mw-redirect" title="Social Security Administration">Social Security Administration</a> and <a href="/U.S._Department_of_Homeland_Security" title="U.S. Department of Homeland Security">U.S. Department of Homeland Security</a>, but the initial tech issues with the data hub created the inconsistencies that possibly mislead customers about their eligibility to certain plans and tax credits. The inconsistencies that could not be resolved by the federal exchange dealt with citizenship status, income verification, and employee-sponsored minimum essential coverage. Eleven state marketplaces also reported inconsistencies during the rollout, but only four states have reported having unresolved problems. If the customer received a premium tax credit due to an inconsistency, the IRS would likely either seek benefits that were not supposed to be given or award tax credits to those who should have been eligible. The report stated, "If the applicant chooses the advance premium tax credit, the Internal Revenue Service (IRS) will reconcile the actual credit amount made on behalf of the individual when an individual files a tax return at the close of the year."<sup id="cite_ref-55" class="reference"><a href="#cite_note-55">[55]</a></sup> </p> <h3><span class="mw-headline" id="Website_outages">Website outages</span></h3> <p>During Sebelius' House hearing on October 30, 2013, the website displayed a message stating: </p> <dl><dd>"The system is down at the moment. We are experiencing technical difficulties and hope to have them resolved soon. Please try again later."</dd></dl> <p>Some debate ensued about whether "crash" is the right word to use when a website is not working; several members of Congress during the hearing used the term as a synonym for "the website isn't working." Sebelius, however, advanced the perspective that the website had never "crashed." A spokesperson for the Health and Human Services Department separately backed Sebelius, claiming, "As the secretary says, the site works. But it is slow and has a lot of user errors. But even on the first day, some people could get all the way through the system. So it did not crash. If it crashed, it would have been totally down."<sup id="cite_ref-CNN5_56-0" class="reference"><a href="#cite_note-CNN5-56">[56]</a></sup> </p> <h3><span class="mw-headline" id="Security_concerns">Security concerns</span></h3> <p>Highly-placed government IT officials from the <a href="/Centers_for_Medicare_and_Medicaid_Services" title="Centers for Medicare and Medicaid Services">Centers for Medicare and Medicaid Services</a> wrote a memo several days before the October 1, 2013 launch of Healthcare.gov warning about security risks. The memo said that the risk of security issues was "high."<sup id="cite_ref-57" class="reference"><a href="#cite_note-57">[57]</a></sup> </p><p>Security flaws were said to pose a risk of compromising the privacy of social security numbers and birth dates.<sup id="cite_ref-hillsec_58-0" class="reference"><a href="#cite_note-hillsec-58">[58]</a></sup> </p><p>The memo was made public because the <a href="/United_States_House_of_Representatives_Committee_on_Oversight_and_Government_Reform" class="mw-redirect" title="United States House of Representatives Committee on Oversight and Government Reform">House Oversight Committee</a> requested it. According to the memo, "Due to system readiness issues, the SCA (security control assessment) was only partly completed...This constitutes a risk that must be accepted and mitigated to support the Marketplace Day 1 operations."<sup id="cite_ref-CNNsec_59-0" class="reference"><a href="#cite_note-CNNsec-59">[59]</a></sup> </p><p>The White House, through its spokesperson <a href="/Jay_Carney" title="Jay Carney">Jay Carney</a>, disputed that there was a risk. Carney said that "a process was put into place" to monitor security flaws. He also said, "In any website like this you have to constantly monitor and mitigate any security risks."<sup id="cite_ref-hillsec_58-1" class="reference"><a href="#cite_note-hillsec-58">[58]</a></sup> </p> <h3><span class="mw-headline" id="Manual_back-up_systems">Manual back-up systems</span></h3> <p>On December 11, 2013, Sebelius acknowledged that a manual back-up system was in place temporarily to cover for software that had not yet been built and tested. The systems requiring manual back-ups are the verification process to see that those who sign up are actually enrolled with health insurance companies and a system for paying the subsidies to insurers. When asked about the back-ups, Sebelius stated, "There's a manual workaround for virtually everything that isn't fully automated yet."<sup id="cite_ref-60" class="reference"><a href="#cite_note-60">[60]</a></sup> </p> <h3><span class="mw-headline" id="State_exchange_enrollment_problems">State exchange enrollment problems</span></h3> <p>Fourteen states elected to create their own healthcare exchanges. As of November 12, 2013, signups had reached only 3 percent of their expected enrollment numbers in the 12 states where exchanges were "mostly working smoothly."<sup id="cite_ref-61" class="reference"><a href="#cite_note-61">[61]</a></sup> Following is a list of some problems the individual state exchanges faced. </p> <ul><li><b>California</b>: The Covered California exchanged hosted an event at the Sacramento Convention Center to manually enroll people in health insurance plans. Of the 1,500 people that showed up for the event, 10 applications were completed and 46 others were started by the 300 volunteers present.<sup id="cite_ref-62" class="reference"><a href="#cite_note-62">[62]</a></sup></li> <li><b>Connecticut</b>: President Obama pointed out Connecticut's Access Health CT as a success attracting young, health individuals during his October 21, 2013, press conference, but the <i>CT Mirror</i> pointed out that many of the under-35 crowd that signed up would not count toward the private insurers' risk pools because they signed up for CHIP and <a href="/Medicaid" title="Medicaid">Medicaid</a>. The age group with the most signups counting toward the risk pools were those between 55 and 64.<sup id="cite_ref-63" class="reference"><a href="#cite_note-63">[63]</a></sup></li> <li>More than 2,400 <i>Access Health CT</i> users were given incorrect information about the insurance plans they signed up for. Each of the individual plans listed on the website had incorrect information about the deductibles and out-of-pocket costs. One man, John Javaruski got a letter notifying him his plan had gone from a $2,000 out-of-pocket maximum with $0 deductible to $6,250 out-of-pocket maximum with a $3,000 deductible.<sup id="cite_ref-64" class="reference"><a href="#cite_note-64">[64]</a></sup></li> <li><b>Hawaii</b>: The Hawaii Health Connector exchange was not fully launched for consumer use until October 15, 2013, at which point some users experienced problems logging on to the site and accessing insurance options.<sup id="cite_ref-65" class="reference"><a href="#cite_note-65">[65]</a></sup></li> <li><b>Maryland</b>: The executive director of Maryland Health Connection, Rebecca Pearce, resigned December 6, 2013, with no explanation for stepping down. The exchange released a statement stating, "Ms. Pearce worked tirelessly and with tremendous dedication to build Maryland Health Connection over more than two years." The exchange struggled managing two contractors, Noridian Healthcare Solutions LLC and EngagePoint LLC which became involved in a legal conflict in federal court.<sup id="cite_ref-66" class="reference"><a href="#cite_note-66">[66]</a></sup> On March 10, 2014, Rep. <a href="/Andrew_Harris" title="Andrew Harris">Andrew Harris</a> called for a federal investigation by the <a href="/U.S._Department_of_Health_and_Human_Services" title="U.S. Department of Health and Human Services">U.S. Department of Health and Human Services</a> into why the exchange had such a poor rollout. As of March 1, 2014, the state exchange had 38,070 signups.<sup id="cite_ref-67" class="reference"><a href="#cite_note-67">[67]</a></sup></li> <li><b>Massachusetts</b>: The <i>Boston Herald</i> interviewed people trying to sign up on the Massachusetts Health Connector exchange, who had serious concerns. Their concerns included being asked to answer questions about their incarceration after selecting that they had never been incarcerated, being stopped in the application process because of hyphenated names and confusion about deadlines and eligibility for part-time workers and the self-employed.<sup id="cite_ref-68" class="reference"><a href="#cite_note-68">[68]</a></sup></li> <li><b>Minnesota</b>: While the MNsure exchange posted a chart showing the income ranges eligible for tax credits, many consumers in those ranges were not eligible to receive the credits because it was deemed certain health plans were low enough in cost to fit with their income. A spokesperson explained the situation, "So while they technically would be eligible for a tax credit, they fall into that income range. It's just that the premiums are so low, that they meet the affordability threshold."<sup id="cite_ref-69" class="reference"><a href="#cite_note-69">[69]</a></sup></li> <li><b>Oregon</b>: The Oregon exchange, Cover Oregon, was not completed as of November 10, 2013, with no specific timeline for when it might launch. A communications officer for Cover Oregon stated, "We stuck to the vision, and we're experiencing now the bumps that go along with having a grand vision that doesn't work out exactly the way you hope it will."<sup id="cite_ref-70" class="reference"><a href="#cite_note-70">[70]</a></sup> The executive director of Cover Oregon resigned in January 2014.<sup id="cite_ref-71" class="reference"><a href="#cite_note-71">[71]</a></sup></li> <li><b>Vermont</b>: Governor <a href="/Peter_Shumlin" title="Peter Shumlin">Peter Shumlin</a> announced on October 31, 2013, that existing coverage, which was to expire on December 31, 2013, would be extended to March 31, 2013, due to website problems.<sup id="cite_ref-72" class="reference"><a href="#cite_note-72">[72]</a></sup></li> <li><b>Washington</b>: About 8,000 Washington residents received letters notifying them that those who enrolled through the Washington Health Benefits Exchange were given an incorrect estimate. The exchange used the federal data hub to calculate tax credits but submitted monthly income to the hub, instead of the annual income they used to calculate the credits. The result was early enrollees were told they would receive higher tax credits than they were eligible for.<sup id="cite_ref-73" class="reference"><a href="#cite_note-73">[73]</a></sup></li> <li><b>Washington, D.C.</b>: In the first month after the site's launch, five Washington, D.C. residents successfully enrolled in the DC HealthLink exchange. A report showed more completed applications for health insurance, but they had not yet paid their premiums to be counted as enrolled. The exchange information was obtained by Sens. <a href="/Chuck_Grassley" title="Chuck Grassley">Chuck Grassley</a>, (R-IA) and <a href="/Orrin_Hatch" title="Orrin Hatch">Orrin Hatch</a>, (R-UT).<sup id="cite_ref-74" class="reference"><a href="#cite_note-74">[74]</a></sup></li></ul> <h2><span class="mw-headline" id="Analysis_of_website_problems">Analysis of website problems</span></h2> <p>A number of theories have been put forward to explain the observed problems with Healthcare.gov. </p> <h3><span class="mw-headline" id="Outdated_technology">Outdated technology</span></h3> <p>The "health care exchange was built using 10-year-old technology," according to technology experts quoted in an October 17 article in <i>USA Today</i>. John Engates, the chief technology officer at Rackspace, said, "It is a core problem in the sense of it's fundamental to this thing actually working, but it's not necessarily a problem that the people who wrote HealthCare.gov can get to. Even if they had a perfect system, it still won't work."<sup id="cite_ref-USAtoday_75-0" class="reference"><a href="#cite_note-USAtoday-75">[75]</a></sup> </p> <h3><span class="mw-headline" id="CMS_level_of_expertise">CMS level of expertise</span></h3> <p>The <a href="/Centers_for_Medicare_and_Medicaid_Services" title="Centers for Medicare and Medicaid Services">Centers for Medicare and Medicaid Services</a> (CMS) were in charge of piecing together databases from 55 different contractors, but people involved in the project did not believe the agency had the overall technological and managerial capability to execute a project of the needed complexity, according to the <i>New York Times</i>.<sup id="cite_ref-nytcontractors_76-0" class="reference"><a href="#cite_note-nytcontractors-76">[76]</a></sup> </p> <h3><span class="mw-headline" id="Lines_of_code">Lines of code</span></h3> <p><i>Slate</i> writer Will Oremus suggested that the 500 million lines of code used to create the website was far too many, and any project that size was doomed to fail. As a comparison, the Windows Vista operating system contained 50 million lines and users complained about the system being too slow.<sup id="cite_ref-77" class="reference"><a href="#cite_note-77">[77]</a></sup> </p><p>David Auerbach, also of <i>Slate</i>, disputed the validity of claims made by fellow writer Will Oremus as well as the <i>New York Times</i>. He stated that the lack of detail given by the <i>New York Times</i> source about the amount and type of code and the source placing blame on the CMS' management of the project, could mean the anonymous source was a management-type working for contractor CGI Federal trying to shift blame for the struggling website.<sup id="cite_ref-78" class="reference"><a href="#cite_note-78">[78]</a></sup> </p><p>Dave Kennedy, CEO of Trusted Sec, compared the 500 million lines of code to the Windows 8 operating system, which has about 80 million lines of code. Online banking system usually have between 75 million and 100 million lines of code. Kennedy said he thought that Healthcare.gov should have in the range of 25 million to 50 million lines of code. He adds, "The [500 million lines of code] says right off the bat that something is egregiously wrong. I jumped back when I read that figure. It's just so excessive."<sup id="cite_ref-cnnnofix_79-0" class="reference"><a href="#cite_note-cnnnofix-79">[79]</a></sup> </p> <h3><span class="mw-headline" id="Size_of_project">Size of project</span></h3> <p><i>ComputerWorld</i>, on October 21, reported on a study of websites costing over $10 million. The study showed that of 3,555 projects in the public and private sector, only 6.4 percent were successful. Over 50 percent of those projects suffered problems, such as going over budget, past deadlines or lack of user satisfaction.<sup id="cite_ref-computerworld_80-0" class="reference"><a href="#cite_note-computerworld-80">[80]</a></sup> </p> <h3><span class="mw-headline" id="Rigid_deadline">Rigid deadline</span></h3> <p>Kevin Drum of <i>Mother Jones</i> opined a large part of the problem came from having a release date that was not able to be moved in case of problems. Drum wrote, "They had to ship on October 1. Period. And so now I find myself thinking back to some of those difficult projects. What would have happened if instead of slipping the schedule, I had been forced to ship on the original release date? Answer: the software flatly wouldn't have worked. It wouldn't just have been bad, it would have been an existential catastrophe. And it would have taken many months to fix, not many weeks."<sup id="cite_ref-motherjones_81-0" class="reference"><a href="#cite_note-motherjones-81">[81]</a></sup> </p> <h3><span class="mw-headline" id="Last-minute_design_changes">Last-minute design changes</span></h3> <p>Gail Wilensky, a health analyst who is a former administrator of CMS, said that the federal government gave contractor CGI a number of last-minute design changes and that this hampered their ability to deliver a working website on deadline. </p><p>Arron Kallenberg, a software engineer, said, "Projects that are done rapidly usually have a lot of [repetitive] code. So when you have a problem, instead of debugging something in a single location, you're tracking it down all through the code base."<sup id="cite_ref-cnnnofix_79-1" class="reference"><a href="#cite_note-cnnnofix-79">[79]</a></sup> </p> <h3><span class="mw-headline" id="Lack_of_funds">Lack of funds</span></h3> <p>Don Berwick, a former administrator of CMS for the Obama administration, said that funding for the website was not available when it would have mattered: "The total implementation budget for Obamacare in the first two years, as I recall, was something in the order of $1 billion. The resources were spread quite thin and it was not possible at that time to get more resources from Congress. We really wished there were more. The money wasn’t there."<sup id="cite_ref-politico_51-1" class="reference"><a href="#cite_note-politico-51">[51]</a></sup> </p> <h3><span class="mw-headline" id="Insularity">Insularity</span></h3> <p>When the ACA passed into law, the Obama administration needed to decide who would implement the reform. National Economic Council Director Larry Summers and Office of Budget and Management Director Peter Orszag agreed with the health adviser for Obama's 2008 campaign, David Cutler, that nobody in the administration would be capable of completing the task. Summers, Orszag and Obama healthcare adviser Zeke Emanuel pushed for the administration to bring someone on with experience in business, insurance and technology. However, other top health aides in the administration wanted to see through to fruition the bill they worked so hard to pass. President Obama chose his own policy team to run the project under direction of the director of the White House Office of Health Reform, Nancy-Ann Deparle. Cutler stated, "They were running the biggest start-up in the world, and they didn't have anyone who had run a start-up, or even run a business. It's very hard to think of a situation where the people best at getting legislation passed are best at implementing it. They are a different set of skills."<sup id="cite_ref-wapopoliticalfear_82-0" class="reference"><a href="#cite_note-wapopoliticalfear-82">[82]</a></sup> </p> <h3><span class="mw-headline" id="Fragmented_construction">Fragmented construction</span></h3> <p>The building of Healthcare.gov was challenged due to the constant threat of Republicans trying to defund any aspect of the law they could. Paired with the fact that money was only specifically set aside for the state exchanges to be created, the federal exchange was patched together by staff throughout the CMS office locations. According to a former administration official, "There wasn't a person who said, 'My job is the seamless implementation of the Affordable Care Act.'"<sup id="cite_ref-wapopoliticalfear_82-1" class="reference"><a href="#cite_note-wapopoliticalfear-82">[82]</a></sup> </p> <h3><span class="mw-headline" id="High-level_meeting_attendance">High-level meeting attendance</span></h3> <p>Starting after the law's passage, monthly meetings were held including <a href="/Kathleen_Sebelius" title="Kathleen Sebelius">Kathleen Sebelius</a>, Treasury Secretary Timothy Geithner, Chief of Staff <a href="/Rahm_Emanuel" title="Rahm Emanuel">Rahm Emanuel</a> and Domestic Policy Council Director Melody Barnes. The group worked through regulatory issues dealing with the implementation of the law, but before the year was out, the meetings stopped due to declining attendance.<sup id="cite_ref-wapopoliticalfear_82-2" class="reference"><a href="#cite_note-wapopoliticalfear-82">[82]</a></sup> </p> <h3><span class="mw-headline" id="Political_pressure">Political pressure</span></h3> <p>Many states opted not to build state exchanges and instead depend on the federal exchanges. While each new state on the federal exchanges added complexity, the administration would not admit to the additional technical issues posed. Instead, they decided to wait for the 2012 elections, hoping more states would opt to create their own exchanges. This meant the contractors, particularly CGI Federal, were not given specifications until after the elections, holding up technical work on the website.<sup id="cite_ref-wapopoliticalfear_82-3" class="reference"><a href="#cite_note-wapopoliticalfear-82">[82]</a></sup> </p><p>The election also impacted important regulations of the law. The standards for insurance coverage and rules for insurance premiums were made official as late as February 2013. A former <a href="/Medicare" title="Medicare">Medicare</a> chief actuary suggested the aides who pushed the law through Congress risked poor implementation "for a short-term political gain."<sup id="cite_ref-wapopoliticalfear_82-4" class="reference"><a href="#cite_note-wapopoliticalfear-82">[82]</a></sup> </p> <h2><span class="mw-headline" id="Efforts_to_fix">Efforts to fix</span></h2> <h3><span class="mw-headline" id="Proposed_fixes">Proposed fixes</span></h3> <p>The Obama administration on October 20, 2013 announced changes they hoped would solve some of the issues faced by those attempting to use the website. </p><p>Proposed fixes included: </p> <ul><li>Adding new code to fix bugs. Contractors believed up to five million lines of code would need to be revamped in order for a major fix to happen, but many were not confident it could be done even by December 15, the deadline for users to enroll in a healthcare plan effective starting in January 2014.<sup id="cite_ref-nytcontractors_76-1" class="reference"><a href="#cite_note-nytcontractors-76">[76]</a></sup></li></ul> <ul><li>The <a href="/U.S._Department_of_Health_and_Human_Services" title="U.S. Department of Health and Human Services">Department of Health and Human Services</a> also announced they would be bringing in some of the "best and brightest" from government as well as the private sector in order to roll out a major update.<sup id="cite_ref-politicosurgeDC_83-0" class="reference"><a href="#cite_note-politicosurgeDC-83">[83]</a></sup></li></ul> <ul><li>On October 23, the administration named Jeffrey Zients to lead the "tech surge" on the Healthcare.gov site.<sup id="cite_ref-fcwsurge_84-0" class="reference"><a href="#cite_note-fcwsurge-84">[84]</a></sup></li></ul> <h3><span class="mw-headline" id="Change_the_sign-up_deadline">Change the sign-up deadline</span></h3> <p>The White House announced late on Wednesday, October 23, 2013, that because of the problems with the website, they were going to redefine the meaning of the March 31, 2014 deadline. Originally, people were required to have a paid policy in place by March 31. The White House, however, said they were going to redefine March 31 as the date by which an individual must have started the enrollment process, rather than the date by which the enrollment must have been successfully concluded.<sup id="cite_ref-85" class="reference"><a href="#cite_note-85">[85]</a></sup> </p> <h3><span class="mw-headline" id="Estimated_time_to_fix">Estimated time to fix</span></h3> <ul><li>During <a href="/Kathleen_Sebelius" title="Kathleen Sebelius">Kathleen Sebelius</a>' House hearing on October 30, 2013, she estimated the completion date for fixes to be November 30, 2013. According to a statement released by the Health and Human Services Department, as of November 26, 2013, 90 percent of Healthcare.gov users were able to create accounts. The site was down for maintenance from November 29 at 9 p.m. EST until November 30 at 8 a.m. EST in order to complete the site upgrades by the November 30 deadline.<sup id="cite_ref-USATSebelius_86-0" class="reference"><a href="#cite_note-USATSebelius-86">[86]</a></sup><sup id="cite_ref-87" class="reference"><a href="#cite_note-87">[87]</a></sup><sup id="cite_ref-88" class="reference"><a href="#cite_note-88">[88]</a></sup> Jeffrey Zients claimed, "HealthCare.gov, on Dec. 1, is night and day from where it was on Oct. 1."<sup id="cite_ref-89" class="reference"><a href="#cite_note-89">[89]</a></sup></li></ul> <ul><li>Some officials in the healthcare industry said that a fix to the website may be on a timeline of months, not weeks.<sup id="cite_ref-politico_51-2" class="reference"><a href="#cite_note-politico-51">[51]</a></sup></li></ul> <ul><li>Mark Bertolini, the CEO of <a href="/Aetna" title="Aetna">Aetna</a>, told CNBC two weeks into the October launch that he thought it might take three years to repair the website.<sup id="cite_ref-politico_51-3" class="reference"><a href="#cite_note-politico-51">[51]</a></sup></li></ul> <ul><li>Dave Kennedy, CEO of information security company Trusted Sec, said that if 20 percent of 500 million lines of code need to be rewritten, it would take six months to a year.<sup id="cite_ref-cnnnofix_79-2" class="reference"><a href="#cite_note-cnnnofix-79">[79]</a></sup></li></ul> <h3><span class="mw-headline" id="Tech_surge_to_fix">Tech surge to fix</span></h3> <p>On October 30, 2013, CMS officials claimed the "tech surge" to repair Healthcare.gov included "dozens" of people from the private and public sectors.<sup id="cite_ref-natjournalsurge_90-0" class="reference"><a href="#cite_note-natjournalsurge-90">[90]</a></sup> </p> <h4><span class="mw-headline" id="Head_of_surge">Head of surge</span></h4> <p>On October 23, 2013, the Obama administration announced Jeffrey Zients would lead the tech surge to fix Healthcare.gov.<sup id="cite_ref-fcwsurge_84-1" class="reference"><a href="#cite_note-fcwsurge-84">[84]</a></sup> Zients had led private companies like Sirius/XM Satellite Radio, Bain & Company management consulting, and Revolution Health, as well as held public offices in the <a href="/Office_of_Management_and_Budget" title="Office of Management and Budget">Office of Management and Budget</a> and led a trade and export reform for the Obama administration in 2011.<sup id="cite_ref-91" class="reference"><a href="#cite_note-91">[91]</a></sup> </p><p>Soon after taking the post, Zients stated, "We're confident by the end of November, HealthCare.gov will be smooth for a vast majority of users." CMS Communications Director Julie Bataille backed up Zients' comment claiming, "People will be able to apply by Dec. 15 to get coverage by Jan. 1." Zients' assessment of the site concluded the top priority was to address the problems insurance companies have received from the exchanges.<sup id="cite_ref-politicoZients_14-1" class="reference"><a href="#cite_note-politicoZients-14">[14]</a></sup> </p> <h4><span class="mw-headline" id="Team_members">Team members</span></h4> <p>The tech surge drew help from top tech companies such as Google Inc., Red Hat, Inc. and Oracle Corp. among others. Each of the individuals and companies participating had had connections to the Obama administration in the past.<sup id="cite_ref-politicosurgeDC_83-1" class="reference"><a href="#cite_note-politicosurgeDC-83">[83]</a></sup> The administration did not release the full list of participants in the "tech surge."<sup id="cite_ref-natjournalsurge_90-1" class="reference"><a href="#cite_note-natjournalsurge-90">[90]</a></sup> </p> <ul><li>Google engineer Michael Dickerson left Google on leave to help on the project. Dickerson conducted analytics for the Obama for America campaign and was assigned to work with contractor Quality Software Services Inc.<sup id="cite_ref-politicosurgeDC_83-2" class="reference"><a href="#cite_note-politicosurgeDC-83">[83]</a></sup></li> <li>Greg Gershman was a Presidential Innovation Fellow for the White House placing innovative candidates on government projects. He was assigned to work with CGI Federal.<sup id="cite_ref-politicosurgeDC_83-3" class="reference"><a href="#cite_note-politicosurgeDC-83">[83]</a></sup></li> <li>Oracle Corp. produced an identity verification tool for the project early in development. Oracle had done contract work with the government in the past.<sup id="cite_ref-politicosurgeDC_83-4" class="reference"><a href="#cite_note-politicosurgeDC-83">[83]</a></sup></li> <li>Red Hat, Inc. also had a history of contracting with the government, specifically on IT projects. They did not comment on their role in the surge.<sup id="cite_ref-politicosurgeDC_83-5" class="reference"><a href="#cite_note-politicosurgeDC-83">[83]</a></sup></li> <li>Other companies may not have wished to be publicly associated with such a politically charged project.<sup id="cite_ref-politicosurgeDC_83-6" class="reference"><a href="#cite_note-politicosurgeDC-83">[83]</a></sup></li></ul> <h4><span class="mw-headline" id="Website_daily_down_time">Website daily down time</span></h4> <p>A banner on Healthcare.gov alerted users of a daily down time from 1 a.m. to 5 a.m. EST. The banner stated: "Additional down times may be possible as we work to make things better."<sup id="cite_ref-92" class="reference"><a href="#cite_note-92">[92]</a></sup> </p> <div class="floatleft"><a href="/File:Improving_healthcare.JPG" class="image"><img alt="Improving healthcare.JPG" src="https://ballotpedia.s3.amazonaws.com/images/thumb/2/2d/Improving_healthcare.JPG/950px-Improving_healthcare.JPG" decoding="async" width="950" height="67" srcset="https://ballotpedia.s3.amazonaws.com/images/2/2d/Improving_healthcare.JPG 1.5x" data-file-width="1174" data-file-height="83" /></a></div> <h3><span class="mw-headline" id="Fix_results">Fix results</span></h3> <p>Following the initial tech surge ending November 30, 2013, new fixes were introduced to the system. </p> <ul><li>By midday the first day the fixes were introduced, the website experienced traffic of about 380,000 visitors. While the site did not crash, a new waiting room feature was introduced in order to limit the number of people on the site at the same time for optimal performance. The site can reportedly handle 50,000 users simultaneously.<sup id="cite_ref-93" class="reference"><a href="#cite_note-93">[93]</a></sup></li> <li>Zients claimed at the start of November the website was only up about 43 percent of the time, while after the November 30 deadline the "up time" was 95 percent.<sup id="cite_ref-USATodayFix_94-0" class="reference"><a href="#cite_note-USATodayFix-94">[94]</a></sup></li> <li>CMS Director of Office Communications Julie Bataille stated that the success rate for sign-ups was up to 80 percent from the 30 percent success rate at the end of October.<sup id="cite_ref-USATodayFix_94-1" class="reference"><a href="#cite_note-USATodayFix-94">[94]</a></sup></li></ul> <h2><span class="mw-headline" id="Post-rollout_issues">Post-rollout issues</span></h2> <h3><span class="mw-headline" id="July_2014_hacker">July 2014 hacker</span></h3> <p>On September 4, 2014, the <i>Wall Street Journal</i> released a report that Healthcare.gov had been hacked in July 2014. HHS discovered the attack in late August, though it was believed no significant damage was done. The department released a statement, explaining, "Our review indicates that the server did not contain consumer personal information; data was not transmitted outside the agency, and the website was not specifically targeted. We have taken measures to further strengthen security." The <a href="/U.S._Department_of_Homeland_Security" title="U.S. Department of Homeland Security">U.S. Department of Homeland Security</a>, <a href="/Federal_Bureau_of_Investigation" title="Federal Bureau of Investigation">Federal Bureau of Investigation</a> and <a href="/National_Security_Agency" title="National Security Agency">National Security Agency</a> began an investigation once briefed by HHS. It was discovered that the hacker installed malware on the Healthcare.gov server, but as far as investigators could tell, no information was compromised.<sup id="cite_ref-95" class="reference"><a href="#cite_note-95">[95]</a></sup> </p><p>Members of <a href="/United_States_Congress" title="United States Congress">Congress</a> were concerned that access was gained to the server as easily as it was. Sen. <a href="/Orrin_Hatch" title="Orrin Hatch">Orrin Hatch</a> (R-UT) criticized the site's security protocol, stating, "Despite numerous warnings from myself and other lawmakers that security breaches were possible, HealthCare.gov underwent virtually no independent security testing. … It’s yet another deeply disturbing failure of the president’s health law, and once again it is the American people who are bearing the brunt of the law’s failures." Sen. <a href="/Tom_Carper" title="Tom Carper">Tom Carper</a> (D-DE) also spoke out but mentioned Congress' need "to reform our laws to better combat attacks from malicious actors and comprehensively address our serious cyber challenges to protect our nation, its people, its critical infrastructure, and its economy."<sup id="cite_ref-96" class="reference"><a href="#cite_note-96">[96]</a></sup> Rep. <a href="/Darrell_Issa" title="Darrell Issa">Darrell Issa</a> (R-CA) called for a hearing on the matter on September 18, 2014, explaining, "For nearly a year, the administration has dismissed concerns about the security of HealthCare.gov, even as it obstructed congressional oversight of the issue. The committee will continue to push for answers from the administration and administrator Tavenner must testify on the subject of transparency, accountability, and information security alongside the Government Accountability Office at our Sept. 18 hearing."<sup id="cite_ref-97" class="reference"><a href="#cite_note-97">[97]</a></sup> </p> <h3><span class="mw-headline" id="CEO_appointed">CEO appointed</span></h3> <p>In an attempt to be better prepared for the second enrollment period, which began November 14, 2014, HHS Secretary <a href="/Sylvia_Mathews_Burwell" title="Sylvia Mathews Burwell">Sylvia Burwell</a> established the position of chief executive officer of Healthcare.gov on August 26, 2014. She appointed the creator of the <a href="/Connecticut" title="Connecticut">Connecticut</a> state healthcare exchange, Kevin Counihan, to head to federal website due to the relative success achieved by the state's website. A chief technology officer position was also created.<sup id="cite_ref-98" class="reference"><a href="#cite_note-98">[98]</a></sup> </p> <h2><span class="mw-headline" id="Penalties">Penalties</span></h2> <p>The penalty for not being enrolled in a health insurance plan by March 31, 2014, was a charge of either $95 per person or 1 percent of household income, whichever was greater.<sup id="cite_ref-mccardle_3-2" class="reference"><a href="#cite_note-mccardle-3">[3]</a></sup> White House Press Secretary <a href="/Jay_Carney" title="Jay Carney">Jay Carney</a> would not say on October 21, 2013 whether the struggles of the website would delay the individual mandate.<sup id="cite_ref-99" class="reference"><a href="#cite_note-99">[99]</a></sup> The administration announced in March 2014, that uninsured users could still enroll in April, paying their first premium, to avoid the penalty as long as a plan was selected by March 31, 2014.<sup id="cite_ref-foxdelay_5-1" class="reference"><a href="#cite_note-foxdelay-5">[5]</a></sup> </p> <h2><span class="mw-headline" id="Costs">Costs</span></h2> <h3><span class="mw-headline" id="GAO_investigation_results">GAO investigation results</span></h3> <p>The <a href="/Government_Accountability_Office" class="mw-redirect" title="Government Accountability Office">Government Accountability Office</a> (GAO) investigated the costs of the Healthcare.gov federal exchange website, estimating that the total cost, as of March 2014, was $840 million.<sup id="cite_ref-100" class="reference"><a href="#cite_note-100">[100]</a></sup> GAO Director of Acquisition and Sourcing Management William Woods claimed that the overrun was due to inconsistent oversight and constantly changing requirements, which were noted by contractors when asked to testify during the website rollout.<sup id="cite_ref-CBSoverrun_101-0" class="reference"><a href="#cite_note-CBSoverrun-101">[101]</a></sup> </p> <h3><span class="mw-headline" id="Project_estimates">Project estimates</span></h3> <ul><li>According to <a href="/Kathleen_Sebelius" title="Kathleen Sebelius">Kathleen Sebelius</a>' House testimony on October 30, 2013, the website had a cost of $118 million plus another $56 million for IT support.<sup id="cite_ref-USATSebelius_86-1" class="reference"><a href="#cite_note-USATSebelius-86">[86]</a></sup></li> <li>As of October 17, 2013, <i>Fiscal Times</i> estimated the CGI Federal contract for the website had a cost of $292 million, after agreeing to an initial contract of $93.7 million in 2010.<sup id="cite_ref-102" class="reference"><a href="#cite_note-102">[102]</a></sup></li> <li><i>Digital Trends</i> estimated the total cost of the website to be $363 million, but due to the shutdown, they could not access CMS salary information and did not include it.<sup id="cite_ref-103" class="reference"><a href="#cite_note-103">[103]</a></sup></li> <li>The <i>Sunlight Foundation</i> claimed that due to the nature of government contracts called "IDIQs" (indefinite delivery, indefinite quantity), the official cost for the Healthcare.gov website is difficult to know. The contract allowed the government to contract tasks to the holder of the contract, CGI Federal, without opening them to competition. Their analysis listed 128 action items for a total of $634,321,919; however, not all tasks were necessarily related to the website.<sup id="cite_ref-104" class="reference"><a href="#cite_note-104">[104]</a></sup></li></ul> <h2><span class="mw-headline" id="Contractors">Contractors</span></h2> <p>According to the <i>Sunlight Foundation</i>, the ten highest paying initial federal contracts for the website are listed below: </p> <table> </table><table class="wikitable collapsible collapsed" style="background:none; text-align:center; width:500px"> <tbody><tr> <th colspan="2" align="center" style="background-color:#008000; color: white;">Highest earning federal contractors for the ACA<sup id="cite_ref-sunlight_105-0" class="reference"><a href="#cite_note-sunlight-105">[105]</a></sup> </th></tr> <tr> <td align="center" style="background-color:#C71585;"><b>Contractor</b> </td> <td align="center" style="background-color:#C71585;"><b>Amount</b> </td></tr> <tr> <td>Serco </td> <td>$114,307,266 </td></tr> <tr> <td>CGI Federal </td> <td>$93,700,000 </td></tr> <tr> <td>Quality Software Services, Inc. </td> <td>$68,339,812 </td></tr> <tr> <td>Maximus Federal Services, Inc. </td> <td>$43,163,074 </td></tr> <tr> <td>Vagent </td> <td>$28,237,831 </td></tr> <tr> <td>McKinsey and Company </td> <td>$13,767,707 </td></tr> <tr> <td>Deloitte Consulting </td> <td>$12,921,093 </td></tr> <tr> <td>Porter Novelli Public Strategies </td> <td>$11,670,603 </td></tr> <tr> <td>Computing Solutions </td> <td>$7,802,076.24 </td></tr> <tr> <td>David-James, LLC </td> <td>$7,283,208 </td></tr></tbody></table> <dl><dd><dl><dd><i>Note: This list does not include the contracts used for state exchanges, including a total of $140 million to Xerox Co. for the exchanges built for Florida and Nevada.</i><sup id="cite_ref-sunlight_105-1" class="reference"><a href="#cite_note-sunlight-105">[105]</a></sup></dd></dl></dd></dl> <h3><span id="Quality_Software_Services.2C_Inc."></span><span class="mw-headline" id="Quality_Software_Services,_Inc.">Quality Software Services, Inc.</span></h3> <p>QSSI was contracted to develop a component focused on identity management, a key part of the login process that experienced problems during rollout, and QSSI was chosen by the administration as the contractor to lead the "tech surge" aimed at fixing the website's problems.<sup id="cite_ref-wapo_34-2" class="reference"><a href="#cite_note-wapo-34">[34]</a></sup><sup id="cite_ref-NYPostqssi_106-0" class="reference"><a href="#cite_note-NYPostqssi-106">[106]</a></sup> The <i>New York Post</i> estimated QSSI had been paid $150 million as of November 1, 2013, but acknowledged more may have been on the way for the website fixes.<sup id="cite_ref-NYPostqssi_106-1" class="reference"><a href="#cite_note-NYPostqssi-106">[106]</a></sup> </p> <h4><span class="mw-headline" id="Connections_to_the_administration">Connections to the administration</span></h4> <p>The company was bought in 2012 by UnitedHealth Group, one of the largest health insurance companies in the United States. In addition to lobbying efforts for <a href="/Obamacare" class="mw-redirect" title="Obamacare">Obamacare</a>, Executive Vice President Anthony Welters and his wife were campaign contributors to <a href="/Barack_Obama" title="Barack Obama">Barack Obama</a>'s 2008 and 2012 campaigns. Welters' wife, Beatrice was appointed to be U.S. ambassador to Trinidad and Tobago in 2009, and the couple have visited President Obama in the White House multiple times.<sup id="cite_ref-NYPostqssi_106-2" class="reference"><a href="#cite_note-NYPostqssi-106">[106]</a></sup> </p> <h3><span class="mw-headline" id="CGI_Group">CGI Group</span></h3> <p>CGI Group, the parent company of Healthcare.gov contractor CGI Federal, was the 29th largest federal IT contractor in 2012, totaling about $950 million in contracts, but that number has grown as they worked on the healthcare website. CEO Michael Roach claimed, "In the Federal Government business, we continue to see more extensions and ceiling increases on our existing work, while we further leverage our position on contract vehicles," continuing to state, "Accordingly, we continue to view U.S. Federal Government as a significant growth opportunity."<sup id="cite_ref-wapocgi_107-0" class="reference"><a href="#cite_note-wapocgi-107">[107]</a></sup> CGI Federal was given six contracts by CMS for <i>Healthcare.gov</i> to build the shopping and enrollment aspects.<sup id="cite_ref-wapo_34-3" class="reference"><a href="#cite_note-wapo-34">[34]</a></sup> They reportedly missed multiple deadlines, though those close to the project claim officials had not finalized parts of the ACA necessary to move forward with the contracted work.<sup id="cite_ref-108" class="reference"><a href="#cite_note-108">[108]</a></sup> </p><p>Of the 55 contractors who have worked on Healthcare.gov, CGI had the largest role. It was awarded its contract in October 2011 for a bid of $94 million. By May 2013, CGI increased its contractual cost ceiling to $292 million.<sup id="cite_ref-109" class="reference"><a href="#cite_note-109">[109]</a></sup> </p> <h4><span class="mw-headline" id="Pre-flight_checklist">Pre-flight checklist</span></h4> <p>According to a report on November 23, 2013, CGI held meetings with the administration to gauge confidence in completing their projects in August 2013. CGI Federal reported high confidence rates in their ability to complete the tasks, but on a "pre-flight checklist," 41 of 91 items critical to a successful launch did not yet work.<sup id="cite_ref-110" class="reference"><a href="#cite_note-110">[110]</a></sup> </p> <h4><span class="mw-headline" id="Past_government_contracts">Past government contracts</span></h4> <ul><li><b>2012</b>: The company was fired by an Ontario, Canada provincial health agency for missing deadlines and failing to provide the online medical registry the company was contracted to create.<sup id="cite_ref-CGIfired_111-0" class="reference"><a href="#cite_note-CGIfired-111">[111]</a></sup></li> <li><b>2009</b>: CGI Federal transformed an existing <a href="/U.S._Environmental_Protection_Agency" title="U.S. Environmental Protection Agency">Environmental Protection Agency</a> program into FederalReporting.gov, deemed a successful and inexpensive project that was completed on time.<sup id="cite_ref-wapocgi_107-1" class="reference"><a href="#cite_note-wapocgi-107">[107]</a></sup></li> <li><b>2007</b>: The company was also fired by the Canadian government in 2007 after going over budget creating a federal online gun registry.<sup id="cite_ref-112" class="reference"><a href="#cite_note-112">[112]</a></sup></li> <li><b>2007</b>: CGI Federal won one of 16 IDIQ contracts for $4 billion to upgrade the <a href="/Medicare" title="Medicare">Medicare</a> and <a href="/Medicaid" title="Medicaid">Medicaid</a> systems.<sup id="cite_ref-wapocgi_107-2" class="reference"><a href="#cite_note-wapocgi-107">[107]</a></sup></li></ul> <h4><span class="mw-headline" id="Connections_to_the_administration_2">Connections to the administration</span></h4> <p>CGI Federal Senior Vice President Toni Townes-Whitley was a college classmate of First Lady Michelle Obama and attended a Christmas party at the White House. Both she and George Schindler, president of CGI Federal, donated to the Barack Obama campaigns.<sup id="cite_ref-natreviewcontractors_113-0" class="reference"><a href="#cite_note-natreviewcontractors-113">[113]</a></sup> </p> <h3><span class="mw-headline" id="Serco">Serco</span></h3> <p>Serco was contracted by the government to process the paper applications for health insurance plans through federal exchanges. The contract was the largest awarded as part of the implementation of the ACA and was valued at a potential of $1.249 billion over the full term.<sup id="cite_ref-natreviewserco_114-0" class="reference"><a href="#cite_note-natreviewserco-114">[114]</a></sup> </p> <h4><span class="mw-headline" id="Scandals">Scandals</span></h4> <ul><li><b>2013</b>: England's Serious Fraud Office began investigating Serco for a overbilling on a contract to surveil criminals released from prison. An audit revealed Serco overbilled the government for about $80 million. The CEO resigned on October 25, 2013.<sup id="cite_ref-natreviewserco_114-1" class="reference"><a href="#cite_note-natreviewserco-114">[114]</a></sup></li> <li><b>2013</b>: A Serco lobbyist and former Capitol Hill staffer, Mark Hayes, went under investigation for insider trading concerning aspects of the ACA. As of May 2013, he was expected to stop lobbying for Serco.<sup id="cite_ref-natreviewserco_114-2" class="reference"><a href="#cite_note-natreviewserco-114">[114]</a></sup></li> <li><b>2013</b>: Women at the Yarl's Wood immigration detention center, contracted to Serco by the British government, claimed officers bribed them with better service to engage in sexual behaviors. In 2012, at least three staff members were fired due to accusations of sexual assault.<sup id="cite_ref-natreviewserco_114-3" class="reference"><a href="#cite_note-natreviewserco-114">[114]</a></sup></li> <li><b>2011</b>: The Serco-managed U.S. Thrift Savings Plan for federal employees experienced a security failure resulting in private information, including social security numbers, being jeopardized for 120,000 plan participants.<sup id="cite_ref-natreviewserco_114-4" class="reference"><a href="#cite_note-natreviewserco-114">[114]</a></sup></li> <li><b>2011</b>: Serco teamed with King's College Hospital and Guy's & St. Thomas Hospital to win a $1.29 billion contract running a National Health Service pathology lab in 2009. Hundreds of errors were discovered in 2011 including mislabeled or lost blood and tissue samples and inaccurate testing results.<sup id="cite_ref-natreviewserco_114-5" class="reference"><a href="#cite_note-natreviewserco-114">[114]</a></sup></li> <li><b>2011</b>: The Australian government uncovered "over-crowding" and "ill-trained" staff at immigrant detention centers. The company also failed to produce regular reports required by their contract, and incidents of self-harm increased in the facilities while Serco was in charge.<sup id="cite_ref-natreviewserco_114-6" class="reference"><a href="#cite_note-natreviewserco-114">[114]</a></sup></li> <li><b>2006</b>: Serco was awarded a contract in England to run an out-of-hours physician service for the country. It was discovered the program's services declined to the point that at times only one physician was on call for the entire country. The Care Quality Commission released a statement saying Serco "routinely altered daily performance reports which showed if the service was meeting its targets for responding to calls from patients on time."<sup id="cite_ref-natreviewserco_114-7" class="reference"><a href="#cite_note-natreviewserco-114">[114]</a></sup></li></ul> <h3><span class="mw-headline" id="Contracting_practices_investigation">Contracting practices investigation</span></h3> <p>On December 11, 2013, Sebelius asked the inspector general of the <a href="/U.S._Department_of_Health_and_Human_Services" title="U.S. Department of Health and Human Services">Health and Human Services Department</a> to open an investigation into the contracting practices involved in the Healthcare.gov website. She said the investigation's results would help to prevent future issues like what happened with the website rollout. She also announced the creation of a chief risk officer position in the <a href="/Centers_for_Medicare_and_Medicaid_Services" title="Centers for Medicare and Medicaid Services">Centers for Medicare and Medicaid Services</a>.<sup id="cite_ref-115" class="reference"><a href="#cite_note-115">[115]</a></sup> </p> <h3><span class="mw-headline" id="New_contractor_search">New contractor search</span></h3> <p>In April 2014, the Obama administration began a search for new contractors to run to Healthcare.gov, with target contractors being small businesses run by women, disabled veterans and "socially and economically disadvantaged individuals."<sup id="cite_ref-116" class="reference"><a href="#cite_note-116">[116]</a></sup> </p> <h2><span class="mw-headline" id="Public_opinion">Public opinion</span></h2> <ul><li>According to a <i>CBS</i> survey conducted between October 18 and October 21, 2013, only 12 percent of Americans believed the sign-up process on Healthcare.gov was going well, while 49 percent believed it was not going well and 38 percent didn't know enough. While the survey showed most believed the rollout was not going well, opinions on the law remained consistent with those at the beginning of the rollout. Americans' disapproval of the law stood at 51 percent while 43 percent approved of it.<sup id="cite_ref-117" class="reference"><a href="#cite_note-117">[117]</a></sup></li></ul> <h2><span class="mw-headline" id="Congressional_hearings">Congressional hearings</span></h2> <h3><span class="mw-headline" id="Contractor_hearings">Contractor hearings</span></h3> <p>UnitedHealth Group's Andrew Slavitt and a CGI Federal senior vice president, Cheryl Campbell, testified before the <a href="/United_States_House" class="mw-redirect" title="United States House">United States House</a> <a href="/United_States_House_of_Representatives_Committee_on_Energy_and_Commerce" title="United States House of Representatives Committee on Energy and Commerce">Energy and Commerce Committee</a> on October 24, 2013. Following are some issues that came up during their testimony:<sup id="cite_ref-nythearings_35-1" class="reference"><a href="#cite_note-nythearings-35">[35]</a></sup> </p> <ul><li>The website was not fully tested by federal officials until two weeks prior to launch. Both Slavitt and Campbell stated months of testing should have been carried out per industry standards.<sup id="cite_ref-nythearings_35-2" class="reference"><a href="#cite_note-nythearings-35">[35]</a></sup><sup id="cite_ref-politicohearings_118-0" class="reference"><a href="#cite_note-politicohearings-118">[118]</a></sup></li> <li>The contractors blamed CMS for the website's troubled rollout due to their roll as "systems integrator." When Republicans requested who was responsible at CMS, the only two names to come up were Deputy CIO Henry Chao and COO Michelle Snyder, whom Campbell claimed to have reported to throughout the project. Campbell also stated, "It was not our decision to go live. It was [CMS’] decision."<sup id="cite_ref-nythearings_35-3" class="reference"><a href="#cite_note-nythearings-35">[35]</a></sup><sup id="cite_ref-politicohearings_118-1" class="reference"><a href="#cite_note-politicohearings-118">[118]</a></sup></li> <li>House Republicans attacked the website as a symbol of the failure of the Affordable Care Act. Rep. <a href="/Fred_Upton" title="Fred Upton">Fred Upton</a> claimed, "This is more than a Web site problem. The Web site should have been the easy part. I'm also concerned about what happens next. Will enrollment glitches become provider payment glitches? Will patients show up at their doctor's office or hospital only to be told that they aren't covered, or even in the system?"<sup id="cite_ref-nythearings_35-4" class="reference"><a href="#cite_note-nythearings-35">[35]</a></sup></li> <li>Slavitt suggested that a late change to the system by the administration contributed to the backup upon the site's initial release. Instead of allowing users to browse the website for plans without an account, the administration insisted users create an account and log in before viewing their options.<sup id="cite_ref-nythearings_35-5" class="reference"><a href="#cite_note-nythearings-35">[35]</a></sup></li></ul> <h3><span class="mw-headline" id="Marilyn_Tavenner_hearing">Marilyn Tavenner hearing</span></h3> <p>Marilyn Tavenner, the head of the Centers of Medicare and Medicaid Services, testified before the <a href="/United_States_House_of_Representatives_Committee_on_Ways_and_Means" title="United States House of Representatives Committee on Ways and Means">House Ways and Means Committee</a> on October 29, 2013. CMS was responsible for Healthcare.gov's creation. Following are some issues that came up during her testimony:<sup id="cite_ref-119" class="reference"><a href="#cite_note-119">[119]</a></sup> </p> <ul><li>On the website, Tavenner stated, "I want to apologize to you that the website does not work as well as it should," but claimed resolutions were in progress and the site should be running smoothly by the end of November. She did say the website was working, "just not working at the speed that we want and at the success rate that we want."</li> <li>On the contractors hired for the project, Tavenner claimed they "have not met expectations."</li> <li>Due to increased requirements under the ACA, Tavenner suggested some people will be forced to change their existing plans to plans that meet the new minimum requirements.</li> <li>Tavenner claimed accurate enrollment numbers would not be available until the mid-November report was produced.</li></ul> <h3><span class="mw-headline" id="Kathleen_Sebelius_hearing">Kathleen Sebelius hearing</span></h3> <div class="thumb tright"><div class="thumbinner" style="width:211px;"><a href="/File:Kathleen_Sebelius_official_HHS_portrait.PNG" class="image"><img alt="" src="https://ballotpedia.s3.amazonaws.com/images/3/30/Kathleen_Sebelius_official_HHS_portrait.PNG" decoding="async" width="209" height="267" class="thumbimage" data-file-width="209" data-file-height="267" /></a> <div class="thumbcaption"><div class="magnify"><a href="/File:Kathleen_Sebelius_official_HHS_portrait.PNG" class="internal" title="Enlarge"></a></div><a href="/Kathleen_Sebelius" title="Kathleen Sebelius">Kathleen Sebelius</a></div></div></div> <p>Secretary of Health and Human Services <a href="/Kathleen_Sebelius" title="Kathleen Sebelius">Kathleen Sebelius</a> testified before the <a href="/United_States_House_Committee_on_Energy_and_Commerce" class="mw-redirect" title="United States House Committee on Energy and Commerce">Energy and Commerce Committee</a> about the Healthcare.gov website rollout. Following are issues that came up during her testimony: </p> <ul><li>According to Sebelius, the website had cost $118 million plus another $56 million for IT support.<sup id="cite_ref-USATSebelius_86-2" class="reference"><a href="#cite_note-USATSebelius-86">[86]</a></sup></li> <li>Sebelius supported Jeffrey Zients' estimation that the website would be fully functional and fixed by November 30, 2013.<sup id="cite_ref-USATSebelius_86-3" class="reference"><a href="#cite_note-USATSebelius-86">[86]</a></sup></li> <li>Reps. <a href="/Mike_Rogers" title="Mike Rogers">Mike Rogers</a>, (R-MI) and <a href="/G.K._Butterfield" title="G.K. Butterfield">G.K. Butterfield</a>, (D-NC) brought up potential security issues due to the inadequate testing performed on the website before rollout. Sebelius insisted the suggested recommendations were being followed for security, including daily tests, monitoring the site's security and a thorough test of the complete website within three months. Sebelius also acknowledged more testing was not possible due to time shortages leading up to the launch date.<sup id="cite_ref-USATSebelius_86-4" class="reference"><a href="#cite_note-USATSebelius-86">[86]</a></sup></li> <li>Sebelius confirmed that the contracts for the construction of the website did not include "built-in penalties" for faulty work, but claimed the department would not honor the contracts if work was left incomplete.<sup id="cite_ref-CNNSebelius_120-0" class="reference"><a href="#cite_note-CNNSebelius-120">[120]</a></sup></li> <li>Sebelius refused to release any numbers indicating the amount of people enrolled through the website until the first report was released in mid-November.<sup id="cite_ref-USATSebelius_86-5" class="reference"><a href="#cite_note-USATSebelius-86">[86]</a></sup></li> <li>When asked whether Sebelius would join the healthcare exchange if she could by law, after some back and forth with Rep. <a href="/Billy_Long" title="Billy Long">Billy Long</a>, (R-MO) Sebelius stated, "I think it's illegal for me to access the marketplace. I would gladly join the exchange if I didn't have affordable coverage in my workplace. I would gladly join it."<sup id="cite_ref-CNN5_56-1" class="reference"><a href="#cite_note-CNN5-56">[56]</a></sup></li></ul> <h3><span class="mw-headline" id="IT_specialist_hearing">IT specialist hearing</span></h3> <p>On November 13, 2013, major IT specialists who worked on the project testified before <a href="/United_States_House_Committee_on_Oversight_and_Government_Reform" class="mw-redirect" title="United States House Committee on Oversight and Government Reform">House Oversight Committee</a>. The six witness included Chief Technology Officer Todd Park, CMS Deputy Chief of Information Henry Chao and Office of Management and Budget Chief Information Officer Steve VanRoekel.<sup id="cite_ref-USNWRtestimony_121-0" class="reference"><a href="#cite_note-USNWRtestimony-121">[121]</a></sup> Following are some of the topics raised at the hearing. </p> <ul><li>When asked of the improvements being made to the website, Park stated, "The website is getting better each week as we work to improve its performance, its stability, and its functionality."<sup id="cite_ref-verge_122-0" class="reference"><a href="#cite_note-verge-122">[122]</a></sup></li> <li>Rep. <a href="/Darrell_Issa" title="Darrell Issa">Darrell Issa</a>, (R-CA) accused the White House of forcing the website on Americans before it was ready because of "political deadlines, and continued to state, "They weren't ready. They weren't close to ready. This wasn't a small mistake. ... This was a monumental mistake to go live and effectively explode on the launch pad."<sup id="cite_ref-Foxittestimony_123-0" class="reference"><a href="#cite_note-Foxittestimony-123">[123]</a></sup></li> <li>David Powner, a <a href="/Government_Accountability_Office" class="mw-redirect" title="Government Accountability Office">Government Accountability Office</a> official offering testimony, claimed the total cost of the website as over $600 million by the end of September. However, according to the <i>Washington Post</i>, the number he gave was an outdated overestimation, and that the updated version of the form Powner referred to claimed the site had cost $318 million.<sup id="cite_ref-124" class="reference"><a href="#cite_note-124">[124]</a></sup></li></ul> <h2><span class="mw-headline" id="Sebelius_resignation">Sebelius resignation</span></h2> <p>On April 10, 2014, <a href="/U.S._Department_of_Health_and_Human_Services" title="U.S. Department of Health and Human Services">Secretary of Health and Human Services</a> <a href="/Kathleen_Sebelius" title="Kathleen Sebelius">Kathleen Sebelius</a> resigned from her position following the troubled rollout of <a href="/Obamacare" class="mw-redirect" title="Obamacare">Obamacare</a>. She and President <a href="/Barack_Obama" title="Barack Obama">Obama</a> determined that the end of the open enrollment period provided a chance for change. Sebelius saw her public appearances dwindle as the problems with the Healthcare.gov rollout persisted. President Obama named <a href="/U.S._Office_of_Management_and_Budget" class="mw-redirect" title="U.S. Office of Management and Budget">Director of the Office of Management and Budget</a> <a href="/Sylvia_Mathews_Burwell" title="Sylvia Mathews Burwell">Sylvia Mathews Burwell</a> as the nominee to succeed Sebelius.<sup id="cite_ref-125" class="reference"><a href="#cite_note-125">[125]</a></sup> </p> <h2><span class="mw-headline" id="Possible_ramifications">Possible ramifications</span></h2> <h3><span class="mw-headline" id="Miscalculated_eligibility_frustrations">Miscalculated eligibility frustrations</span></h3> <p>Jessica Sanford, a Washington state resident President Obama mentioned during his October press conference on Healthcare.gov, initially wrote a letter to the president upon enrolling in an insurance plan in October, telling him what a financial relief the ACA was on her family. She chose a gold-level plan that, with subsidies, cost $198 per month. Sanford then received a letter informing her that there was a miscalculation in her tax credit eligibility, raising the cost of the plan to $280 per month. After that, she received another letter from the state exchange stating there was another error resulting in applicants qualifying for higher than allowed tax credits, resulting in quotes of $390 for a silver-level plan or $324 for a bronze-level plan, each with higher deductibles. A final letter came telling Sanford she did not qualify for any federal tax credits. Sanford responded, stating, "This is it. I'm not getting insurance. That's where it stands right now unless they fix it."<sup id="cite_ref-126" class="reference"><a href="#cite_note-126">[126]</a></sup> </p> <h3><span class="mw-headline" id="Popular_media_blowback">Popular media blowback</span></h3> <p>While early support from various stars was common, as the struggles with Obamacare have continued, satire grew more popular with television shows such as <i>The Daily Show</i>, <i>South Park</i> and <i>Saturday Night Live</i> airing segments highly critical of the website and administration. Celebrity supporters and media outlets such as <i>Funny Or Die</i> still have long-term efforts in mind but have largely remained quiet during the troublesome rollout.<sup id="cite_ref-127" class="reference"><a href="#cite_note-127">[127]</a></sup> </p> <h3><span class="mw-headline" id="Supporter_morale">Supporter morale</span></h3> <p>Barack Obama's grassroots organizers for the <a href="/Obamacare" class="mw-redirect" title="Obamacare">Obamacare</a> rollout were some of the hardest hit by the problematic rollout of Healthcare.gov. The volunteers and coordinators filled out forms and knocked on doors to enroll people in insurance plans with the website not allowing many users to enroll. Their planning for the October 1 launch date of the new federal exchanges went from excited and carefully laid out to frustration and creating new plans on the go. Niki King, vice president of Access to Healthcare Network in Nevada, one of the many nonprofits aimed at walking consumers through the new process, struggled with using Excel sheets to calculate costs and said, "It's a mess. I'm fascinated to know how Obama says you can complete enrollment by paper." While frustrations were common, organizers insisted they would not stop helping the underserved get health insurance.<sup id="cite_ref-128" class="reference"><a href="#cite_note-128">[128]</a></sup> </p> <h3><span class="mw-headline" id="Congressional_pushback">Congressional pushback</span></h3> <h4><span class="mw-headline" id="Direct_enrollment_letters">Direct enrollment letters</span></h4> <p>Eight <a href="/United_States_Senate" title="United States Senate">Senate</a> Democrats signed a letter in the end of November 2013, urging the administration to allow internet health insurance brokers to complete enrollment for all aspects of <a href="/Obamacare" class="mw-redirect" title="Obamacare">Obamacare</a> without forcing consumers to use Healthcare.gov, stating, "We believe it is appropriate for consumers to have multiple enrollment channels in order to maximize choice and make enrollment as convenient as possible." The senators stated the letter was necessary because many of their constituents had difficulty signing up for health insurance coverage on the official website. The eight Senators to sign the letter were:<sup id="cite_ref-NineDems_129-0" class="reference"><a href="#cite_note-NineDems-129">[129]</a></sup> </p> <div style="-moz-column-count:2; -webkit-column-count:2; column-count:2;" class="mobile-columns"> <ul><li><a href="/Democratic_Party" title="Democratic Party"><img alt="Democratic Party" src="https://cdn.ballotpedia.org/images/d/d4/Electiondot.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Chuck_Schumer" title="Chuck Schumer">Chuck Schumer</a> (D-NY)</li> <li><a href="/Democratic_Party" title="Democratic Party"><img alt="Democratic Party" src="https://cdn.ballotpedia.org/images/d/d4/Electiondot.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Joe_Donnelly" title="Joe Donnelly">Joe Donnelly</a> (D-IN)</li> <li><a href="/Democratic_Party" title="Democratic Party"><img alt="Democratic Party" src="https://cdn.ballotpedia.org/images/d/d4/Electiondot.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Jeanne_Shaheen" title="Jeanne Shaheen">Jeanne Shaheen</a> (D-NH)</li> <li><a href="/Democratic_Party" title="Democratic Party"><img alt="Democratic Party" src="https://cdn.ballotpedia.org/images/d/d4/Electiondot.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Mark_Warner" title="Mark Warner">Mark Warner</a> (D-VA)</li> <li><a href="/Democratic_Party" title="Democratic Party"><img alt="Democratic Party" src="https://cdn.ballotpedia.org/images/d/d4/Electiondot.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Mary_Landrieu" title="Mary Landrieu">Mary Landrieu</a> (D-LA)</li> <li><a href="/Democratic_Party" title="Democratic Party"><img alt="Democratic Party" src="https://cdn.ballotpedia.org/images/d/d4/Electiondot.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Mark_Udall" title="Mark Udall">Mark Udall</a> (D-CO)</li> <li><a href="/Democratic_Party" title="Democratic Party"><img alt="Democratic Party" src="https://cdn.ballotpedia.org/images/d/d4/Electiondot.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Kay_Hagan" title="Kay Hagan">Kay Hagan</a> (D-NC)</li> <li><a href="/Democratic_Party" title="Democratic Party"><img alt="Democratic Party" src="https://cdn.ballotpedia.org/images/d/d4/Electiondot.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Bill_Nelson" title="Bill Nelson">Bill Nelson</a> (D-FL)</li></ul> </div> <p>Senator <a href="/Mark_Pryor" title="Mark Pryor">Mark Pryor</a> (D-AR) wrote his own, similarly focused letter to the administration.<sup id="cite_ref-NineDems_129-1" class="reference"><a href="#cite_note-NineDems-129">[129]</a></sup> </p> <h4><span class="mw-headline" id="Investigation_into_Healthcare.gov_rollout_failure">Investigation into Healthcare.gov rollout failure</span></h4> <p>Sen. <a href="/Kay_Hagan" title="Kay Hagan">Kay Hagan</a>, (D-NC) passed around a letter seeking signatures in November 2013, to order an investigation on the rollout of Healthcare.gov including initial expected costs, final cost estimates, contract sizes, contract performances and the contract bidding process. The letter was expected to receive signatures from both parties. A portion of the letter reads, "These problems are simply unacceptable, and Americans deserve answers and swift solutions. Taxpayers are owed a full and transparent accounting of how the vendors contracted to build the site failed to launch it successfully."<sup id="cite_ref-130" class="reference"><a href="#cite_note-130">[130]</a></sup> </p> <h4><span class="mw-headline" id="Individual_mandate_extension_letter">Individual mandate extension letter</span></h4> <p>On October 25, 2013, 10 <a href="/Democratic_Party" title="Democratic Party">Democratic</a> senators signed on to a letter written by Sen. <a href="/Jeanne_Shaheen" title="Jeanne Shaheen">Jeanne Shaheen</a>, (D-NH). The letter urged President <a href="/Barack_Obama" title="Barack Obama">Obama</a> to push back the deadline for the individual health insurance mandate due to the issues with the Healthcare.gov website. The letter did not suggest how long the mandate should be delayed, though one signer, Sen. <a href="/Kay_Hagan" title="Kay Hagan">Kay Hagan</a>, (D-NC), separately called for a two-month delay. A portion of the letter stated, "Extending this period will give consumers critical time in which to become familiar with the website and choose a plan that is best for them. Individuals should not be penalized for lack of coverage if they are unable to purchase health insurance due to technical problems."<sup id="cite_ref-wapoletter_131-0" class="reference"><a href="#cite_note-wapoletter-131">[131]</a></sup> </p><p>The signers of the letter were:<sup id="cite_ref-wapoletter_131-1" class="reference"><a href="#cite_note-wapoletter-131">[131]</a></sup> </p> <div style="-moz-column-count:2; -webkit-column-count:2; column-count:2;" class="mobile-columns"> <ul><li><a href="/Democratic_Party" title="Democratic Party"><img alt="Democratic Party" src="https://cdn.ballotpedia.org/images/d/d4/Electiondot.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Jeanne_Shaheen" title="Jeanne Shaheen">Jeanne Shaheen</a>, (D-NH)</li> <li><a href="/Democratic_Party" title="Democratic Party"><img alt="Democratic Party" src="https://cdn.ballotpedia.org/images/d/d4/Electiondot.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Kay_Hagan" title="Kay Hagan">Kay Hagan</a>, (D-NC)</li> <li><a href="/Democratic_Party" title="Democratic Party"><img alt="Democratic Party" src="https://cdn.ballotpedia.org/images/d/d4/Electiondot.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Mark_Begich" title="Mark Begich">Mark Begich</a>, (D-AK)</li> <li><a href="/Democratic_Party" title="Democratic Party"><img alt="Democratic Party" src="https://cdn.ballotpedia.org/images/d/d4/Electiondot.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Mark_Pryor" title="Mark Pryor">Mark Pryor</a>, (D-AR)</li> <li><a href="/Democratic_Party" title="Democratic Party"><img alt="Democratic Party" src="https://cdn.ballotpedia.org/images/d/d4/Electiondot.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Mary_Landrieu" title="Mary Landrieu">Mary Landrieu</a>, (D-LA)</li> <li><a href="/Democratic_Party" title="Democratic Party"><img alt="Democratic Party" src="https://cdn.ballotpedia.org/images/d/d4/Electiondot.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Dianne_Feinstein" title="Dianne Feinstein">Dianne Feinstein</a>, (D-CA)</li> <li><a href="/Democratic_Party" title="Democratic Party"><img alt="Democratic Party" src="https://cdn.ballotpedia.org/images/d/d4/Electiondot.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Mark_Udall" title="Mark Udall">Mark Udall</a>, (D-CO)</li> <li><a href="/Democratic_Party" title="Democratic Party"><img alt="Democratic Party" src="https://cdn.ballotpedia.org/images/d/d4/Electiondot.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Tom_Udall" title="Tom Udall">Tom Udall</a>, (D-NM)</li> <li><a href="/Democratic_Party" title="Democratic Party"><img alt="Democratic Party" src="https://cdn.ballotpedia.org/images/d/d4/Electiondot.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Michael_Bennet" title="Michael Bennet">Michael Bennet</a>, (D-CO)</li> <li><a href="/Democratic_Party" title="Democratic Party"><img alt="Democratic Party" src="https://cdn.ballotpedia.org/images/d/d4/Electiondot.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Martin_Heinrich" title="Martin Heinrich">Martin Heinrich</a>, (D-NM)</li></ul> </div> <h4><span id="Letter_for_Sebelius.27_resignation"></span><span class="mw-headline" id="Letter_for_Sebelius'_resignation">Letter for Sebelius' resignation</span></h4> <p>On October 24, 2013, 32 House Republicans signed a letter to President Obama calling for the resignation of Secretary of Health and Human Services Kathleen Sebelius. Text of the letter included, "The scope of the problem is so great that, were this a private company or military command, the CEO or general would have been fired. We are, therefore, calling on you to hold Secretary Sebelius accountable for the fiasco that is HealthCare.gov and ask for her resignation."<sup id="cite_ref-waporesignletter_132-0" class="reference"><a href="#cite_note-waporesignletter-132">[132]</a></sup> </p><p>Those who signed the letter include:<sup id="cite_ref-waporesignletter_132-1" class="reference"><a href="#cite_note-waporesignletter-132">[132]</a></sup> </p> <div style="-moz-column-count:4; -webkit-column-count:4; column-count:4;" class="mobile-columns"> <ul><li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/David_Schweikert" title="David Schweikert">David Schweikert</a>, (R-AZ)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Jim_Jordan" title="Jim Jordan">Jim Jordan</a>, (R-OH)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Bill_Shuster" title="Bill Shuster">Bill Shuster</a>, (R-PA)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Jeff_Duncan" title="Jeff Duncan">Jeff Duncan</a>, (R-SC)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Mike_Pompeo" title="Mike Pompeo">Mike Pompeo</a>, (R-KS)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Tim_Huelskamp" title="Tim Huelskamp">Tim Huelskamp</a>, (R-KS)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Kerry_Bentivolio" title="Kerry Bentivolio">Kerry Bentivolio</a>, (R-MI)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Steve_Daines" title="Steve Daines">Steve Daines</a>, (R-MT)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Ron_DeSantis" title="Ron DeSantis">Ron DeSantis</a>, (R-FL)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Jim_Bridenstine" title="Jim Bridenstine">Jim Bridenstine</a>, (R-OK)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Randy_Weber" title="Randy Weber">Randy Weber</a>, (R-TX)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Ted_Yoho" title="Ted Yoho">Ted Yoho</a>, (R-FL)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Larry_Bucshon" title="Larry Bucshon">Larry Bucshon</a>, (R-IN)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Andrew_Harris" title="Andrew Harris">Andrew Harris</a>, (R-MD)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Alan_Nunnelee" title="Alan Nunnelee">Alan Nunnelee</a>, (R-MS)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Walter_Jones" title="Walter Jones">Walter Jones</a>, (R-SC)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Louie_Gohmert" title="Louie Gohmert">Louie Gohmert</a>, (R-TX)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Trent_Franks" title="Trent Franks">Trent Franks</a>, (R-AZ)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Paul_Broun" title="Paul Broun">Paul Broun</a>, (R-GA)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Blaine_Luetkemeyer" title="Blaine Luetkemeyer">Blaine Luetkemeyer</a>, (R-MO)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Steve_Southerland" title="Steve Southerland">Steve Southerland</a>, (R-FL)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Mo_Brooks" title="Mo Brooks">Mo Brooks</a>, (R-AL)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Roger_Williams" title="Roger Williams">Roger Williams</a>, (R-TX)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Vicky_Hartzler" title="Vicky Hartzler">Vicky Hartzler</a>, (R-MO)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Michele_Bachmann" title="Michele Bachmann">Michele Bachmann</a>, (R-MN)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Stephen_Fincher" class="mw-redirect" title="Stephen Fincher">Stephen Fincher</a>, (R-TN)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Bob_Gibbs" title="Bob Gibbs">Bob Gibbs</a>, (R-OH)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Jim_Renacci" title="Jim Renacci">Jim Renacci</a>, (R-OH)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Pete_Olson" title="Pete Olson">Pete Olson</a>, (R-TX)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Phil_Gingrey" title="Phil Gingrey">Phil Gingrey</a>, (R-GA)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Steve_Stockman" title="Steve Stockman">Steve Stockman</a>, (R-TX)</li> <li><a href="/Republican_Party" title="Republican Party"><img alt="Republican Party" src="https://cdn.ballotpedia.org/images/f/fd/Ends.png" width="18" height="18" data-file-width="16" data-file-height="16" /></a><a href="/Doug_LaMalfa" title="Doug LaMalfa">Doug LaMalfa</a>, (R-CA)</li></ul> </div> <h2><span class="mw-headline" id="International_government-run_healthcare_IT_comparisons">International government-run healthcare IT comparisons</span></h2> <h3><span class="mw-headline" id="England">England</span></h3> <ul><li>In 2002, the British National Health Service(NHS) began a program aimed at improving the use of technology in healthcare by digitizing medical records and unifying healthcare IT under one system for hospitals nationwide. The program was stopped in 2013 and named by a Public Accounts Committee report as one of the "worst and most expensive contracting fiascos" in British government history. The total amount spent on the project was estimated to have been over 9.8 billion British pounds due to technical problems and contractual problems.<sup id="cite_ref-133" class="reference"><a href="#cite_note-133">[133]</a></sup></li></ul> <h3><span class="mw-headline" id="Canada">Canada</span></h3> <ul><li>The Ontario provincial government attempted to create an online registry for people suffering from diabetes in 2010. They contracted CGI Group, Inc. for a $46 million, 6-year deal, but the company was fired in 2012 after missing multiple deadlines, including creating the registry itself.<sup id="cite_ref-wapocgi_107-3" class="reference"><a href="#cite_note-wapocgi-107">[107]</a></sup><sup id="cite_ref-CGIfired_111-1" class="reference"><a href="#cite_note-CGIfired-111">[111]</a></sup></li></ul> <h2><span class="mw-headline" id="Alternatives_to_Healthcare.gov_for_insurance">Alternatives to Healthcare.gov for insurance</span></h2> <p>The alternative ways to become compliant with the ACA without using the Healthcare.gov website include:<sup id="cite_ref-134" class="reference"><a href="#cite_note-134">[134]</a></sup> </p> <ul><li>State-run exchanges</li> <li>Paper applications</li> <li>Telephone hotline</li> <li>In-person navigators</li> <li>State <a href="/Medicaid" title="Medicaid">Medicaid</a> offices (if qualified)</li> <li>Directly through health insurance companies</li> <li>Other online brokers and aggregators</li> <li>In-person insurance brokers</li></ul> <h3><span class="mw-headline" id="Health_Sherpa">Health Sherpa</span></h3> <p>Three programmers living in California were frustrated with their struggles using the federal exchange and created a semi-alternative to Healthcare.gov using available public data. Consumers could insert their age, location and family and income details to preview what plans would be available to them. Users can't purchase plans on the site, but <a target="_blank" rel="noreferrer noopener" class="external text" href="https://www.healthsherpa.com/">Health Sherpa</a> attracted over 200,000 unique viewers in less than a week. The site reported cost a few hundred dollars to create. Co-creator George George Kalogeropoulos stated the reasoning behind their idea being, "We were surprised to see that it was actually fairly difficult to use HealthCare.gov to find and understand our options. Given that the data was publicly available, we thought that it made a lot of sense to take the data that was on there and just make it easy to search through and view available plans."<sup id="cite_ref-135" class="reference"><a href="#cite_note-135">[135]</a></sup> </p> <h2><span class="mw-headline" id="Reactions">Reactions</span></h2> <h3><span class="mw-headline" id="Executive_branch">Executive branch</span></h3> <ul><li><a href="/Kathleen_Sebelius" title="Kathleen Sebelius">Kathleen Sebelius</a></li></ul> <dl><dd><b>November 26, 2013</b>: On the administration's self-imposed goal of having the website optimized by November 30: "We are seeing more and more enrollments each and every day. A very different kind of user issues. We've added hardware. We've added software. We're continuing to work on the parts of the website that were too confusing to people and well beyond December 1, those improvements will continue. We get feedback on a regular basis from user experiences. We want to continue to update this."</dd> <dd><b>October 30, 2013</b>: During testimony in front of the <a href="/United_States_House_Committee_on_Energy_and_Commerce" class="mw-redirect" title="United States House Committee on Energy and Commerce">House Energy and Commerce Committee</a>, Sebelius stated, "In these early weeks, access to HealthCare.gov has been a miserably frustrating experience for way too many Americans, including many who have waited years, in some cases their entire lives, for the security of health insurance."<sup id="cite_ref-CNNSebelius_120-1" class="reference"><a href="#cite_note-CNNSebelius-120">[120]</a></sup></dd> <dd><b>October 22, 2013</b>: When asked if she had spoken with President Obama about resigning: "What I talked about is doing the job that I came here to do. ... I think my job is to get this fully implemented and to get the website working right. And that’s what I’m focused on."<sup id="cite_ref-136" class="reference"><a href="#cite_note-136">[136]</a></sup></dd> <dd><b>October 10, 2013</b>: At a promotional event for Healthcare.gov in <a href="/Pittsburgh,_Pennsylvania" title="Pittsburgh, Pennsylvania">Pittsburgh</a>, Sebelius stated, "Believe me, we had some early glitches, but it's getting better every day."<sup id="cite_ref-137" class="reference"><a href="#cite_note-137">[137]</a></sup></dd> <dd><b>April 12, 2013</b>: On whether or not the Health and Human Services Department needed a backup plan for potential delays: "No. We are determined and on track to meet the Oct. 1 deadline."<sup id="cite_ref-138" class="reference"><a href="#cite_note-138">[138]</a></sup></dd></dl> <ul><li><a href="/Barack_Obama" title="Barack Obama">Barack Obama</a></li></ul> <dl><dd><b>November 25, 2013</b>: "I think it's fair to say I’m not happy about the fact that we didn't have a Web site that worked on the day it was supposed to work -- although it's actually starting to work pretty well now, and it's going to be working even better in the coming weeks."<sup id="cite_ref-139" class="reference"><a href="#cite_note-139">[139]</a></sup></dd> <dd><b>October 21, 2013</b>: On opponents of the law rooting for the healthcare law's failure: "That product is working. It's really good. And it turns out there's a massive demand for it." He continued, "But we did not wage this long and contentious battle just around a website. That’s not what this was about."<sup id="cite_ref-NBC_25-1" class="reference"><a href="#cite_note-NBC-25">[25]</a></sup></dd> <dd><b>October 15, 2013</b>: On the struggles of the website: "The website that was supposed to do this all in a seamless way has had way more glitches than I think are acceptable."<sup id="cite_ref-politico_51-4" class="reference"><a href="#cite_note-politico-51">[51]</a></sup></dd> <dd><b>October 1, 2013</b>: On the problems encountered on the initial release of Healthcare.gov: "Consider that just a couple of weeks ago, Apple rolled out a new mobile operating system, and within days, they found a glitch, so they fixed it. I don't remember anybody suggesting Apple should stop selling iPhones or iPads or threatening to shut down the company if they didn't. That's not how we do things in America. We don't actively root for failure. We get to work, we make things happen, we make them better, we keep going."<sup id="cite_ref-cnet_140-0" class="reference"><a href="#cite_note-cnet-140">[140]</a></sup></dd></dl> <ul><li><a href="/Jay_Carney" title="Jay Carney">Jay Carney</a></li></ul> <dl><dd><b>October 15, 2013</b>: On calls for Secretary of Health and Human Services <a href="/Kathleen_Sebelius" title="Kathleen Sebelius">Kathleen Sebelius</a>'s resignation: "The secretary does have the full confidence of the president. She, like everyone else in this effort, is focused on our No. 1 priority, which is making the implementation of the Affordable Care Act work well. People are working 24/7 to address the problems and isolate them and fix them, when it comes to the website and enrollment issues."<sup id="cite_ref-politico25_141-0" class="reference"><a href="#cite_note-politico25-141">[141]</a></sup></dd></dl> <ul><li>Robert Gibbs</li></ul> <dl><dd><b>October 14, 2013</b>: Former Press Secretary for President Obama, Robert Gibbs, stated about the website's problems: "I hope they're working day and night to get this done. And when they get it fixed, I hope they fire some people that were in charge of making sure that this thing was supposed to work."<sup id="cite_ref-yahoo_13-1" class="reference"><a href="#cite_note-yahoo-13">[13]</a></sup></dd></dl> <ul><li><a href="/Jack_Lew" title="Jack Lew">Jack Lew</a></li></ul> <dl><dd><b>October 6, 2013</b>: On the problems during the website's launch: "It is not unique that when you have a very large, new software program come out that people work to clean it up."<sup id="cite_ref-politico25_141-1" class="reference"><a href="#cite_note-politico25-141">[141]</a></sup></dd></dl> <table class="infobox" style="text-align: center; width:25%;"> <tbody><tr> <td><div class="center"><div class="floatnone"><a href="/Portal:Legislative_Branch" title="Portal:Legislative Branch"><img alt="Portal:Legislative Branch" src="https://ballotpedia.s3.amazonaws.com/images/thumb/2/23/CongressLogo.png/160px-CongressLogo.png" decoding="async" width="160" height="162" srcset="https://ballotpedia.s3.amazonaws.com/images/thumb/2/23/CongressLogo.png/240px-CongressLogo.png 1.5x, https://ballotpedia.s3.amazonaws.com/images/thumb/2/23/CongressLogo.png/320px-CongressLogo.png 2x" data-file-width="1266" data-file-height="1282" /></a></div></div><center><b>Features of Congress</b></center><hr /> </td></tr> <tr> <td><center><b>Background</b></center> <small><center> <a href="/Federal_Election_Commission" title="Federal Election Commission">Federal Election Commission</a> • <a href="/Democratic_Congressional_Campaign_Committee" title="Democratic Congressional Campaign Committee">Democratic Congressional Campaign Committee</a> • <a href="/National_Republican_Congressional_Committee" title="National Republican Congressional Committee">National Republican Congressional Committee</a> • <a href="/Filing_requirements_for_congressional_candidates" title="Filing requirements for congressional candidates">Filing requirements for congressional candidates</a> • <a href="/Classes_of_United_States_Senators" title="Classes of United States Senators">Classes of United States Senators</a> • <a href="/Filling_vacancies_in_the_U.S._Senate" title="Filling vacancies in the U.S. Senate">Filling vacancies in Senate</a> • <a href="/Filling_vacancies_in_the_U.S._House_of_Representatives" title="Filling vacancies in the U.S. House of Representatives">Filling vacancies in House</a> • <a href="/President_of_the_U.S._Senate" title="President of the U.S. Senate">President Pro Tempore of the Senate</a> • <a href="/United_States_Speaker_of_the_House" title="United States Speaker of the House">United States Speaker of the House</a> • <a href="/Filibuster" class="mw-redirect" title="Filibuster">Filibuster</a> • <a href="/Budget_reconciliation_in_U.S._Congress" title="Budget reconciliation in U.S. Congress">Reconciliation</a> • <a href="/Key_votes" title="Key votes">Key votes</a> • <a href="/Vote-a-ramas_in_the_U.S._Senate" title="Vote-a-ramas in the U.S. Senate">Vote-a-ramas</a> • <a href="/Senate_Parliamentarian" title="Senate Parliamentarian">Parliamentarian</a> • <a href="/Christmas_tree_bill" title="Christmas tree bill">Christmas tree bill</a> • <a href="/Presidential_addresses_to_joint_sessions_of_Congress" title="Presidential addresses to joint sessions of Congress">Presidential addresses</a></center></small><hr /> </td></tr> <tr> <td><center><b>Sessions</b></center> <small><center><a href="/119th_United_States_Congress" title="119th United States Congress">119th Congress</a><br /><a href="/118th_United_States_Congress" title="118th United States Congress">118th</a> • <a href="/117th_United_States_Congress" title="117th United States Congress">117th</a> • <a href="/116th_United_States_Congress" title="116th United States Congress">116th</a> • <a href="/115th_United_States_Congress" title="115th United States Congress">115th</a> • <a href="/114th_United_States_Congress" title="114th United States Congress">114th</a> • <a href="/113th_United_States_Congress" title="113th United States Congress">113th</a> • <a href="/112th_United_States_Congress" title="112th United States Congress">112th</a> • <a href="/111th_United_States_Congress" title="111th United States Congress">111th</a> • <a href="/110th_United_States_Congress" title="110th United States Congress">110th</a></center></small> </td></tr></tbody></table> <h3><span class="mw-headline" id="Congress">Congress</span></h3> <h4><span class="mw-headline" id="Republicans">Republicans</span></h4> <ul><li>Rep. <a href="/Fred_Upton" title="Fred Upton">Fred Upton</a>, (R-MI)</li></ul> <dl><dd><b>October 24, 2013</b>: During a congressional hearing with the Healthcare.gov contractors: "This is more than a Web site problem. The Web site should have been the easy part. I'm also concerned about what happens next. Will enrollment glitches become provider payment glitches? Will patients show up at their doctor's office or hospital only to be told that they aren't covered, or even in the system?"<sup id="cite_ref-nythearings_35-6" class="reference"><a href="#cite_note-nythearings-35">[35]</a></sup></dd> <dd><b>October 17, 2013</b>: On Sebelius not clearing time on her schedule to testify before the <a href="/United_States_House_of_Representatives_Committee_on_Energy_and_Commerce" title="United States House of Representatives Committee on Energy and Commerce">House Energy and Commerce committee</a>: "The rollout has been a complete mess, beyond the worst case scenario, and yet those administration officials responsible have indicated they will not be available to testify next week. This is wholly unacceptable. Secretary Sebelius had time for Jon Stewart, and we expect her to have time for Congress."<sup id="cite_ref-sebeliushearing_142-0" class="reference"><a href="#cite_note-sebeliushearing-142">[142]</a></sup></dd> <dd><b>October 10, 2013</b>: On the website's unsteady rollout: "Despite the widespread belief that the administration was not ready for the health law’s Oct. 1 launch, top officials and lead IT contractors looked us in the eye and assured us all systems were a go. Instead, here we are 10 days later, and delays and technical failures have reached epidemic proportions."<sup id="cite_ref-politico25_141-2" class="reference"><a href="#cite_note-politico25-141">[141]</a></sup></dd></dl> <ul><li>Sen. <a href="/Ted_Cruz" title="Ted Cruz">Ted Cruz</a>, (R-TX)</li></ul> <dl><dd><b>October 21, 2013</b>: On the troubled website rollout: "You may have noticed that all the Nigerian email scammers have become a lot less active lately. They all have been hired to run the Obamacare website."<sup id="cite_ref-143" class="reference"><a href="#cite_note-143">[143]</a></sup></dd></dl> <ul><li>Rep. <a href="/John_Fleming" title="John Fleming">John Fleming</a>, (R-KS)</li></ul> <dl><dd><b>October 14, 2013</b>: On Sen. Roberts' call for Secretary Sebelius' resignation:<sup id="cite_ref-144" class="reference"><a href="#cite_note-144">[144]</a></sup> "The rollout of Obamacare, like the law itself, has been a mess. For the sake of the American health care system, as well as jobs and the economy, Obamacare should be repealed. In the meantime, someone must be held accountable for wasting taxpayer dollars on a rollout that was more than three years in the making."</dd></dl> <div style="float:right"> <table class="wikitable" cellspacing="0" cellpadding="5" width="205"> <tbody><tr> <td><div class="thumb embedvideo autoResize" style="width: 208px;"><div class="embedvideo autoResize" style=""><div class="embedvideowrap youtube" style="width: 200px"><iframe loading="lazy" frameborder="0" allow="accelerometer; clipboard-write; encrypted-media; fullscreen; gyroscope; picture-in-picture" modestbranding="1" width="200" height="113" src="//www.youtube-nocookie.com/embed/mQf_c7SNv-U"></iframe></div></div></div><span style="font-size:80%"><a href="/Pat_Roberts" title="Pat Roberts">Pat Roberts</a> calls for <a href="/Kathleen_Sebelius" title="Kathleen Sebelius">Sebelius</a>' resignation.</span> </td></tr></tbody></table></div> <ul><li>Sen. <a href="/Pat_Roberts" title="Pat Roberts">Pat Roberts</a>, (R-KS)</li></ul> <dl><dd><b>October 11, 2013</b>: Sen. Roberts issued a YouTube video calling for Sebelius to resign, stating:<sup id="cite_ref-145" class="reference"><a href="#cite_note-145">[145]</a></sup> "Enough is enough. Today I am calling on Kathleen Sebelius to resign her post as Secretary of Health and Human Services. Secretary Sebelius has had three and a half years to launch Obamacare, and she has failed."</dd></dl> <ul><li>Rep. <a href="/John_Boehner" title="John Boehner">John Boehner</a>, (R-OH)</li></ul> <dl><dd><b>October 10, 2013</b>: On the administration not adjusting the individual mandate deadline: "How can we tax people for not buying a product from a website that doesn’t work?"<sup id="cite_ref-politico25_141-3" class="reference"><a href="#cite_note-politico25-141">[141]</a></sup></dd></dl> <ul><li>Rep. <a href="/Darrell_Issa" title="Darrell Issa">Darrell Issa</a>, (R-CA)</li></ul> <dl><dd><b>October 9, 2013</b>: On the Healthcare.gov rollout problems: "Basically, HHS has screwed this whole thing up."<sup id="cite_ref-politico25_141-4" class="reference"><a href="#cite_note-politico25-141">[141]</a></sup></dd></dl> <h4><span class="mw-headline" id="Democrats">Democrats</span></h4> <ul><li>Sen. <a href="/Jay_Rockefeller" title="Jay Rockefeller">Jay Rockefeller</a>, (D-WV)</li></ul> <dl><dd><b>October 21, 2013</b>: On the implementation of the healthcare law:<sup id="cite_ref-uproar_146-0" class="reference"><a href="#cite_note-uproar-146">[146]</a></sup> "I firmly believe these technical glitches will get worked out so people can more easily sign up for health insurance. Transforming an entire health care system, especially one as enormous and fractious as ours, doesn't happen overnight."</dd></dl> <ul><li>Rep. <a href="/Nancy_Pelosi" title="Nancy Pelosi">Nancy Pelosi</a>, (D-CA)</li></ul> <dl><dd><b>October 21, 2013</b>: On the initial problems with the website:<sup id="cite_ref-uproar_146-1" class="reference"><a href="#cite_note-uproar-146">[146]</a></sup> "They were overwhelmed to begin with. There is much that needs to be done to correct the situation."</dd></dl> <ul><li>Sen. <a href="/Max_Baucus" title="Max Baucus">Max Baucus</a>, (D-MT)</li></ul> <dl><dd><b>October 16, 2013</b>: On the website's troubles:<sup id="cite_ref-147" class="reference"><a href="#cite_note-147">[147]</a></sup> "Any major undertaking will have a few glitches. They’re working them out. In the end it’s going to work fine. I have a lot of confidence — because of the people I’ve been talking with inside government and outside government, both public and private sector."</dd></dl> <ul><li>Rep. <a href="/Sandy_Levin" title="Sandy Levin">Sandy Levin</a>, (D-MI)</li></ul> <dl><dd><b>October 16, 2013</b>: On the website's early issues:<sup id="cite_ref-politico_51-5" class="reference"><a href="#cite_note-politico-51">[51]</a></sup> "Clearly, there are problems that need to be fixed and they’re under way but it has to be accelerated."</dd></dl> <ul><li>Sen. <a href="/Ed_Markey" class="mw-redirect" title="Ed Markey">Ed Markey</a>, (D-MA)</li></ul> <dl><dd><b>October 10, 2013</b>: On the website rollout problems and the shutdown: "[It’s] pretty clear that they’re working on the glitches in Obamacare, and it’s pretty clear that we need a geek squad for the website, not a firing squad for the entire bill."<sup id="cite_ref-politico25_141-5" class="reference"><a href="#cite_note-politico25-141">[141]</a></sup></dd></dl> <ul><li>Rep. <a href="/Rob_Andrews" class="mw-redirect" title="Rob Andrews">Rob Andrews</a>, (D-NJ)</li></ul> <dl><dd><b>October 8, 2013</b>: On speaking with the White House in the summer of 2013 about potential flaws in the system:<sup id="cite_ref-148" class="reference"><a href="#cite_note-148">[148]</a></sup> "Nothing I told them ever surprised them. The White House has acknowledged all along something this massive was going to have implementation problems."</dd></dl> <h3><span class="mw-headline" id="Media">Media</span></h3> <table> <tbody><tr> <td> <div style="float:right"> <table class="wikitable" cellspacing="0" cellpadding="5" width="205"> <tbody><tr> <td><div class="thumb embedvideo autoResize" style="width: 258px;"><div class="embedvideo autoResize" style=""><div class="embedvideowrap youtube" style="width: 250px"><iframe loading="lazy" frameborder="0" allow="accelerometer; clipboard-write; encrypted-media; fullscreen; gyroscope; picture-in-picture" modestbranding="1" width="250" height="141" src="//www.youtube-nocookie.com/embed/nZiiS2XGHt0"></iframe></div></div></div><span style="font-size:80%">Secretary <a href="/Kathleen_Sebelius" title="Kathleen Sebelius">Sebelius</a> appeared on <i>The Daily Show with Jon Stewart</i> on October 7, 2013.</span> </td></tr></tbody></table></div> </td> <td> <div style="float:right"> <table class="wikitable" cellspacing="0" cellpadding="5" width="205"> <tbody><tr> <td><div class="thumb embedvideo autoResize" style="width: 258px;"><div class="embedvideo autoResize" style=""><div class="embedvideowrap youtube" style="width: 250px"><iframe loading="lazy" frameborder="0" allow="accelerometer; clipboard-write; encrypted-media; fullscreen; gyroscope; picture-in-picture" modestbranding="1" width="250" height="141" src="//www.youtube-nocookie.com/embed/2Qtx_ZcHOjw"></iframe></div></div></div><span style="font-size:80%"><i>The Daily Show'</i>s John Stewart breaks down the issues with <i>Healthcare.gov</i> on October 21, 2013.</span> </td></tr></tbody></table></div> </td> <td> <div style="float:right"> <table class="wikitable" cellspacing="0" cellpadding="5" width="205"> <tbody><tr> <td><div class="thumb embedvideo autoResize" style="width: 258px;"><div class="embedvideo autoResize" style=""><div class="embedvideowrap youtube" style="width: 250px"><iframe loading="lazy" frameborder="0" allow="accelerometer; clipboard-write; encrypted-media; fullscreen; gyroscope; picture-in-picture" modestbranding="1" width="250" height="141" src="//www.youtube-nocookie.com/embed/CfJGPjldNt8"></iframe></div></div></div><span style="font-size:80%"><i>USA Today</i> reporter suggests total overhaul necessary on October 18, 2013.</span> </td></tr></tbody></table></div> </td></tr></tbody></table> <table> <tbody><tr> <td> <div style="float:right"> <table class="wikitable" cellspacing="0" cellpadding="5" width="205"> <tbody><tr> <td><div class="thumb embedvideo autoResize" style="width: 258px;"><div class="embedvideo autoResize" style=""><div class="embedvideowrap youtube" style="width: 250px"><iframe loading="lazy" frameborder="0" allow="accelerometer; clipboard-write; encrypted-media; fullscreen; gyroscope; picture-in-picture" modestbranding="1" width="250" height="141" src="//www.youtube-nocookie.com/embed/NRP8Do-IyRU"></iframe></div></div></div><span style="font-size:80%">Carrie Underwood and Brad Paisley sing about <i>Healthcare.gov</i> at the <i>Country Music Awards</i>.</span> </td></tr></tbody></table></div> </td> <td> <div style="float:right"> <table class="wikitable" cellspacing="0" cellpadding="5" width="205"> <tbody><tr> <td><div class="thumb embedvideo autoResize" style="width: 258px;"><div class="embedvideo autoResize" style=""><div class="embedvideowrap youtube" style="width: 250px"><iframe loading="lazy" frameborder="0" allow="accelerometer; clipboard-write; encrypted-media; fullscreen; gyroscope; picture-in-picture" modestbranding="1" width="250" height="141" src="//www.youtube-nocookie.com/embed/w6iEmGuuLWQ"></iframe></div></div></div><span style="font-size:80%">A <i>Saturday Night Live</i> skit about the website's technical problems.</span> </td></tr></tbody></table></div> </td> <td> <div style="float:right"> <table class="wikitable" cellspacing="0" cellpadding="5" width="205"> <tbody><tr> <td><div class="thumb embedvideo autoResize" style="width: 258px;"><div class="embedvideo autoResize" style=""><div class="embedvideowrap youtube" style="width: 250px"><iframe loading="lazy" frameborder="0" allow="accelerometer; clipboard-write; encrypted-media; fullscreen; gyroscope; picture-in-picture" modestbranding="1" width="250" height="141" src="//www.youtube-nocookie.com/embed/5oSSgLoDBvs"></iframe></div></div></div><span style="font-size:80%"><i>Washington Post'</i>s Ezra Klein reports on the website's problems on October 18, 2013.</span> </td></tr></tbody></table></div> </td></tr></tbody></table> <div id="div-gpt-ad-1548351761485-0"><script>googletag.cmd.push(function() { googletag.display("div-gpt-ad-1548351761485-0"); });</script></div><h2><span class="mw-headline" id="Recent_news">Recent news</span></h2> <p>This section links to a Google news search for the term <b>Healthcare.gov + website + issues</b> </p><p><br /> </p> <div class="rss-feed"> <p><b><span style="font-size:135%"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://google.com/search?hl=en&gl=us&tbm=nws&q=Healthcare.gov+website+issues&um=1&ie=UTF-8">Healthcare.gov website issues news feed</a></span></b> </p> </div> <h2><span class="mw-headline" id="See_also">See also</span></h2> <ul><li><a href="/Obamacare_overview" class="mw-redirect" title="Obamacare overview">Obamacare overview</a></li> <li><a href="/Health_insurance_policy_cancellations_since_Obamacare" title="Health insurance policy cancellations since Obamacare">Health insurance policy cancellations since Obamacare</a></li> <li><a href="/Healthcare_policy_in_the_United_States" title="Healthcare policy in the United States">Healthcare policy in the United States</a></li> <li><a href="/Effect_of_the_Affordable_Care_Act_in_the_United_States" class="mw-redirect" title="Effect of the Affordable Care Act in the United States">Effect of the Affordable Care Act in the United States</a></li> <li><a href="/United_States_budget_debate,_2013" title="United States budget debate, 2013">United States budget debate, 2013</a></li></ul> <h2><span class="mw-headline" id="External_links">External links</span></h2> <ul><li><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.healthcare.gov">Healthcare.gov</a></li> <li><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.hhs.gov/">U.S. Department of Health and Human Services</a></li></ul> <h2><span class="mw-headline" id="Footnotes">Footnotes</span></h2> <p> <script type="text/javascript"> if(document.getElementsByClassName("reference").length==0) if(document.getElementById('Footnotes')!==null) document.getElementById('Footnotes').parentNode.style.display = 'none'; </script> </p> <div class="references-small"><div class="mobile-columns" style="-moz-column-count:2; -webkit-column-count:2; column-count:2;"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><a href="#cite_ref-1">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.nbcnews.com/health/better-use-phone-why-obamacare-website-such-fail-8C11433702"><i>NBC News</i>, "Better use the phone: Why Obamacare website is such a fail," October 21, 2013</a></span> </li> <li id="cite_note-rockystart-2"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-rockystart_2-0">2.0</a></sup> <sup><a href="#cite_ref-rockystart_2-1">2.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://usnews.nbcnews.com/_news/2013/10/22/21064709-obamacares-rocky-start-what-you-need-to-know?lite"><i>NBC News</i>, "Obamacare's rocky start: What you need to know," October 21, 2013</a></span> </li> <li id="cite_note-mccardle-3"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-mccardle_3-0">3.0</a></sup> <sup><a href="#cite_ref-mccardle_3-1">3.1</a></sup> <sup><a href="#cite_ref-mccardle_3-2">3.2</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.bloomberg.com/news/2013-10-18/four-things-we-think-we-know-about-obamacare.html"><i>Bloomberg</i>, "Four things we think we know about Obamacare," October 18, 2013</a></span> </li> <li id="cite_note-nbcdeadline-4"><span class="mw-cite-backlink"><a href="#cite_ref-nbcdeadline_4-0">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://web.archive.org/web/20160517214658/http://www.nbcnews.com/news/other/administration-adjust-health-care-penalty-deadline-guidance-f8C11447365"><i>NBC News</i>, "Administration to adjust health care penalty deadline guidance," October 23, 2013</a></span> </li> <li id="cite_note-foxdelay-5"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-foxdelay_5-0">5.0</a></sup> <sup><a href="#cite_ref-foxdelay_5-1">5.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.foxnews.com/opinion/2014/03/26/another-day-another-delay-obamacare-deadline-extended-yet-again/"><i>Fox News</i>, "Surprise, surprise -- ObamaCare deadline extended yet again," March 26, 2014</a></span> </li> <li id="cite_note-wapoSebelius-6"><span class="mw-cite-backlink"><a href="#cite_ref-wapoSebelius_6-0">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.washingtonpost.com/national/health-science/sebelius-on-health-care-law-rollout-hold-me-accountable-for-the-debacle-im-responsible/2013/10/30/7ef34e04-4197-11e3-a624-41d661b0bb78_story.html"><i>Washington Post</i>, "Sebelius on health-care law rollout: 'Hold me accountable for the debacle. I'm responsible.'," October 31, 2013</a></span> </li> <li id="cite_note-njoctenrollment-7"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-njoctenrollment_7-0">7.0</a></sup> <sup><a href="#cite_ref-njoctenrollment_7-1">7.1</a></sup> <sup><a href="#cite_ref-njoctenrollment_7-2">7.2</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.nationaljournal.com/health-care/it-s-official-obamacare-enrollment-is-super-low-20131113"><i>National Journal</i>, "It's Official: Obamacare Enrollment Is Super Low," November 13, 2013</a></span> </li> <li id="cite_note-Octofficialreport-8"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-Octofficialreport_8-0">8.0</a></sup> <sup><a href="#cite_ref-Octofficialreport_8-1">8.1</a></sup> <sup><a href="#cite_ref-Octofficialreport_8-2">8.2</a></sup> <sup><a href="#cite_ref-Octofficialreport_8-3">8.3</a></sup> <sup><a href="#cite_ref-Octofficialreport_8-4">8.4</a></sup> <sup><a href="#cite_ref-Octofficialreport_8-5">8.5</a></sup> <sup><a href="#cite_ref-Octofficialreport_8-6">8.6</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://online.wsj.com/public/resources/documents/rpt_enrollment11132013.pdf"><i>ASPE Issue Brief</i>, "Health Insurance Marketplace: November Enrollment Report," November 13, 2013</a></span> </li> <li id="cite_note-9"><span class="mw-cite-backlink"><a href="#cite_ref-9">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.foxnews.com/politics/2013/11/22/obamacare-enrollment-for-2015-to-reportedly-be-delayed-until-after-midterms/"><i>Fox News</i>, "HHS announces small extension for ObamaCare sign-up, bigger delay next year," November 22, 2013</a></span> </li> <li id="cite_note-10"><span class="mw-cite-backlink"><a href="#cite_ref-10">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.washingtonpost.com/blogs/wonkblog/wp/2013/11/27/obamacares-online-exchange-for-small-businesses-is-delayed-by-one-year/"><i>Washington Post</i>, "Obamacare’s online SHOP enrollment delayed by one year," November 27, 2013</a></span> </li> <li id="cite_note-11"><span class="mw-cite-backlink"><a href="#cite_ref-11">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.nytimes.com/2014/04/11/us/politics/sebelius-resigning-as-health-secretary.html"><i>New York Times</i>, "Health Secretary Resigns After Woes of HealthCare.gov," April 10, 2014</a></span> </li> <li id="cite_note-12"><span class="mw-cite-backlink"><a href="#cite_ref-12">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://thehill.com/blogs/healthwatch/health-reform-implementation/328681-white-house-stands-by-sebelius-amid-calls-for-her-ouster"><i>The Hill</i>, "White House stands by Sebelius amid ouster calls over ObamaCare rollout," October 15, 2013</a></span> </li> <li id="cite_note-yahoo-13"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-yahoo_13-0">13.0</a></sup> <sup><a href="#cite_ref-yahoo_13-1">13.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://news.yahoo.com/obamacare-website-shows-improvement-problems-emerge-211711095--sector.html"><i>Yahoo! News</i>, "Obamacare website shows improvement, new problems emerge," October 14, 2013</a></span> </li> <li id="cite_note-politicoZients-14"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-politicoZients_14-0">14.0</a></sup> <sup><a href="#cite_ref-politicoZients_14-1">14.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.politico.com/story/2013/10/jeff-zients-healthcaregov-working-by-end-of-november-98850.html"><i>Politico</i>, "Jeff Zients: HealthCare.gov working by end of November," October 25, 2013</a></span> </li> <li id="cite_note-Marchofficialreport-15"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-Marchofficialreport_15-0">15.0</a></sup> <sup><a href="#cite_ref-Marchofficialreport_15-1">15.1</a></sup> <sup><a href="#cite_ref-Marchofficialreport_15-2">15.2</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Apr2014/ib_2014Apr_enrollment.pdf"><i>Department of Health and Human Services</i>, "April Enrollment report," May 1, 2014</a></span> </li> <li id="cite_note-Febofficialreport-16"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-Febofficialreport_16-0">16.0</a></sup> <sup><a href="#cite_ref-Febofficialreport_16-1">16.1</a></sup> <sup><a href="#cite_ref-Febofficialreport_16-2">16.2</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Mar2014/ib_2014mar_enrollment.pdf"><i>Department of Health and Human Services</i>, "March Enrollment Report," March 11, 2014</a></span> </li> <li id="cite_note-Janofficialreport-17"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-Janofficialreport_17-0">17.0</a></sup> <sup><a href="#cite_ref-Janofficialreport_17-1">17.1</a></sup> <sup><a href="#cite_ref-Janofficialreport_17-2">17.2</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Feb2014/ib_2014feb_enrollment.pdf"><i>Department of Health and Human Services</i>, "February Enrollment Report," February 12, 2014</a></span> </li> <li id="cite_note-Decofficialreport-18"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-Decofficialreport_18-0">18.0</a></sup> <sup><a href="#cite_ref-Decofficialreport_18-1">18.1</a></sup> <sup><a href="#cite_ref-Decofficialreport_18-2">18.2</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Jan2014/ib_2014jan_enrollment.pdf"><i>Department of Health and Human Services</i>, "January Enrollment Report," January 13, 2013</a></span> </li> <li id="cite_note-Novofficialreport-19"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-Novofficialreport_19-0">19.0</a></sup> <sup><a href="#cite_ref-Novofficialreport_19-1">19.1</a></sup> <sup><a href="#cite_ref-Novofficialreport_19-2">19.2</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://aspe.hhs.gov/health/reports/2013/MarketPlaceEnrollment/Dec2013/ib_2013dec_enrollment.pdf"><i>Department of Health and Human Services</i>, "December Enrollment Report," December 11, 2013</a></span> </li> <li id="cite_note-20"><span class="mw-cite-backlink"><a href="#cite_ref-20">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.washingtonpost.com/blogs/wonkblog/wp/2013/11/11/who-counts-as-an-obamacare-enrollee-the-obama-administration-settles-on-a-definition/"><i>Washington Post</i>, "Who counts as an Obamacare enrollee? The Obama administration settles on a definition.," November 11, 2013</a></span> </li> <li id="cite_note-21"><span class="mw-cite-backlink"><a href="#cite_ref-21">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://online.wsj.com/news/articles/SB10001424052702303460004579192190709762378"><i>Wall Street Journal</i>, "Healthcare.gov Enrollment Falls Far Short of Target," November 11, 2013</a></span> </li> <li id="cite_note-cbslittle-22"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-cbslittle_22-0">22.0</a></sup> <sup><a href="#cite_ref-cbslittle_22-1">22.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.cbsnews.com/8301-18563_162-57610328/obamacare-enrollments-got-off-to-very-slow-start-documents-show/"><i>CBS News</i>, "Obamacare enrollments got off to very slow start, documents show," October 31, 2013</a></span> </li> <li id="cite_note-23"><span class="mw-cite-backlink"><a href="#cite_ref-23">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://oversight.house.gov/wp-content/uploads/2013/10/10.2.2013-am.pdf"><i>House Oversight Committee</i>, "CCIIO-Wide War Room Notes"</a></span> </li> <li id="cite_note-npr-24"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-npr_24-0">24.0</a></sup> <sup><a href="#cite_ref-npr_24-1">24.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.npr.org/blogs/health/2013/10/21/236999257/enrollments-for-the-health-care-exchanges-trickle-in-slowly"><i>NPR</i>, "Enrollments For The Healthcare Exchanges Trickle In, Slowly," October 21, 2013</a></span> </li> <li id="cite_note-NBC-25"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-NBC_25-0">25.0</a></sup> <sup><a href="#cite_ref-NBC_25-1">25.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://firstread.nbcnews.com/_news/2013/10/21/21064263-obama-the-affordable-care-act-is-not-just-a-website?lite"><i>NBC News</i>, "Obama: 'The Affordable Care Act is not just a website'," October 21, 2013</a></span> </li> <li id="cite_note-26"><span class="mw-cite-backlink"><a href="#cite_ref-26">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://thehill.com/blogs/healthwatch/health-reform-implementation/328681-white-house-stands-by-sebelius-amid-calls-for-her-ouster"><i>The Hill</i>, "White House stands by Sebelius amid ouster calls over ObamaCare rollout," October 15, 2013</a></span> </li> <li id="cite_note-27"><span class="mw-cite-backlink"><a href="#cite_ref-27">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.washingtonpost.com/blogs/wonkblog/wp/2013/11/26/obamacare-wont-get-7-million-enrollees-in-2014-and-thats-okay/?wprss=rss_ezra-klein&clsrd"><i>Washington Post</i>, "Obamacare won’t get 7 million enrollees in 2014 — and that’s okay," November 26, 2013</a></span> </li> <li id="cite_note-28"><span class="mw-cite-backlink"><a href="#cite_ref-28">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.rand.org/pubs/research_briefs/RB9812z2.html">RAND Corporation, "How does enrollment of young invincibles affect premiums in the ACA individual market?" 2015</a></span> </li> <li id="cite_note-29"><span class="mw-cite-backlink"><a href="#cite_ref-29">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://thehill.com/blogs/healthwatch/health-reform-implementation/189054-frustrated-media-groups-petition-govt-for"><i>The Hill</i>, "O-Care stonewall: Media stymied (Video)," accessed November 5, 2013</a></span> </li> <li id="cite_note-30"><span class="mw-cite-backlink"><a href="#cite_ref-30">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://thehill.com/policy/healthcare/217441-hhs-pledges-more-funds-to-enroll-minorities-in-o-care"><i>The Hill</i>, "HHS pledges more funds to enroll minorities in O-Care," September 11, 2014</a></span> </li> <li id="cite_note-31"><span class="mw-cite-backlink"><a href="#cite_ref-31">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.washingtonpost.com/blogs/wonkblog/wp/2013/11/26/obamacare-wont-get-7-million-enrollees-in-2014-and-thats-okay/?wprss=rss_ezra-klein&clsrd"><i>Washington Post</i>, "Obamacare won’t get 7 million enrollees in 2014 — and that’s okay," November 26, 2013</a></span> </li> <li id="cite_note-32"><span class="mw-cite-backlink"><a href="#cite_ref-32">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.politico.com/story/2013/12/poll-obamacare-young-americans-100542.html"><i>Politico</i>, "Poll: Young least familiar with Obamacare," December 2, 2013</a></span> </li> <li id="cite_note-33"><span class="mw-cite-backlink"><a href="#cite_ref-33">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.washingtonpost.com/national/health-science/healthcaregov-goal-80-percent-able-to-enroll-for-insurance-through-web-site/2013/11/16/04fa02a2-4e1a-11e3-ac54-aa84301ced81_print.html"><i>Washington Post</i>, "HealthCare.gov goal is for 80% of users to be able to enroll for insurance," November 19, 2013</a></span> </li> <li id="cite_note-wapo-34"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-wapo_34-0">34.0</a></sup> <sup><a href="#cite_ref-wapo_34-1">34.1</a></sup> <sup><a href="#cite_ref-wapo_34-2">34.2</a></sup> <sup><a href="#cite_ref-wapo_34-3">34.3</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.washingtonpost.com/national/health-science/health-insurance-exchange-launched-despite-signs-of-serious-problems/2013/10/21/161a3500-3a85-11e3-b6a9-da62c264f40e_print.html"><i>Washington Post</i>, "Health insurance exchange launched despite signs of serious problems," October 21, 2013</a></span> </li> <li id="cite_note-nythearings-35"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-nythearings_35-0">35.0</a></sup> <sup><a href="#cite_ref-nythearings_35-1">35.1</a></sup> <sup><a href="#cite_ref-nythearings_35-2">35.2</a></sup> <sup><a href="#cite_ref-nythearings_35-3">35.3</a></sup> <sup><a href="#cite_ref-nythearings_35-4">35.4</a></sup> <sup><a href="#cite_ref-nythearings_35-5">35.5</a></sup> <sup><a href="#cite_ref-nythearings_35-6">35.6</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.nytimes.com/2013/10/25/us/politics/bipartisan-dismay-over-health-plan-woes-at-house-hearing.html?hp&_r=0"><i>New York Times</i>, "Bipartisan Dismay Over Health Plan Woes at House Hearing," October 24, 2013</a></span> </li> <li id="cite_note-carneynot-36"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-carneynot_36-0">36.0</a></sup> <sup><a href="#cite_ref-carneynot_36-1">36.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.politico.com/politico44/2013/10/white-house-didnt-anticipate-scale-of-problems-with-175770.html"><i>Politico</i>, "White House didn't anticipate scale of problems with HealthCare.gov," October 23, 2013</a></span> </li> <li id="cite_note-37"><span class="mw-cite-backlink"><a href="#cite_ref-37">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://hotair.com/archives/2013/11/04/cbs-white-house-warned-three-years-ago-that-obamacare-was-running-off-the-rails/"><i>Hot Air</i>, "CBS: White House warned three years ago that ObamaCare was running off the rails," accessed November 5, 2013</a></span> </li> <li id="cite_note-38"><span class="mw-cite-backlink"><a href="#cite_ref-38">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.washingtonpost.com/politics/private-consultants-warned-of-risks-before-healthcaregovs-oct-1-launch/2013/11/18/9d2db5f4-5096-11e3-9fe0-fd2ca728e67c_story.html"><i>Washington Post</i>, "Private consultants warned of risks before HealthCare.gov’s Oct. 1 launch," November 18, 2013</a></span> </li> <li id="cite_note-39"><span class="mw-cite-backlink"><a href="#cite_ref-39">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.nationaljournal.com/health-care/the-gao-launched-an-obamacare-sting-operation-and-almost-all-fake-insurance-applications-were-approved-20140723"><i>National Journal</i>, "GAO Launched an Obamacare Sting Operation—and Almost All Fake Insurance Applications Were Approved," July 23, 2014</a></span> </li> <li id="cite_note-40"><span class="mw-cite-backlink"><a href="#cite_ref-40">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="https://web.archive.org/web/20170818011536/http://www.politico.com/story/2014/07/obamacare-fraud-fake-applicants-government-accountability-office-109288"><i>Politico</i>, "GAO: Too early to draw Obamacare fraud conclusions," July 23, 2014</a></span> </li> <li id="cite_note-newaccount-41"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-newaccount_41-0">41.0</a></sup> <sup><a href="#cite_ref-newaccount_41-1">41.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.usatoday.com/story/news/nation/2013/10/05/health-care-website-repairs/2927597/"><i>USA Today</i>, "Obama adviser: Demand overwhelmed Healthcare.gov," October 6, 2013</a></span> </li> <li id="cite_note-42"><span class="mw-cite-backlink"><a href="#cite_ref-42">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://articles.chicagotribune.com/2013-10-01/business/chi-obamacare-affordable-care-act-20131001_1_state-exchange-tuesday-morning-call-center"><i>Chicago Tribune</i>, "Computer glitches, overloads hit health care exchanges," October 1, 2013</a></span> </li> <li id="cite_note-43"><span class="mw-cite-backlink"><a href="#cite_ref-43">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.businessweek.com/articles/2013-10-16/open-source-everything-the-moral-of-the-healthcare-dot-gov-debacle"><i>Bloomberg Businessweek</i>, "The Obamacare Website Didn't Have to Fail. How to Do Better Next Time," October 16, 2013</a></span> </li> <li id="cite_note-cnbc-44"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-cnbc_44-0">44.0</a></sup> <sup><a href="#cite_ref-cnbc_44-1">44.1</a></sup> <sup><a href="#cite_ref-cnbc_44-2">44.2</a></sup> <sup><a href="#cite_ref-cnbc_44-3">44.3</a></sup> <sup><a href="#cite_ref-cnbc_44-4">44.4</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.cnbc.com/id/101118447"><i>CNBC</i>, "How bad are Obamacare tech hurdles? Real bad, poll finds," October 17, 2013</a></span> </li> <li id="cite_note-bloombergdata-45"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-bloombergdata_45-0">45.0</a></sup> <sup><a href="#cite_ref-bloombergdata_45-1">45.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.bloomberg.com/news/2013-10-08/insurers-getting-faulty-data-from-u-s-health-exchanges.html"><i>Bloomberg</i>, "Insurers Getting Faulty Data From U.S. Health Exchanges," October 8, 2013</a></span> </li> <li id="cite_note-politicoenrollment-46"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-politicoenrollment_46-0">46.0</a></sup> <sup><a href="#cite_ref-politicoenrollment_46-1">46.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.politico.com/story/2013/10/another-obstacle-to-signing-up-for-aca-crops-up-98573.html"><i>Politico</i>, "Another obstacle to signing up for ACA crops up," October 21, 2013</a></span> </li> <li id="cite_note-47"><span class="mw-cite-backlink"><a href="#cite_ref-47">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://online.wsj.com/news/articles/SB10001424052702304410204579142141827109638"><i>Wall Street Journal</i>, "Health Website Woes Widen as Insurers Get Wrong Data," October 17, 2013</a></span> </li> <li id="cite_note-48"><span class="mw-cite-backlink"><a href="#cite_ref-48">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.cbsnews.com/8301-505269_162-57608843/healthcare.gov-pricing-feature-can-be-off-the-mark/?fb_action_ids=10100204634542560&fb_action_types=og.likes&fb_ref=fbrecT&fb_source=other_multiline&action_object_map=%7B%2210100204634542560%22%3A473716306074898%7D&action_type_map=%7B%2210100204634542560%22%3A%22og.likes%22%7D&action_ref_map=%7B%2210100204634542560%22%3A%22fbrecT%22%7D"><i>CBS News</i>, "HealthCare.gov pricing feature can be off the mark," October 23, 2013</a></span> </li> <li id="cite_note-49"><span class="mw-cite-backlink"><a href="#cite_ref-49">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://techcrunch.com/2013/10/23/healthcare-gov-ignores-birthdates-dramatically-underestimates-prices/"><i>TechCrunch</i>, "Healthcare.gov Ignores Birthdates, Dramatically Underestimates Prices," October 23, 2013</a></span> </li> <li id="cite_note-50"><span class="mw-cite-backlink"><a href="#cite_ref-50">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.foxnews.com/politics/2013/11/25/administration-going-to-plan-b-on-exchanges/"><i>Fox News</i>, "Administration launches program to let users circumvent HealthCare.gov," November 25, 2013</a></span> </li> <li id="cite_note-politico-51"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-politico_51-0">51.0</a></sup> <sup><a href="#cite_ref-politico_51-1">51.1</a></sup> <sup><a href="#cite_ref-politico_51-2">51.2</a></sup> <sup><a href="#cite_ref-politico_51-3">51.3</a></sup> <sup><a href="#cite_ref-politico_51-4">51.4</a></sup> <sup><a href="#cite_ref-politico_51-5">51.5</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.politico.com/story/2013/10/obamacare-aca-website-broken-98412_Page2.html"><i>Politico</i>, "Two weeks in, Obamacare website still broken," October 16, 2013</a></span> </li> <li id="cite_note-chitrib-52"><span class="mw-cite-backlink"><a href="#cite_ref-chitrib_52-0">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="https://web.archive.org/web/2/http://www.chicagotribune.com/news/chi-obama-healthcare-website-20131028,0,1708645.story"><i>Chicago Tribune</i>, "Healthcare.gov data center back online after crashing," October 28, 2013</a></span> </li> <li id="cite_note-53"><span class="mw-cite-backlink"><a href="#cite_ref-53">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.huffingtonpost.com/2013/10/28/obamacare-data-hub_n_4170119.html"><i>Huffington Post</i>, "Key Obamacare Data Hub Working Again After Day-Long Crash," October 28, 2013</a></span> </li> <li id="cite_note-54"><span class="mw-cite-backlink"><a href="#cite_ref-54">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.reuters.com/article/2013/10/30/us-usa-healthcare-outage-idUSBRE99T01L20131030"><i>Reuters</i>, "U.S. Obamacare data hub 'experiencing an outage', Connecticut says," October 29, 2013</a></span> </li> <li id="cite_note-55"><span class="mw-cite-backlink"><a href="#cite_ref-55">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.foxnews.com/politics/interactive/2014/07/01/inspector-general-report-on-obamacare-data-discrepancies/"><i>Department of Health and Human Services</i>, "Marketplaces Faced Early Challenges Resolving Inconsistencies With Applicant Data," June 2014</a></span> </li> <li id="cite_note-CNN5-56"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-CNN5_56-0">56.0</a></sup> <sup><a href="#cite_ref-CNN5_56-1">56.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.cnn.com/2013/10/30/politics/sebelius-hearing-5-things/"><i>CNN</i>, "5 things we learned from Sebelius Obamacare hearing," October 30, 2013</a></span> </li> <li id="cite_note-57"><span class="mw-cite-backlink"><a href="#cite_ref-57">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://i2.cdn.turner.com/cnn/2013/images/10/30/2013-90-27.cms.memo.signed.by.tavenner.pdf?hpt=hp_t1"><i>Memo from James Kerr and Henry Chao to Marilyn Tavenner</i></a></span> </li> <li id="cite_note-hillsec-58"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-hillsec_58-0">58.0</a></sup> <sup><a href="#cite_ref-hillsec_58-1">58.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://thehill.com/blogs/healthwatch/health-reform-implementation/188857-wh-no-security-risks-on-healthcaregov"><i>The Hill</i>, "WH: No security risks on HealthCare.gov," October 31, 2013</a></span> </li> <li id="cite_note-CNNsec-59"><span class="mw-cite-backlink"><a href="#cite_ref-CNNsec_59-0">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.cnn.com/2013/10/30/politics/obamacare-website-warning-memo/"><i>CNN</i>, "Government memo warned of high security risk at health care website," October 30, 2013</a></span> </li> <li id="cite_note-60"><span class="mw-cite-backlink"><a href="#cite_ref-60">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://news.yahoo.com/obamacare-health-enrollment-doubled-november-report-140141437--sector.html"><i>Yahoo</i>, "Obamacare agency relies on manual back-ups as enrollment rises," December 11, 2013</a></span> </li> <li id="cite_note-61"><span class="mw-cite-backlink"><a href="#cite_ref-61">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.reuters.com/article/2013/11/11/usa-healthcare-enrollment-idUSL2N0IW0XX20131111?feedType=RSS&irpc=22"><i>Reuters</i>, "State Obamacare exchanges enroll 3 pct of target so far -report," November 11, 2013</a></span> </li> <li id="cite_note-62"><span class="mw-cite-backlink"><a href="#cite_ref-62">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.sacbee.com/2013/11/09/5897106/health-care-sign-ups-proceeding.html"><i>Sacramento Bee</i>, "Healthcare sign-ups proceeding, at least in California," November 10, 2013</a></span> </li> <li id="cite_note-63"><span class="mw-cite-backlink"><a href="#cite_ref-63">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.ctmirror.org/story/2013/10/22/obama-misspeaks-about-connecticut-health-exchange"><i>CT Mirror</i>, "Obama misspeaks about Connecticut health exchange," October 22, 2013</a></span> </li> <li id="cite_note-64"><span class="mw-cite-backlink"><a href="#cite_ref-64">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.courant.com/health/connecticut/hc-access-health-ct-mixup-20131211,0,808386.story"><i>The Courant</i>, "Misinformation Marred First Month Of State Health Website," December 11, 2013</a></span> </li> <li id="cite_note-65"><span class="mw-cite-backlink"><a href="#cite_ref-65">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.hawaiireporter.com/hawaiis-obamacare-exchange-relaunches-with-more-glitches/123"><i>Hawaii Reporter</i>, "Hawaii’s Obamacare exchange relaunches with more glitches," October 16, 2013</a></span> </li> <li id="cite_note-66"><span class="mw-cite-backlink"><a href="#cite_ref-66">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://blogs.wsj.com/washwire/2013/12/07/maryland-health-exchange-still-sluggish-after-tech-battles/"><i>Wall Street Journal</i>, "Maryland Health Exchange Director Resigns Amid Website Woes," December 7, 2013</a></span> </li> <li id="cite_note-67"><span class="mw-cite-backlink"><a href="#cite_ref-67">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://westminster.patch.com/groups/politics-and-elections/p/feds-to-investigate-maryland-health-care-exchange-problems"><i>Westminster Patch</i>, "Feds to Investigate Maryland Health Care Exchange Problems," March 10, 2014</a></span> </li> <li id="cite_note-68"><span class="mw-cite-backlink"><a href="#cite_ref-68">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://bostonherald.com/news_opinion/local_coverage/2013/11/mass_errors_stymie_bay_staters_sign_ups"><i>Boston Herald</i>, "Mass. errors stymie Bay Staters’ sign-ups," November 8, 2013</a></span> </li> <li id="cite_note-69"><span class="mw-cite-backlink"><a href="#cite_ref-69">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://minnesota.publicradio.org/display/web/2013/11/12/health/mnsure-consumers-confused-about-subsidies"><i>MPR News</i>, "$0 credit subsidy confuses MNsure consumers," November 12, 2013</a></span> </li> <li id="cite_note-70"><span class="mw-cite-backlink"><a href="#cite_ref-70">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.newsregister.com/article?articleTitle=cover-oregon-clings-to-grand-vision-despite-delays--1384268095--10277--"><i>Yamhill Valley News Register</i>, "Cover Oregon clings to grand vision despite delays," November 10, 2013</a></span> </li> <li id="cite_note-71"><span class="mw-cite-backlink"><a href="#cite_ref-71">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://dyn.politico.com/printstory.cfm?uuid=9F3742F0-7076-4C6B-8544-C36DDC44C735"><i>Politico</i>, "Democrats blame big business for botched rollout," January 9, 2014</a></span> </li> <li id="cite_note-72"><span class="mw-cite-backlink"><a href="#cite_ref-72">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://digital.vpr.net/post/shumlin-announces-major-health-care-exchange-delay"><i>VPR</i>, "Shumlin Announces Major Healthcare Exchange Delay," October 31, 2013</a></span> </li> <li id="cite_note-73"><span class="mw-cite-backlink"><a href="#cite_ref-73">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://capsules.kaiserhealthnews.org/index.php/2013/11/washington-state-to-8000-obamacare-enrollees-we-goofed-on-cost-estimate/"><i>Kaiser Health News</i>, "Washington State To 8,000 Obamacare Enrollees: We Goofed On Cost Estimate," November 11, 2013</a></span> </li> <li id="cite_note-74"><span class="mw-cite-backlink"><a href="#cite_ref-74">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.politico.com/story/2013/11/obamacare-enrollments-washington-dc-99589.html"><i>Politico</i>, "Only 5 enrollments completed in D.C. Obamacare exchange," November 8, 2013</a></span> </li> <li id="cite_note-USAtoday-75"><span class="mw-cite-backlink"><a href="#cite_ref-USAtoday_75-0">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.usatoday.com/story/news/nation/2013/10/17/health-exchange-week-three-start-over/2995989/"><i>USA Today</i>, "Tech experts: Health exchange site needs total overhaul," October 17, 2013</a></span> </li> <li id="cite_note-nytcontractors-76"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-nytcontractors_76-0">76.0</a></sup> <sup><a href="#cite_ref-nytcontractors_76-1">76.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.nytimes.com/2013/10/21/us/insurance-site-seen-needing-weeks-to-fix.html?_r=0"><i>New York Times</i>, "Contractors See Weeks of Work on Health Site," October 20, 2013</a></span> </li> <li id="cite_note-77"><span class="mw-cite-backlink"><a href="#cite_ref-77">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.slate.com/blogs/future_tense/2013/10/21/healthcare_gov_problems_why_5_million_lines_of_code_is_the_wrong_way_to.html"><i>Slate</i>, "The One Disheartening Number That Suggests HealthCare.gov Will Not Be Fixed Anytime Soon," October 21, 2013</a></span> </li> <li id="cite_note-78"><span class="mw-cite-backlink"><a href="#cite_ref-78">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.slate.com/articles/technology/bitwise/2013/10/healthcare_gov_problems_what_5_million_lines_of_code_really_means.html"><i>Slate</i>, "5 Million Lines of Obfuscation," October 22, 2013</a></span> </li> <li id="cite_note-cnnnofix-79"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-cnnnofix_79-0">79.0</a></sup> <sup><a href="#cite_ref-cnnnofix_79-1">79.1</a></sup> <sup><a href="#cite_ref-cnnnofix_79-2">79.2</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://money.cnn.com/2013/10/23/technology/obamacare-website-fix/"><i>CNN</i>, "To fix Obamacare website, blow it up, start over," October 23, 2013</a></span> </li> <li id="cite_note-computerworld-80"><span class="mw-cite-backlink"><a href="#cite_ref-computerworld_80-0">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.computerworld.com.au/article/529631/healthcare_gov_website_didn_t_chance_hell_/"><i>ComputerWorld</i>, "Healthcare.gov website 'didn't have a chance in hell'," October 21, 2013</a></span> </li> <li id="cite_note-motherjones-81"><span class="mw-cite-backlink"><a href="#cite_ref-motherjones_81-0">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.motherjones.com/kevin-drum/2013/10/just-how-bad-obamacare-website-anyway"><i>Mother Jones</i>, "Just How Bad Is the Obamacare Website, Anyway?" October 15, 2013</a></span> </li> <li id="cite_note-wapopoliticalfear-82"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-wapopoliticalfear_82-0">82.0</a></sup> <sup><a href="#cite_ref-wapopoliticalfear_82-1">82.1</a></sup> <sup><a href="#cite_ref-wapopoliticalfear_82-2">82.2</a></sup> <sup><a href="#cite_ref-wapopoliticalfear_82-3">82.3</a></sup> <sup><a href="#cite_ref-wapopoliticalfear_82-4">82.4</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.washingtonpost.com/politics/challenges-have-dogged-obamas-health-plan-since-2010/2013/11/02/453fba42-426b-11e3-a624-41d661b0bb78_story.html"><i>Washington Post</i>, "HealthCare.gov: How political fear was pitted against technical needs," November 2, 2013</a></span> </li> <li id="cite_note-politicosurgeDC-83"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-politicosurgeDC_83-0">83.0</a></sup> <sup><a href="#cite_ref-politicosurgeDC_83-1">83.1</a></sup> <sup><a href="#cite_ref-politicosurgeDC_83-2">83.2</a></sup> <sup><a href="#cite_ref-politicosurgeDC_83-3">83.3</a></sup> <sup><a href="#cite_ref-politicosurgeDC_83-4">83.4</a></sup> <sup><a href="#cite_ref-politicosurgeDC_83-5">83.5</a></sup> <sup><a href="#cite_ref-politicosurgeDC_83-6">83.6</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.politico.com/story/2013/10/obamacare-tech-surge-dc-ties-99205.html?hp=f3"><i>Politico</i>, "Obamacare 'tech surge' has D.C. ties," October 31, 2013</a></span> </li> <li id="cite_note-fcwsurge-84"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-fcwsurge_84-0">84.0</a></sup> <sup><a href="#cite_ref-fcwsurge_84-1">84.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://fcw.com/articles/2013/10/23/zients-to-manage-healthcare.gov-tech-surge.aspx"><i>FCW</i>, "Zients to lead HealthCare.gov reboot," October 23, 2013</a></span> </li> <li id="cite_note-85"><span class="mw-cite-backlink"><a href="#cite_ref-85">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://usnews.nbcnews.com/_news/2013/10/23/21094684-white-house-to-adjust-health-care-penalty-deadline-guidance?lite"><i>NBC News</i>, "White House to adjust health care penalty deadline guidance," October 23, 2013</a></span> </li> <li id="cite_note-USATSebelius-86"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-USATSebelius_86-0">86.0</a></sup> <sup><a href="#cite_ref-USATSebelius_86-1">86.1</a></sup> <sup><a href="#cite_ref-USATSebelius_86-2">86.2</a></sup> <sup><a href="#cite_ref-USATSebelius_86-3">86.3</a></sup> <sup><a href="#cite_ref-USATSebelius_86-4">86.4</a></sup> <sup><a href="#cite_ref-USATSebelius_86-5">86.5</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.usatoday.com/story/news/politics/2013/10/30/sebelius-health-care-house-hearing/3308771/"><i>USA Today</i>, "Health chief Sebelius apologizes for botched website," October 30, 2013</a></span> </li> <li id="cite_note-87"><span class="mw-cite-backlink"><a href="#cite_ref-87">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.nbcnews.com/health/did-feds-fix-healthcare-gov-how-well-know-2D11664080"><i>NBC News</i>, "Did the feds fix Healthcare.gov? How we'll know," November 30, 2013</a></span> </li> <li id="cite_note-88"><span class="mw-cite-backlink"><a href="#cite_ref-88">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="https://web.archive.org/web/2/http://www.nbcnews.com/health/healthcare-gov-down-overnight-maintenance-2D11674276"><i>NBC News</i>, "Healthcare.gov down for overnight maintenance," November 29, 2013</a></span> </li> <li id="cite_note-89"><span class="mw-cite-backlink"><a href="#cite_ref-89">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.washingtontimes.com/news/2013/dec/1/white-house-healthcaregov-performance-now-night-an/#ixzz2mKgm1wBH"><i>Washington Times</i>, "Obamacare website ‘fixed,’ but label of failure sticks; more bumps expected, lawmakers are wary," December 1, 2013</a></span> </li> <li id="cite_note-natjournalsurge-90"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-natjournalsurge_90-0">90.0</a></sup> <sup><a href="#cite_ref-natjournalsurge_90-1">90.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.nationaljournal.com/health-care/obamacare-tech-surge-draws-from-google-oracle-20131031"><i>National Journal</i>, "Obamacare 'Tech Surge' Draws From Google, Oracle," October 31, 2013</a></span> </li> <li id="cite_note-91"><span class="mw-cite-backlink"><a href="#cite_ref-91">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.washingtonpost.com/blogs/federal-eye/wp/2013/10/24/who-is-jeffrey-zients-and-why-is-he-qualified-to-fix-healthcare-gov/"><i>Washington Post</i>, "Who is Jeffrey Zients, and how is he qualified to fix HealthCare.gov?" October 24, 2013</a></span> </li> <li id="cite_note-92"><span class="mw-cite-backlink"><a href="#cite_ref-92">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="https://www.healthcare.gov/"><i>HealthCare.gov</i>, "HealthCare.gov," accessed November 5, 2013</a></span> </li> <li id="cite_note-93"><span class="mw-cite-backlink"><a href="#cite_ref-93">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.politico.com/story/2013/12/obamacare-million-visitors-healthcare-website-100579.html"><i>Politico</i>, "Million visitors to HealthCare.gov," December 3, 2013</a></span> </li> <li id="cite_note-USATodayFix-94"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-USATodayFix_94-0">94.0</a></sup> <sup><a href="#cite_ref-USATodayFix_94-1">94.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.usatoday.com/story/news/politics/2013/12/01/federalexchangmeetsgoal/3795523/"><i>USA Today</i>, "White House claims success on HealthCare.gov repairs," December 1, 2013</a></span> </li> <li id="cite_note-95"><span class="mw-cite-backlink"><a href="#cite_ref-95">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://online.wsj.com/articles/hacker-breached-healthcare-gov-insurance-site-1409861043"><i>Wall Street Journal</i>, "Hacker Breached HealthCare.gov Insurance Site," September 4, 2014</a></span> </li> <li id="cite_note-96"><span class="mw-cite-backlink"><a href="#cite_ref-96">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.politico.com/story/2014/09/healthcare-gov-hacked-consumer-information-not-breached-110611.html#ixzz3CTKSfg3F"><i>Politico</i>, "GOP chorus attacks Obamacare over Healthcare.gov hack," September 4, 2014</a></span> </li> <li id="cite_note-97"><span class="mw-cite-backlink"><a href="#cite_ref-97">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://thehill.com/policy/technology/216733-house-panel-eyes-hearing-on-healthcaregov-hack#ixzz3CTMINjhi"><i>The Hill</i>, "Issa wants hearing on Healthcare.gov hack," September 4, 2014</a></span> </li> <li id="cite_note-98"><span class="mw-cite-backlink"><a href="#cite_ref-98">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://online.wsj.com/articles/connecticut-exchange-ceo-kevin-counihan-to-run-healthcare-gov-1409073144"><i>Wall Street Journal</i>, "Connecticut Exchange CEO to Run HealthCare.gov," August 26, 2014</a></span> </li> <li id="cite_note-99"><span class="mw-cite-backlink"><a href="#cite_ref-99">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="https://web.archive.org/web/2/http://thehill.com/blogs/healthwatch/health-reform-implementation/329651-carney-hedges-on-whether-obamacare-mandate-could-be-delayed"><i>The Hill</i>, "Carney hedges on whether ObamaCare mandate could be delayed," October 21, 2013</a></span> </li> <li id="cite_note-100"><span class="mw-cite-backlink"><a href="#cite_ref-100">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://online.wsj.com/articles/poorly-managed-healthcare-gov-construction-cost-840-million-watchdog-finds-1406751529"><i>Wall Street Journal</i>, "Poorly Managed HealthCare.gov Construction Cost $840 Million, Watchdog Finds," July 30, 2014</a></span> </li> <li id="cite_note-CBSoverrun-101"><span class="mw-cite-backlink"><a href="#cite_ref-CBSoverrun_101-0">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.cbsnews.com/news/healthcare-gov-has-already-cost-840-million-report/"><i>CBS News</i>, "HealthCare.gov has already cost $840 million," July 30, 2014</a></span> </li> <li id="cite_note-102"><span class="mw-cite-backlink"><a href="#cite_ref-102">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.thefiscaltimes.com/Articles/2013/10/17/Cost-Obamacare-Website-Date-292-Million"><i>Fiscal Times</i>, "Cost of Obamacare Website to Date: $292 Million," October 17, 2013</a></span> </li> <li id="cite_note-103"><span class="mw-cite-backlink"><a href="#cite_ref-103">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.digitaltrends.com/opinion/obamacare-healthcare-gov-website-cost/"><i>Digital Trends</i>, "We paid over $500 million for the Obamacare sites and all we got was this lousy 404 (updated)," October 8, 2013</a></span> </li> <li id="cite_note-104"><span class="mw-cite-backlink"><a href="#cite_ref-104">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://sunlightfoundation.com/blog/2013/10/22/how-much-did-healthcare-gov-actually-cost/"><i>Sunlight Foundation</i>, "How Much Did Healthcare.gov Actually Cost?" October 22, 2013</a></span> </li> <li id="cite_note-sunlight-105"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-sunlight_105-0">105.0</a></sup> <sup><a href="#cite_ref-sunlight_105-1">105.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://reporting.sunlightfoundation.com/2013/aca-contractors/"><i>Sunlight Foundation</i>, "Good enough for government work? The contractors building Obamacare," October 9, 2013</a></span> </li> <li id="cite_note-NYPostqssi-106"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-NYPostqssi_106-0">106.0</a></sup> <sup><a href="#cite_ref-NYPostqssi_106-1">106.1</a></sup> <sup><a href="#cite_ref-NYPostqssi_106-2">106.2</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://nypost.com/2013/11/01/obama-donors-firm-hired-to-fix-web-mess-it-helped-make/"><i>New York Post</i>, "Obama donor's firm hired to fix Web mess it created," November 1, 2013</a></span> </li> <li id="cite_note-wapocgi-107"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-wapocgi_107-0">107.0</a></sup> <sup><a href="#cite_ref-wapocgi_107-1">107.1</a></sup> <sup><a href="#cite_ref-wapocgi_107-2">107.2</a></sup> <sup><a href="#cite_ref-wapocgi_107-3">107.3</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.washingtonpost.com/blogs/wonkblog/wp/2013/10/16/meet-cgi-federal-the-company-behind-the-botched-launch-of-healthcare-gov/"><i>Washington Post</i>, "Meet CGI Federal, the company behind the botched launch of HealthCare.gov," October 16, 2013</a></span> </li> <li id="cite_note-108"><span class="mw-cite-backlink"><a href="#cite_ref-108">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.reuters.com/article/2013/10/17/us-usa-healthcare-technology-insight-idUSBRE99G05Q20131017"><i>Reuters</i>, "Insight: As Obamacare tech woes mounted, contractor payments soared," October 17, 2013</a></span> </li> <li id="cite_note-109"><span class="mw-cite-backlink"><a href="#cite_ref-109">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="https://web.archive.org/web/2/http://usnews.nbcnews.com/_news/2013/10/18/21025507-obamacare-glitches-govt-contract-for-troubled-site-has-swelled-gop-targets-sebelius?lite"><i>NBC News</i>, "Obamacare glitches: Gov't contract for troubled site has swelled; GOP targets Sebelius," October 18, 2013</a></span> </li> <li id="cite_note-110"><span class="mw-cite-backlink"><a href="#cite_ref-110">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.washingtonpost.com/national/health-science/healthcaregov-contractor-had-high-confidence-but-low-success/2013/11/23/1ab2c2b2-5407-11e3-9fe0-fd2ca728e67c_story.html"><i>Washington Post</i>, "HealthCare.gov contractor had high confidence but low success," November 23, 2013</a></span> </li> <li id="cite_note-CGIfired-111"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-CGIfired_111-0">111.0</a></sup> <sup><a href="#cite_ref-CGIfired_111-1">111.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://washingtonexaminer.com/canadian-officials-fired-it-firm-behind-troubled-obamacare-website/article/2537101"><i>Washington Examiner</i>, "Canadian officials fired IT firm behind troubled Obamacare website," October 10, 2013</a></span> </li> <li id="cite_note-112"><span class="mw-cite-backlink"><a href="#cite_ref-112">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.thestar.com/news/2007/11/08/gun_registry_contract_cancelled_after_81m_spent.html?app=noRedirect"><i>Toronto Star</i>, "Gun registry contract canceled after $81M spent," November 8, 2007</a></span> </li> <li id="cite_note-natreviewcontractors-113"><span class="mw-cite-backlink"><a href="#cite_ref-natreviewcontractors_113-0">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.nationalreview.com/corner/362920/more-questions-about-insurance-exchange-contractors-jillian-kay-melchior"><i>National Review</i>, "More Questions about the Insurance Exchange Contractors," November 1, 2013</a></span> </li> <li id="cite_note-natreviewserco-114"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-natreviewserco_114-0">114.0</a></sup> <sup><a href="#cite_ref-natreviewserco_114-1">114.1</a></sup> <sup><a href="#cite_ref-natreviewserco_114-2">114.2</a></sup> <sup><a href="#cite_ref-natreviewserco_114-3">114.3</a></sup> <sup><a href="#cite_ref-natreviewserco_114-4">114.4</a></sup> <sup><a href="#cite_ref-natreviewserco_114-5">114.5</a></sup> <sup><a href="#cite_ref-natreviewserco_114-6">114.6</a></sup> <sup><a href="#cite_ref-natreviewserco_114-7">114.7</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.nationalreview.com/article/362544/sercos-checkered-history-jillian-kay-melchior"><i>National Review</i>, "Serco's Checkered History," October 30, 2013</a></span> </li> <li id="cite_note-115"><span class="mw-cite-backlink"><a href="#cite_ref-115">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://online.wsj.com/news/articles/SB10001424052702303293604579252211088615216#"><i>Wall Street Journal</i>, "Sebelius Calls for Review of Healthcare.gov Contracting Practices," December 11, 2013</a></span> </li> <li id="cite_note-116"><span class="mw-cite-backlink"><a href="#cite_ref-116">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.nytimes.com/2014/04/29/us/administration-begins-search-for-new-contractors-to-run-health-care-site.html?_r=0"><i>New York Times</i>, "Administration Begins Search for New Contractors to Run Health Care Site," April 29, 2014</a></span> </li> <li id="cite_note-117"><span class="mw-cite-backlink"><a href="#cite_ref-117">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.cbsnews.com/8301-250_162-57608603/poll-congress-tea-party-take-hits-from-government-shutdown/"><i>CBS News</i>, "Poll: Congress, tea party take hits from government shutdown," October 22, 2013</a></span> </li> <li id="cite_note-politicohearings-118"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-politicohearings_118-0">118.0</a></sup> <sup><a href="#cite_ref-politicohearings_118-1">118.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.politico.com/story/2013/10/obamacare-hearings-healthcare-glitches-98788.html"><i>Politico</i>, "Contractors grilled on the Hill," October 24, 2013</a></span> </li> <li id="cite_note-119"><span class="mw-cite-backlink"><a href="#cite_ref-119">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.cnn.com/2013/10/29/politics/obamacare-hearing/"><i>CNN</i>, "Obamacare website administrator apologizes, says system works," October 29, 2013</a></span> </li> <li id="cite_note-CNNSebelius-120"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-CNNSebelius_120-0">120.0</a></sup> <sup><a href="#cite_ref-CNNSebelius_120-1">120.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.cnn.com/2013/10/30/politics/obamacare-sebelius/"><i>CNN</i>, "Sebelius: 'I apologize, I'm accountable' for Obamacare website flaws," October 30, 2013</a></span> </li> <li id="cite_note-USNWRtestimony-121"><span class="mw-cite-backlink"><a href="#cite_ref-USNWRtestimony_121-0">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.usnews.com/news/articles/2013/11/13/healthcaregov-concerns-lost-amid-partisan-sniping"><i>U.S. News and World Report</i>, "Healthcare.gov Concerns Lost Amid Partisan Sniping," November 13, 2013</a></span> </li> <li id="cite_note-verge-122"><span class="mw-cite-backlink"><a href="#cite_ref-verge_122-0">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.theverge.com/2013/11/13/5099450/congress-grills-admin-officials-as-fears-swarm-that-healthcare-gov"><i>The Verge</i>, "Congress grills admin officials as fears swarm that Healthcare.gov will not be ready in time," November 13, 2013</a></span> </li> <li id="cite_note-Foxittestimony-123"><span class="mw-cite-backlink"><a href="#cite_ref-Foxittestimony_123-0">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.foxnews.com/politics/2013/11/13/tech-officials-face-questions-on-troubled-healthcaregov-launch/"><i>Fox News</i>, "Tech officials face questions on troubled HealthCare.gov launch," November 13, 2013</a></span> </li> <li id="cite_note-124"><span class="mw-cite-backlink"><a href="#cite_ref-124">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.washingtonpost.com/blogs/fact-checker/wp/2013/11/19/how-much-did-healthcare-gov-cost-part-2/?wprss=rss_politics&clsrd"><i>Washington Post</i>, "How much did Healthcare.gov cost (part 2)?" November 19, 2013</a></span> </li> <li id="cite_note-125"><span class="mw-cite-backlink"><a href="#cite_ref-125">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.nytimes.com/2014/04/11/us/politics/sebelius-resigning-as-health-secretary.html"><i>New York Times</i>, "Health Secretary Resigns After Woes of HealthCare.gov," April 10, 2014</a></span> </li> <li id="cite_note-126"><span class="mw-cite-backlink"><a href="#cite_ref-126">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://politicalticker.blogs.cnn.com/2013/11/19/woman-cited-by-president-as-obamacare-success-story-frustrated-by-sign-up-process/"><i>CNN</i>, "Woman cited by President as Obamacare success story frustrated by sign up process," November 19, 2013</a></span> </li> <li id="cite_note-127"><span class="mw-cite-backlink"><a href="#cite_ref-127">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.politico.com/story/2013/11/obamacare-tv-movie-jokes-99688.html"><i>Politico</i>, "For Hollywood, the joke's on Obamacare," November 12, 2013</a></span> </li> <li id="cite_note-128"><span class="mw-cite-backlink"><a href="#cite_ref-128">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.buzzfeed.com/evanmcsan/obamacares-grassroots-army-is-starting-to-get-burned-out"><i>Buzzfeed</i>, "Obamacare's Grassroots Army Is Starting To Get Burned Out," October 30, 2013</a></span> </li> <li id="cite_note-NineDems-129"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-NineDems_129-0">129.0</a></sup> <sup><a href="#cite_ref-NineDems_129-1">129.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.cnbc.com/id/101232194"><i>CNBC</i>, "Nine Senate Dems push for Obamacare work-around," November 27, 2013</a></span> </li> <li id="cite_note-130"><span class="mw-cite-backlink"><a href="#cite_ref-130">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.politico.com/story/2013/11/kay-hagan-obamacare-probe-99675.html#ixzz2kY4uhGJH"><i>Politico</i>, "Kay Hagan seeks 'complete' Obamacare probe," November 11, 2013</a></span> </li> <li id="cite_note-wapoletter-131"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-wapoletter_131-0">131.0</a></sup> <sup><a href="#cite_ref-wapoletter_131-1">131.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.washingtonpost.com/blogs/post-politics/wp/2013/10/25/9-senate-democrats-sign-shaheen-letter-pushing-for-open-enrollment-extension/?wprss=rss_politics&clsrd"><i>Washington Post</i>, "10 Senate Democrats sign Shaheen letter pushing for open enrollment extension," October 25, 2013</a></span> </li> <li id="cite_note-waporesignletter-132"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-waporesignletter_132-0">132.0</a></sup> <sup><a href="#cite_ref-waporesignletter_132-1">132.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.washingtonpost.com/blogs/post-politics/wp/2013/10/24/32-house-republicans-call-for-sebeliuss-resignation/"><i>Washington Post</i>, "32 House Republicans call for Sebelius's resignation," October 24, 2013</a></span> </li> <li id="cite_note-133"><span class="mw-cite-backlink"><a href="#cite_ref-133">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.bbc.co.uk/news/uk-politics-24130684"><i>BBC</i>, "NHS IT system one of 'worst fiascos ever', say MPs," September 18, 2013</a></span> </li> <li id="cite_note-134"><span class="mw-cite-backlink"><a href="#cite_ref-134">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.huffingtonpost.com/2013/10/16/alternatives-healthcare-gov-obamacare-website_n_4109749.html"><i>Huffington Post</i>, "Seven Alternatives to Healthcare.gov, Obamacare's Glitchy Website," October 16, 2013</a></span> </li> <li id="cite_note-135"><span class="mw-cite-backlink"><a href="#cite_ref-135">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.cnn.com/2013/11/11/tech/web/alternate-healthcare-site/index.html"><i>CNN</i>, "Trio of young coders build health-care website in days," November 11, 2013</a></span> </li> <li id="cite_note-136"><span class="mw-cite-backlink"><a href="#cite_ref-136">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.politico.com/story/2013/10/why-kathleen-sebelius-is-safe-obamacare-affordable-care-act-98715.html#ixzz2ieQI6P2p"><i>Politico</i>, "Why Kathleen Sebelius is safe," October 23, 2013</a></span> </li> <li id="cite_note-137"><span class="mw-cite-backlink"><a href="#cite_ref-137">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://triblive.com/business/headlines/4855077-74/website-sebelius-health#axzz2hPkERiqj"><i>Pittsburgh Tribune-Review</i>, "Sebelius visit fails to reassure as health care website glitches persist," October 10, 2013</a></span> </li> <li id="cite_note-138"><span class="mw-cite-backlink"><a href="#cite_ref-138">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://thehill.com/blogs/healthwatch/health-reform-implementation/293617-sebelius-exchanges-will-be-ready-on-time-no-need-for-backup-plan"><i>The Hill</i>, "Sebelius: Exchanges will be ready on time, no need for backup plan," April 12, 2013</a></span> </li> <li id="cite_note-139"><span class="mw-cite-backlink"><a href="#cite_ref-139">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.washingtonpost.com/blogs/post-politics/wp/2013/11/26/obama-healthcare-gov-working-pretty-well-now/?wprss=rss_politics&clsrd"><i>Washington Post</i>, "Obama: HealthCare.gov working 'pretty well now'," November 26, 2013</a></span> </li> <li id="cite_note-cnet-140"><span class="mw-cite-backlink"><a href="#cite_ref-cnet_140-0">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://news.cnet.com/8301-13579_3-57605534-37/obama-on-healthcare.gov-bugs-patience-even-apple-has-issues/"><i>CNet</i>, "Obama on HealthCare.gov bugs: Patience, even Apple has issues," October 1, 2013</a></span> </li> <li id="cite_note-politico25-141"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-politico25_141-0">141.0</a></sup> <sup><a href="#cite_ref-politico25_141-1">141.1</a></sup> <sup><a href="#cite_ref-politico25_141-2">141.2</a></sup> <sup><a href="#cite_ref-politico25_141-3">141.3</a></sup> <sup><a href="#cite_ref-politico25_141-4">141.4</a></sup> <sup><a href="#cite_ref-politico25_141-5">141.5</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.politico.com/gallery/2013/10/obamacare-online-glitches-25-great-quotes/001365-019445.html"><i>Politico</i>, "Obamacare online glitches: 25 great quotes," October 15, 2013</a></span> </li> <li id="cite_note-sebeliushearing-142"><span class="mw-cite-backlink"><a href="#cite_ref-sebeliushearing_142-0">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.politico.com/story/2013/10/kathleen-sebelius-testify-obamacare-98612.html"><i>Politico</i>, "Kathleen Sebelius offers to testify on Obamacare," October 22, 2013</a></span> </li> <li id="cite_note-143"><span class="mw-cite-backlink"><a href="#cite_ref-143">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.politico.com/story/2013/10/ted-cruz-nigerian-emailers-run-affordable-care-act-site-98658.html"><i>Politico</i>, "Ted Cruz: Nigerian emailers run Affordable Care Act site," October 22, 2013</a></span> </li> <li id="cite_note-144"><span class="mw-cite-backlink"><a href="#cite_ref-144">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.washingtontimes.com/blog/inside-politics/2013/oct/14/second-lawmaker-calls-hhs-secretary-sebelius-resig/"><i>Washington Times</i>, "Second lawmaker calls on HHS Secretary Sebelius to resign over Obamacare woes," October 14, 2013</a></span> </li> <li id="cite_note-145"><span class="mw-cite-backlink"><a href="#cite_ref-145">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.youtube.com/watch?feature=player_embedded&v=mQf_c7SNv-U"><i>Youtube</i>, "Senator Roberts Call For Secretary Sebelius to Resign," October 11, 2013</a></span> </li> <li id="cite_note-uproar-146"><span class="mw-cite-backlink">↑ <sup><a href="#cite_ref-uproar_146-0">146.0</a></sup> <sup><a href="#cite_ref-uproar_146-1">146.1</a></sup></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.politico.com/story/2013/10/dems-caught-up-in-obamacare-uproar-98585.html"><i>Politico</i>, "Dems caught in Obamacare uproar," October 21, 2013</a></span> </li> <li id="cite_note-147"><span class="mw-cite-backlink"><a href="#cite_ref-147">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.politico.com/politicopulse/1013/politicopulse11934.html"><i>Politico</i>, "Competing views on Obamacare sink House debt ceiling plan — Baucus: Obamacare will get back on track," October 16, 2013</a></span> </li> <li id="cite_note-148"><span class="mw-cite-backlink"><a href="#cite_ref-148">↑</a></span> <span class="reference-text"><a target="_blank" rel="noreferrer noopener" class="external text" href="http://www.washingtonpost.com/national/health-science/many-remain-locked-out-of-federal-health-care-web-site/2013/10/08/be8e71e6-302c-11e3-bbed-a8a60c601153_story.html?hpid=z3"><i>Washington Post</i>, "Many remain locked out of federal healthcare Web site," October 8, 2013</a></span> </li> </ol></div></div></div> <table class="navbox" cellspacing="0" style=";"><tbody><tr><td style="padding:2px;"><table cellspacing="0" class="collapsible autocollapse" 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Please use the preview button before saving.">e</span></a></div></div><span style="font-size:110%;"><big><a href="/Executive_Branch" title="Executive Branch">U.S. Executive Branch</a></big></span></th></tr><tr style="height:2px;"><td></td></tr><tr><td class="navbox-group" style=";background:#bbccee;;">Elected offices</td><td style="text-align:left;border-left:2px solid #fdfdfd;width:100%;padding:0px;padding:0.25em 0; line-height:1.4em;;;" class="navbox-list navbox-odd"><div style="padding:0em 0.25em">President <a href="/Donald_Trump" title="Donald Trump">Donald Trump</a> • Vice President <a href="/J.D._Vance" title="J.D. Vance">J.D. 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