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Topics: Obamacare

Lack of transparency plagued Healthcare.gov from start

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Philip Klein,Columnists,Barack Obama,Obamacare,Health and Human Services,Health Care,Analysis,Healthcare.gov

On Jan. 21, 2009, President Obama's first full day in office, he issued an executive order on transparency, promising “an unprecedented level of openness in government.”

The order predicted, “openness will strengthen our democracy and promote efficiency and effectiveness in government.”

Nearly five years later, intense secrecy has threatened the signature project of Obama’s presidency and of 21st century liberalism.

Ever since the Department of Health and Human Services began building a website to help Americans access subsidized health insurance through Obamacare, the process has been shrouded in mystery.

While states building their own exchanges held regular public meetings to work through problems that arose over the course of this year, the federal system was largely a black box.

As evidence trickled out that HHS was encountering technological problems, officials repeatedly said the exchange was on track to be ready on Oct. 1.

In June, for instance, when a Government Accountability Office report warned that development of the exchange was behind schedule, HHS officials responded with a statement insisting they were "extremely confident that on Oct. 1 the marketplace will be open on schedule and millions of Americans will have access to affordable quality health insurance."

On Monday, Obama himself held a White House event for acknowledging that the website Healthcare.gov did not live up to his promises, and he was forced to point Americans seeking to enroll in health insurance to a 1-800 number.

But, though his administration has promised a “tech surge” to deal with the site's problems, the details on that surge are rather scant.

It’s unclear how much it will cost, who exactly is involved and what specific issues the new team of experts will be seeking to resolve. Nor are there any timelines or metrics for success.

More than three weeks in, the administration has not released numbers on how many people have been able to successfully enroll through Healthcare.gov.

All along, Obama has been driven by fear of ridicule from Republicans if any evidence was released of problems facing his signature legislation. And this fear has gotten in the way of building a functioning system.

“My sense is that the biggest reason Obamacare is now in trouble is because of the top-secret way in which the administration has handled the rollout,” health care consultant Bob Laszewski wrote on his blog.

“If they had developed the computer system in a transparent way, the marketplace would have told them long ago this would not work,” Laszewski said.

Politico has reported that “facing such intense opposition from congressional Republicans, the administration was in a bunker mentality as it built the enrollment system, one former administration official said.

"Officials feared that if they called on outsiders to help with the technical details of how to run a commerce website, those companies could be subpoenaed by Hill Republicans, the former aide said. So the task fell to trusted campaign tech experts.”

One of the most oft-quoted lines about presidential scandals is that it isn’t the crime but the cover-up that causes problems. It never ceases to amaze how often presidents repeat the mistakes of predecessors by seeking safety in secrecy.

If Obama had just been willing to accept the short-term political embarrassment of seeking help or delaying the start of the enrollment period, Healthcare.gov might be in much better shape by now.

Instead, with a technological disaster threatening not only his law but the stability of the U.S. private market for individual insurance, the president is stuck scrambling to rework a malfunctioning system.

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