What Healthcare.gov has to do with the Hawaii false alarm — and what to do about it

Code for America Blog
4 min readJan 19, 2018


By now, you’ve heard of the Hawaii False Alarm, and about the blowback and blame as people try to sort out how this could have happened. In government circles, however, there have been empathy and knowing cringes. It is the norm, not the exception, that government systems are confusing and hard to use. Horrible mistakes happen when people use clunky government systems — they just usually don’t make the news.

An actual punch card with a line of COBOL programming on it. By Rainer Gerhards

In fact, the last time a government technology failure was so thoroughly plastered across the news was when healthcare.gov failed to launch. At the time, I was working for the Chief Technology Officer of the United States in the White House. It was a difficult, frustrating time — but the media glare and public outrage opened up an opportunity to make some critical progress on changes that government workers had been asking for, for years, to prevent it from happening again. Government design is news right now, so I thought I’d share some thoughts on what people working on this problem could do next.

​One privilege the insured and well-off have is to excuse the terrible quality of services the government routinely delivers to the poor. Too often, the press ignores — or simply never knows — the pain and trouble of interfacing with government bureaucracies that the poor struggle with daily.” — Ezra Klein

What do we do now?

1. Usability Test Your Most Important Services.

Usability test your most important services. Test services that residents count on like food benefits applications, but also internal tools that government workers use, like the software that, say, sends out alerts about incoming missiles. This doesn’t have to be an expensive, slow process with consultants. There are excellent materials and support to do lightweight, frequent, in-house testing that can prevent these issues. The goal isn’t just to find the biggest problems with the service — it’s also to get buy-in and focus from your executives.

Last year, Harvard asked me to present on technology to newly elected members of Congress as part of the longstanding bipartisan program they run to prepare them for their new jobs.

Instead of using my ~15 minutes to rant about my pet government tech issues, I showed them this video of Dominic, a Veteran struggling with homelessness, trying to apply for healthcare.*

The video worked. The congresspeople-to-be weren’t just engaged, they were angry. How could it be this bad? More importantly, how can we help? This set up the rest of the conversation — the specific steps we must take to prevent these problems

2. Adopt the Digital Services Playbook

After the Healthcare.gov rescue, we developed a Digital Service Playbook which hopefully, if followed, would prevent such a disaster again. Every recommendation is written in plain English, and comes with a checklist to help follow along. It was released by the White House and anyone can use it as a hit list of the important issues to cover.

3. Get Help

Great! So now you’ve done usability testing and found the biggest issues and gotten buy-in from leadership that change is needed, you’ve gone through the Digital Service Playbook and know what you’re missing… But how do you actually get it done?

Hire people
Working to keep the people of Hawaii (or Ohioans or Tuscaloosans) safe is some brilliant designer’s dream job. If you need help finding that designer (or engineer or Chief Technology Officer), post your job for free on the Code for America Public Interest Technology job board. (Note to brilliant designers — this is where you can get your dream job)

Get training
If you’re already in government and want to learn skills to help address issues like this, come to the Code for America summit, especially the workshops. Every session — from procurement to hiring — is designed to build exactly the skills we think government leaders need.

Develop relationships with local volunteers

In cities across the country, from Tulsa, OK to Miami, FL, Code for America Brigade volunteers get together with government to help improve services. For example, they’re improving services designed to serve people experiencing homelessness (Asheville, NC) and simplifying benefits applications into SMS-based conversations you can have on a flip phone (Anchorage, AK). Go meet them. There are engineers and designers, but also EMTs and school teachers. They’re ready, today, to help.

Contract help
Government contractors can do incredible work, but the work is typically not set up for success. The key to getting the best out of a contract is to include usability testing and the digital service playbook in the statement of work, but also in breaking down the contract into the smallest pieces possible. 18F is doing groundbreaking work on this front and is happy to help.

Make friends
There are almost 22 million government employees.** They’re all struggling with the exact same things. If you’re a government employee looking for your people, here are some listservs you can join to meet them, team up, and share resources:

Digital Service Listserv
Discussions about developments and best practices in digital services in government.
To join: Email listserv@listserv.gsa.gov with no subject and subscribe digitalservice in the body.

Security Today Listserv
Discussions about developments and best practices in security and privacy, with a focus on technology and the internet.
To join: Email listserv@listserv.gsa.gov with no subject and subscribe security-today in the body.

Devops Today Listserv
Discussions about DevOps practices within government IT organizations, including overcoming the organizational and cultural challenges to effecting change.
To join: Email listserv@listserv.gsa.gov with no subject and subscribe devops-today in the body.

Note: You must have a .gov email address to join these listservs

*Dominic now has healthcare, and 296,588 other Veterans do, too.



Code for America Blog

America’s foremost technologist named after a Great Lake. Now @CodeforAmerica! Co-founder @techladymafia + @usds. Former @harvard @whitehouse @cfpb.