HealthCare.Gov Only Had a 6% Chance of Success
How the archaic and flawed technology procurement policies of the United States government caused HealthCare.Gov’s failure and cost billions of taxpayer dollars annually.
President Obama’s campaign relied on a mix of private-sector-trained technology workers and a well-developed ecosystem of technologies available from competitive consultants to beat Mitt Romney in the 2012 United States Presidential Election. During the Obama administration’s second term they began phasing in all major components of the Affordable Care Act. The act met unprecedented opposition and numerous aspects of the legislation were highly controversial. However, the digital components of the legislation never received an equal amount of national attention preceding HealthCare.Gov’s launch on October 1st, 2013. Despite the vast debate of political ideologies, philosophy, and nitty-gritty healthcare details it would ultimately be a failed website that would cause HealthCare.Gov to have a disastrous launch. Within the first 24 hours of the website going live only 6 individuals throughout the country were able to sign up online successfully. The problems that HealthCare.Gov encountered during its launch did not stem from either the Democratic or Republican parties, rather the archaic and flawed Federal Acquisition Regulation that the government has to abide by during federal technology procurement.
Statistically HealthCare.Gov had a 6 percent chance of success
according to the research firm the Standish Group. The group found that 94 percent of large federal information technology projects over the past 10 years were unsuccessful — more than half were delayed, over budget, or didn’t meet user expectations, and 41.4 percent failed completely. HealthCare.Gov is the latest in a long history of failed digital projects implemented by the United States government. For example, Sam.gov, a system for government contractors developed by I.B.M. that started in 2012, has cost taxpayers $181 million ($38 million over budget) after being delayed for two months and being taken on and offline numerous times after launch for repair. Before that, a new version of USAJobs.gov failed, after years during which millions were spent. In 2001, the F.B.I. started a virtual case file system, and after dumping the project, renaming it, and finding new vendors to build it, the project, “Sentinel,” finally launched in 2013, 12 years after its conception.
“The episode is all too typical of how government creates IT services,”
stated Tom Lee, director of Sunlight Labs, the research arm of the Sunlight Foundation, which advocates for more government transparency.
“The procurement process tends to select for firms that are good at navigating the procurement process, not providing good IT services for the dollar.”
Politicians and contractors argue that the services they are trying to provide are more complicated than those in the private sector.
Aneesh Chopra, a former White House chief technology officer, said there is a common misperception that any “three kids in a garage” can put together a Web site. However those sentiments have proved to be untrue, especially in the case of HealthCare.Gov. The one element of the site that has received significant praise is the “front-end” in other words the part with the smiling young woman and the encouraging words “The Health Insurance Marketplace is Open!” has worked with few glitches, earning praise for how easily it adapts to different devices, including the small screens of most smartphones. Unlike other elements of the website this was developed by a small 12-man start-up technology company based out of garage in the District of Columbia entitled Development Seed.
The Federal Acquisition Regulation
is a 1,800 page legal document which contains standard solicitation provisions and contract clauses. This legislation prevents small technology firms from competing with large, entrenched vendors providing subpar services. President Obama even acknowledged the procurement systems inefficiencies, stating
“The way the federal government does procurement and does IT is just generally not very efficient.”
He went on to say,
“In fact, there’s probably no bigger gap between the private sector and the public sector than IT.”
Procurement is the term for the government’s procedure for buying things.
Under the current system, the federal government buys technology the way it buys battleships: with broad “Indefinite Delivery / Indefinite Quantity” (ID / IQ) contracts that pre-screen vendors to handle an agency’s projects for up to 10 years. This ten year pre-screening process squashes any attempt to save money with cutting-edge technologies and ultimately puts the United States at a disadvantage globally. According to Moore’s Law, written by Intel co-founder Gordon E. Moore, technology gets twice as good or half as expensive every 18 months thus the government will forever be behind that curve with the current legislation. Trey Hodgkins, senior vice president at the Information Technology Industry Council, a trade group states,
“It’s almost impossible for the government to find what it wants and get Congress and the [Office of Management and Budget] to buy that thing in a timely fashion,”
Fixing the procurement process is just as important for all aspects of our twenty-first century democracy as it is for the success HealthCare.Gov.
A recent internal government report revealed Washington spends $76 billion annually on information technology of which $12.5 billion is wasted on unsuccessful projects. However private studies conducted by groups such as Standish Group believe that number is almost three times higher. Beyond the ramifications of money and effectiveness of programs it is essential for a twenty-first century democracy to be as participatory and as interactive with its citizen as our political process is. Despite the hardships caused by HealthCare.Gov’s bumpy rollout it has helped lay the foundation for national interest in procurement reform.
Representative Darrell E. Issa of California sponsored legislation entitled, Federal Information Technology Acquisition Reform Act
which strives to institute a White House office of IT procurement and gives all American innovators a fair shake at competing for valuable federal IT contracts by lowering the burden of entry. Representative Gerry Connolly of Virginia, co-sponsor of the bill states,
“In the 21st century, effective governance is inextricably linked with how well government leverages technology to serve its citizens… Despite incremental improvements in federal IT management over the years, the bottom line is that large-scale federal IT program failures continue to waste taxpayers’ dollars, while jeopardizing our Nation’s ability to carry out fundamental constitutional responsibilities, from conducting a census to securing our borders.”
The Reforming Federal Procurement of Information Technology Act aims to,
“Create a new office within the Executive Office of the President to review major IT projects before they begin. Healthcare.gov failed because HHS/CMS tried to manage it on their own, and it was only fixed once the White House brought in industry-leading managers and programmers. This draft bill would create a new office of top IT talent to review all major IT projects and help agencies plan the contracting process.In addition to enabling more small businesses to bid on federal IT contracts without having to spend thousands on compliance costs by lifting the threshold for a streamlined contracting process from $150,000 to $500,000.”
The success of the United States relies on the success of mavericks, entrepreneurs, and inventors in addition to setting the stage operating as its very own maverick in governance.
The failure of HealthCare.Gov has made it painstakingly obvious that reform in the technological practices of the United States government is necessary, and crucial to maintain American exceptionalism. The internet is the new frontier, and whatever country can capitalize upon the new frontier will become exceptional. Large federal information technology purchases have to end. Any methodology with a 94 percent chance of failure or delay, and costs taxpayers billions of dollars, doesn’t belong in a 21st-century government.
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