OIG’s review spans 5 years, providing a chronology of events and identifying factors that contributed to the website’s breakdown at launch, its recovery following corrective action, and implementation of the Federal Marketplace through the second open enrollment period.
We found that HHS and CMS made many missteps throughout development and implementation that led to the poor launch of HealthCare.gov. Most critical was the absence of clear leadership, which caused delays in decisionmaking and a lack of clarity in project tasks. Additional missteps included devoting too much time to developing policy, which left too little time for developing the website, and failing to properly manage its key website development contract. CMS’s organizational structure and culture also hampered progress, including poor coordination between policy and technical work. CMS continued on a failing path despite signs of trouble, making rushed corrections that proved insufficient.
In addition, the Federal Marketplace project and development of HealthCare.gov came at a substantial cost financially and organizationally to CMS. CMS contract costs for the Federal Marketplace project were ultimately much higher than initially estimated by CMS, but the total contract amount would have been expected to rise from the initial allotment. CMS originally estimated the contract value for six key Federal Marketplace contracts to be $464 million. As of early 2014, CMS had updated the estimated value of these contracts to $824 million. The value more than tripled for the FFM contract awarded to CGI Federal, from $58 million to $207 million. In addition, the value for the Hub contract more than doubled, from $69 million to $180 million. The remaining four contract values increased between 1 and 54 percent.Read the full report