THE PROGRESSIVE REVIEW - November 21, 2013

*-- Obama says should have anticipated tough healthcare reform rollout --*
WASHINGTON - President Obama told U.S. business executives Tuesday he should have anticipated political opposition would make rolling out healthcare reform more difficult.

The president, speaking at The Wall Street Journal CEO Council annual meeting, was asked what the rough rollout of the health insurance marketplace signup website has taught him about the federal government's ability to executive such far-reaching reform, the Affordable Care Act itself and his administration.

Obama said he's learned setting up the health insurance marketplaces "is very challenging just mechanically."

"The challenge has been just making sure that consumers are actually able to get on a website, see those choices, and shop," he said. "And I think that we probably underestimated the complexities of building out a website that needed to work the way it should.

"There is a larger problem that I probably -- speak personally, but also as the administration -- could have identified earlier, and that is the way the federal government does procurement and does IT [information technology] is just generally not very efficient. In fact, there's probably no bigger gap between the private sector and the public sector than IT."

Obama said IT shortcomings have also hindered the work of the Veterans Administration and Defense Department.

He said with creating the health insurance marketplace website, "what we probably needed to do on the front end was to blow up how we procure for IT, especially on a system this complicated. We did not do that successfully. Now, we are getting it fixed, but it would have been better to do it on the front end rather than the back end."

Obama said having had to "fight tooth and nail" to get health reform passed, came with a price.

"And it was that what was already going to be hard was operating within a very difficult political environment," he said. "And we should have anticipated that that would create a rockier rollout than if Democrats and Republicans were both invested in success.

"And one of the problems we've had is one side of Capitol Hill is invested in failure, and that makes, I think, the kind of iterative process of fixing glitches as they come up and fine-tuning the law more challenging. But I'm optimistic that we can get it fixed."

White House officials had been warned by an outside consulting firm eight months ago the HealthCare.gov site risked failure, papers released by lawmakers indicate.

The McKinsey & Co. warning, in the form of a 14-slide presentation released by the House Energy and Commerce Committee, said "lack of transparency and alignment on critical issues" threatened site progress, despite a looming Oct. 1 launch deadline.

The slides also pointed to many likely troubles that ended up coming to pass. These included the probability call centers wouldn't work properly if the online system broke down and the prediction inadequate "end-to-end testing" would make it hard to fix problems after the site went live.

The officials warned by McKinsey in four briefings between March 28 and April 8 included Health and Human Services Secretary Kathleen Sebelius; Marilyn Tavenner, HHS Centers for Medicare & Medicaid Services acting administrator at the time; White House Chief Technology Officer Todd Park; Obama healthcare-reform policy adviser Jeanne Lambrew; and Mark B. Childress, who was White House deputy chief of staff, The Washington Post reported.

"Despite assurances from Secretary Sebelius, Marilyn Tavenner and [CMS official] Gary Cohen that all was well and on track with the launch of the Affordable Care Act, we now have documents dating back to April that call into question the assertions made to this committee," Rep. Timothy Murphy, R-Pa., co-chairman of the Energy and Commerce panel's subcommittee on oversight and investigations, told the Post.

Medicare & Medicaid Services said in a statement the McKinsey report was "part of a standard process to identify potential risks and develop mitigating strategies."

The review "was completed six months before the beginning of open enrollment, was in line with industry best practices and was followed by concrete action to address potential risks -- as was intended," the statement said.

White House spokesman Eric Schultz told the Post "flags were definitely raised throughout the development of the website, 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."

The site has been performing better over the past 1 1/2 weeks, the Post said, but significant glitches remain.

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