Lessons From the Feds’ Healthcare.gov Fiasco

A lot of people have experienced trouble accessing even this screen.

In theory, the federal government’s Health Insurance Marketplace was supposed to make things easy for anyone in the market for health insurance.

But fourteen days after the Website made its debut, the online initiative—an integral part of the Obama administration’s Affordable Care Act—has metastasized into a disaster. Despite costing $400 million (so far) and employing an army of experienced IT contractors (such as Booz Allen Hamilton and CGI Group), the Website is prone to glitches and frequent crashes, frustrating many of those seeking to sign up for a health-insurance policy.

“The extent of the problems is pretty enormous,” an unnamed insurance executive told The New York Times, which interviewed dozens of contractors and officials who backed up that assessment. One of those anonymous sources estimated the Website and its underlying infrastructure at 70 percent complete, but had no idea when it would finally cross the finish line.

Unless you’re the leader of a major federal agency or a huge company launching an online initiative targeted at millions of users, it’s unlikely you’ll ever wrestle with a project (and problems) on the scale of the Health Insurance Marketplace. Nonetheless, the debacle offers some handy lessons in project management for Websites and portals of any size:

Know Your Scope

The contractors behind the Health Insurance Marketplace were hindered by a lack of IT specifications, which didn’t arrive from the client (the federal government) until this spring, which forced developers and engineers to code an enormous Website in a matter of months. Had the Feds locked down their feature set and specifications earlier in the process, it might have resulted in a more complete, less glitch-prone Website on launch day.

Prepare Your Capacity

Lots of Web services start small and grow bigger via word of mouth and advertising campaigns, which gives their creators lots of time to prepare the necessary IT infrastructure to handle customers. Instead of initially launching its health portal to a limited audience, the federal government made the decision to not only kick off in the biggest way possible, but to encourage all potential customers to sign up on the first day. (To be fair, the Obama administration probably felt it needed to make the biggest possible splash from Day One, in order to buy the Affordable Care Act some much-needed political cover.)

As a result of that push to “go big,” the Health Insurance Marketplace was overwhelmed from its first day, leading to frequent crashes. Perhaps if they’d spent a bit more of that $400 million on infrastructure capacity, things would have gone a bit more smoothly. Let that be a lesson to anyone building a Web service that could very rapidly become popular. (The bungled launch of the SimCity game in March is another real-world example of what happens when a company doesn’t anticipate the load on cloud infrastructure.)

Choose the Right Management

Rather than hand off the project to a contractor with experience wrangling massive systems and multiple pieces of hardware, the administrators behind the Health Insurance Marketplace decided to entrust the Medicare and Medicaid agency with ensuring that everything would work in sync. That proved disastrous, as the agency reportedly didn’t have the experience to handle that sort of workload. When choosing a project manager, it pays to make sure they can manage everything that needs to happen as launch day approaches, whether dealing with employees or making sure that various pieces of software can operate in sync.

Test, Test, Test

From day one, those attempting to create online accounts for the Health Insurance Marketplace have run into significant trouble, ranging from frequent crashes to an inability to compare health plans. In many ways, that’s the least significant of the program’s issues at the moment: insurers have received incomplete or corrupted files for many applicants, and state-run exchanges in states such as Minnesota have reported issues with using federal databases to confirm applicants’ identities. While early (and frequent) testing might not have mitigated all those problems along the chain—especially when dealing with a project of this size—it might have eased a significant portion of them.

What Happened?

If these pointers seem pretty obvious, it’s because they are. But the Health Insurance Marketplace fiasco speaks to an unfortunate truth about Web development: even when an entity (whether public or private, corporation or federal government) has keen minds and millions of dollars at its disposal, forgetting or mishandling the basics of successful Web construction can lead to embarrassing problems. For the Obama administration, the chaos must seem particularly unnerving, given the superior skill of Obama’s second reelection campaign in assembling a breathtakingly efficient Web platform.


Image: Healthcare.gov