Federal Health Site Stymied By Lack of Direction - Absence of Single Leader, Disjointed Bureaucracy Tied to Troubles

From The Wall Street Journal:

Key work to create the website was given to CMS [Centers for Medicare & Medicaid Services, the Medicare and Medicaid agency], which had experience running a site for Medicare drug plans. But the agency, which is overseen by Health and Human Services Secretary Kathleen Sebelius, had a siloed management structure, and no single unit was designed to pull off a mammoth task like HealthCare.gov.

In one camp were computer experts reporting to a veteran CMS official, Michelle Snyder, who were among the first to recognize the scale of the problems facing the website, current and former officials say, such as errors in the calculation of insurance prices and eligibility determinations.

But a separate policy arm built the road map for what the exchange needed to accomplish, with strained communication with its computer counterparts; that team reported to Gary Cohen, a former California lawyer.

Word of the software problems was slow to reach Mr. Cohen, who testified to Congress on Sept. 19 that the exchange was on track even as the agency's computer experts were working around the clock at a key contractor location to hammer out a host of unanticipated flaws.

HealthCare.gov is the highest-profile experiment yet in the Obama administration's effort to modernize government by using technology, with the site intended to become a user-friendly pathway to new health insurance options for millions of uninsured Americans.

"This was the president's signature project and no one with the right technology experience was in charge," said Bob Kocher, a former White House aide who helped draft the law.

Testing of the system by insurers that had been scheduled for July didn't begin until the third week of September, said people familiar with the development and insurance executives who participated in testing. Dozens of features of the site were behind schedule, they said.

On Oct. 1, nearly three million consumers stormed the site. It crashed as the first wave sought to create accounts.