THE ROLL OUT OF HEALTHCARE.GOV: THE LIMITATIONS OF BIG GOVERNMENT HEARING BEFORE THE COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM HOUSE OF REPRESENTATIVES ONE HUNDRED THIRTEENTH CONGRESS FIRST SESSION DECEMBER 4, 2013 Serial No. 113–83 Printed for the use of the Committee on Oversight and Government Reform ( Available via the World Wide Web: http://www.fdsys.gov http://www.house.gov/reform U.S. GOVERNMENT PRINTING OFFICE 87–022PDF WASHINGTON : 2014 For sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800 Fax: (202) 512–2104 Mail: Stop IDCC, Washington, DC 20402–0001 VerDate Aug 31 2005 10:20 Mar 20, 2014 Jkt 000000 PO 00000 Frm 00001 Fmt 5011 Sfmt 5011 C:\DOCS\87022.TXT APRIL COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM DARRELL E. ISSA, California, Chairman JOHN L. MICA, Florida ELIJAH E. CUMMINGS, Maryland, Ranking MICHAEL R. TURNER, Ohio Minority Member JOHN J. DUNCAN, JR., Tennessee CAROLYN B. MALONEY, New York PATRICK T. MCHENRY, North Carolina ELEANOR HOLMES NORTON, District of JIM JORDAN, Ohio Columbia JASON CHAFFETZ, Utah JOHN F. TIERNEY, Massachusetts TIM WALBERG, Michigan WM. LACY CLAY, Missouri JAMES LANKFORD, Oklahoma STEPHEN F. LYNCH, Massachusetts JUSTIN AMASH, Michigan JIM COOPER, Tennessee PAUL A. GOSAR, Arizona GERALD E. CONNOLLY, Virginia PATRICK MEEHAN, Pennsylvania JACKIE SPEIER, California SCOTT DESJARLAIS, Tennessee MATTHEW A. CARTWRIGHT, Pennsylvania TREY GOWDY, South Carolina TAMMY DUCKWORTH, Illinois BLAKE FARENTHOLD, Texas ROBIN L. KELLY, Illinois DOC HASTINGS, Washington DANNY K. DAVIS, Illinois CYNTHIA M. LUMMIS, Wyoming PETER WELCH, Vermont ROB WOODALL, Georgia TONY CARDENAS, California THOMAS MASSIE, Kentucky STEVEN A. HORSFORD, Nevada DOUG COLLINS, Georgia MICHELLE LUJAN GRISHAM, New Mexico MARK MEADOWS, North Carolina Vacancy KERRY L. BENTIVOLIO, Michigan RON DESANTIS, Florida LAWRENCE J. BRADY, Staff Director JOHN D. CUADERES, Deputy Staff Director STEPHEN CASTOR, General Counsel LINDA A. GOOD, Chief Clerk DAVID RAPALLO, Minority Staff Director (II) VerDate Aug 31 2005 10:20 Mar 20, 2014 Jkt 000000 PO 00000 Frm 00002 Fmt 5904 Sfmt 5904 C:\DOCS\87022.TXT APRIL C O N T E N T S Page Hearing held on December 4, 2013 ........................................................................ 1 WITNESSES Ms. Veronique De Rugy, Senior Research Fellow, Mercatus Center, George Mason University Oral Statement ................................................................................................. 6 Written Statement ............................................................................................ 9 Dr. Clifford Winston, Searle Freedom Trust Senior Fellow, Economic Studies Program, The Brookings Institution Oral Statement ................................................................................................. 14 Written Statement ............................................................................................ 16 Mr. Mark A. Calabria, Director of Financial Regulation Studies, Cato Insti- tute Oral Statement ................................................................................................. 23 Written Statement ............................................................................................ 25 Dr. Karen Kruse Thomas, Historian and Communications Associate, Johns Hopkins Bloomberg School of Public Health, External Affairs Oral Statement ................................................................................................. 37 Written Statement ............................................................................................ 39 APPENDIX The Hon. Elijah E. Cummings, a Member of Congress from the State of Maryland, Opening Statement ............................................................................ 94 Chairman Issa submitted and article from Wikipedia on Alexander Fleming ... 96 Rep Connolly submitted for the record an article from the Washington Month- ly called, ‘‘The Best Care Anywhere’’ .................................................................. 102 Chairman Issa submitted for the record letters sent to 15 Health Insurance Companies ............................................................................................................ 117 Chairman Issa sent a letter to Mr. Mark Bertolini, Chairman, President, and CEO, Aetna, Inc ............................................................................................ 118 Chairman Issa submitted for the record a NewYorker Article ‘‘GOP Healthcare.gov Too Fast Now’’ ............................................................................ 122 Rep. Cartwright submitted for the record article titled ‘‘What About Social Security’s Rollout?’’ .............................................................................................. 125 Questions submitted from Rep. Collins to Dr. Calabria, Dr. De Rugy, Dr. Thomas, and Dr. Winston .................................................................................... 130 (III) VerDate Aug 31 2005 10:20 Mar 20, 2014 Jkt 000000 PO 00000 Frm 00003 Fmt 5904 Sfmt 5904 C:\DOCS\87022.TXT APRIL VerDate Aug 31 2005 10:20 Mar 20, 2014 Jkt 000000 PO 00000 Frm 00004 Fmt 5904 Sfmt 5904 C:\DOCS\87022.TXT APRIL THE ROLL OUT OF HEALTHCARE.GOV: THE LIMITATIONS OF BIG GOVERNMENT Wednesday, December 4, 2013, HOUSE OF REPRESENTATIVES, COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM, WASHINGTON, D.C. The committee met, pursuant to call, at 9:35 a.m., in Room 2154, Rayburn House Office Building, Hon. Darrell E. Issa [chairman of the committee] presiding. Present: Representatives Issa, Mica, Turner, Duncan, Walberg, Lankford, Amash, Gosar, DesJarlais, Gowdy, Farenthold, Collins, Meadows, Bentivolio, DeSantis, Cummings, Maloney, Norton, Tierney, Connolly, Speier, Cartwright, Davis, Cardenas, Lujan Grisham, and Kelly. Staff Present: Molly Boyl, Majority Deputy General Counsel and Parliamentarian; Lawrence J. Brady, Majority Staff Director; Caitlin Carroll, Majority Deputy Press Secretary; John Cuaderes, Majority Deputy Staff Director; Brian Daner, Majority Counsel; Adam P. Fromm, Majority Director of Member Services and Com- mittee Operations; Linda Good, Majority Chief Clerk; Tyler Grimm, Senior Professional Staff Member; Frederick Hill, Majority Deputy Staff Director for Communications and Strategy; Christopher Hixon, Majority Chief Counsel for Oversight; Mark D. Marin, Ma- jority Deputy Staff Director for Oversight; Laura L. Rush, Majority Deputy Chief Clerk; Sarah Vance, Majority Assistant Clerk; Jedd Bellman, Minority Counsel; Krista Boyd, Minority Deputy Director of Legislation/Counsel; Aryele Bradford, Minority Press Secretary; Jennifer Hoffman, Minority Communications Director; Julia Krieger, Minority New Media Press Secretary; Juan McCullum, Mi- nority Clerk; Jason Powell, Minority Senior Counsel; Brian Quinn, Minority Counsel; Dave Rapallo, Minority Staff Director; Daniel Roberts, Minority Staff Assistant/Legislative Correspondent; and Mark Stephenson, Minority Director of Legislation. Chairman ISSA. The committee will come to order. The Oversight Committee exists to secure two fundamental prin- ciples: first, Americans have a right to know that the money Wash- ington takes from them is well spent and, second, Americans de- serve an efficient, effective Government that works for them. Our duty on the Oversight and Government Reform is to protect these rights. Our solemn responsibility is to hold Government account- able to taxpayers, because taxpayers have a right to know what they get from their Government. It is our job to work tirelessly in partnership with citizen watchdogs to deliver the facts to the (1) VerDate Aug 31 2005 10:20 Mar 20, 2014 Jkt 000000 PO 00000 Frm 00005 Fmt 6633 Sfmt 6633 C:\DOCS\87022.TXT APRIL 2 American people and bring genuine reform to the Federal bureauc- racy. It is our mission statement and it is our calling. Today, when we discuss, once again Healthcare.gov rollout, which has undeniably been, and inarguably, a disaster. It is not a disaster of the making of one man or any one person. In fact, in many ways it is a sign of a failed system that is often seen in the Federal Government and very often seen by this committee. Nearly two months after the Federal website launched, even as the Administration declares its vast improvements, components of the back end are still unfinished. Customers are told that at least in some cases, many cases, their applications may not have been correctly forwarded to the insurance carrier, meaning they have signed up; they are not going to get the benefit. They may go to the hospital and not be covered. Or, if they are covered, it will only be after weeks, months, or years of paperwork. Additionally, it is now learned that the ability to properly pay insurance companies is in doubt and, as a result, estimates are likely to occur. Estimates not how you do business. The project’s failure raises serious questions on what hindrances Government faces when it intervenes in the private market. Presi- dent Obama wisely said that startups, business startups, often have these sort of problems; that these are the nature of private sector startups. The difference here is the private sector wasn’t just starting up; the private sector was fully up. Rather than leveraging the private sector, Healthcare.gov essentially built a whole new layer, a whole new decision process on top of it. Before October 1st, the President told Americans that purchasing insurance on Healthcare.gov