Software contractors who built the Patient Protection andAffordable Care Act (PPACA) federal exchange system defended theirwork at a raucous, standing-room-only House hearing Oct. 24 toallow Republicans, who constitute a majority of the House, anopportunity to cast “Obamacare” in the most negative lightpossible.

The hearing was held to highlight the problems faced by thefederal exchange. The federal exchange is mainly designed to servethe 34 states that have refused to open their own exchanges becausetheir leadership is opposed to the basic concept of any federalinvolvement in regulation of health insurance.

The federal site, however, has faced severe complaints frompotential users of inability to log in, lengthy delays, incorrectinformation relayed to insurance companies and other problems. Theadministration has acknowledged that it did not anticipate the hugeresponse to the opening of the site, as well as design problemsthat are impeding people having access to it and signing up forit.

Republicans, none of whom voted for the law when it was passedby Congress in 2010, used their opening statements to point to thefederal exchanges problems as justifying their opposition toPPACA.

For example, in his opening statement, Rep. Tim Murphy, R-Pa.,called the federal exchanges the “ultimate 'cash for clunkers'program.”

Rep. Fred Upton, R-Mich., chairman of the panel, repeatedlysought to elicit from the contractors whether the Department ofHealth and Human Services (HHS), the parent agency, and the Centersfor Medicare and Medicaid Services (CMS), which administers PPACA,approved launching of the site Oct. 1 even though the contractorsexpressed concern to them that the exchanges were not ready forprime time.

Upton said that in hearings held before Oct. 1, “Topadministration officials and lead contractors appeared before thiscommittee, looked us in the eye and assured us repeatedly thateverything was 'on track.'” Upton said. “Except that it wasn't, aswe now know all too well.

So why did they assure us the website would work? Did they notknow? Or did they not disclose? That's what we are looking to findout, with the contractors today, and with Secretary [Kathleen]Sebelius next week.”

Rep. Marsha Blackburn, R-Tenn., a ranking Republican on thecommittee and an outspoken critic of Obamacare, said in her openingstatement that, “These past three weeks of exchange messinessdemonstrate that no member of this body should be a blindcheerleader for the Affordable Care Act and ignore the problemsbefore their very eyes.” She later raised the issue of whether thesite complied with federal health privacy laws.

Republicans did win acknowledgement during questioning of thevendors that some of the source code for the exchange is beingchanged, although it is unclear if that is being done daily orregularly. Vendors also acknowledged that testing of the integratedsystem, put together by a number of vendors, was not done until thelast minute, for example, the last several weeks before launching,although ideally, the vendors testified, that such a complex sitewould undergo months of intensive testing.

Rep. Michael Burgess, R-Texas, a doctor and outspoken opponentof PPACA, is founder and chairman of the Congressional Health CareCaucus. He asked the contractors, “When should we have comfort[that the federal site will be working]?” Texas, which has thelargest number of people without health care insurance in thecountry, has adamantly refused to participate in the exchanges andalso in the expanded Medicaid program, which launches nextmonth.

Told by the contractors that CMS is responsible for getting thefederal exchange in shape, Burgess said, “No one believes thingswill be fixed with answers like this.”

Officials of CGI and Optum/QSSI, two of the key vendors,admitted that “months of end-to-end testing,” not the days or lasttwo weeks before launching, is the industry standard for thecomplex website being used to solicit applications for insurancepolicies purchased to comply with PPACA.

But Democrats on the panel defended the Obamaadministration.

For example, Rep. Jan Schakowsky, D-Ill., said, “Let's worktogether to fix it, not mix it — as we did on Medicare Part D under[President George W.] Bush.”

Rep. Henry Waxman, D-Calif., outspoken ranking minority memberof the committee and its former chairman, criticized theRepublicans for convening the hearing. He said Republicans “havenot shown us that they are trying to make this law work sofar.”

Waxman called PPACA “an enormous success” even as he admitted ithas “a poorly designed website.”

He said that Americans have already saved thousands of dollarsbecause of the law, although he agreed early performance of thewebsite has caused “notable frustration and anxiety.”

Rep. Frank Pallone, D-N.J., the top Democrat on the panel'shealth subcommittee, called it a “monkey court.” He said theRepublican majority has “a dishonest interest in the website'sflaws. Republicans don't have clean hands coming here. Do youreally care? I don't think so.

“Here we go again, another cynical effort by the Republicans todelay, defund or ultimately repeal the Affordable Care Act,”Pallone said. “I'd like to think this hearing is above board andlegitimate, but it's not.”

The contractors responded by saying that they did share risksand concerns with CMS about the viability of the federal exchangesystem, but that CMS ultimately decided to move forward. CherylCampbell, senior vice president of CGI Federal, the leadcontractor, told Upton that CGI is not supposed to share itsopinion on whether to go live or not.

But, in their testimony, the contractors defended their work.“In systems this complex, it is not unusual to discover problemsthat need to be addressed once the software goes into a liveproduction environment,” Campbell said.

She added that, “This is true regardless of the level of formalend-to-end performance testing — no amount of testing withinreasonable time limits can adequately replicate a live environmentof this nature.”

She also said that another contractor was responsible for thetechnology that allowed users to create new accounts and whichcaused the initial bottleneck issues on the site.

Still, Campbell said, CGI is responsible for some of theproblems, too.

“Now, as more and more users have been able to proceed to the(exchange) over the past several days, more individuals haveenrolled in qualified insurance plans,” Campbell said. “However,the increased number of transactions in the (exchange) have causedsystem performance issues (such as slow response times or dataassurance issues) that now need to be addressed through tuning,optimization and application improvements.”

Campbell blames initial problems on the “enterprise identitymanagement” function known as EIDM that serves as the entry portalto the website. The EIDM tool was designed by Optum. Campbell saidit “created a bottleneck that prevented the vast majority of usersfrom accessing” the federal exchange website when it opened.

But, in his testimony, Andrew Slavitt of Optum, which designedthe EIDM tool, said that an unexpected high volume of peopleregistered at the start and overwhelmed the entry portal and otheraspects of the website. “After the launch, Healthcare.gov wasinundated by many more consumers than anticipated,” Slavitt said.“Many of the critical components developed by these multiplevendors were overwhelmed.

Slavitt blamed the government. “It appears that one of thereasons for the high concurrent volume at the registration systemwas a late decision requiring consumers to register for an accountbefore they could browse for insurance products.”

He said the EIDM tool is only one piece of the federalmarketplace's registration and access management system, whichinvolves multiple vendors and pieces of technology. “Toolsdeveloped by other vendors handle critical functions such as theuser interface, the e-mail that is sent to the user to confirmregistration, the link that the user clicks on to activate theaccount, and the web page the user lands on,” Slavitt said.

He also said that by Oct. 8, “even at high levels ofregistration, the EIDM tool was processing those volumes at errorrates close to zero, and continues to do so.” As a result of thiswork, the EIDM tool is keeping pace with demand, Slavitt said.

Lynn Spellecy, representing a third contractor, EquifaxWorkplace Solutions, said its role was providing “real timeverification of income and employment” information submitted byapplicants has worked properly.”

Equifax conducted “multiple load and stress tests” that showedit could process up to 120,000 verification requests per hour ormore, which it estimated as more than any peak period would demand,Spellecy's testimony says.

The hearing was convened as the White House and the HHSacknowledged major problems with the site, and disclosed that theyare bringing in outside resources to deal with the difficulties forconsumers and insurers.