As of Thursday, March 27, 2014
The (Eugene) Register-Guard, March 21:
Gov. John Kitzhaber said in a telephone interview Thursday that he’s ultimately responsible for the failures of Cover Oregon, the state’s online marketplace for private insurance under the Affordable Care Act. But an independent review released Thursday, he said, shows that the information he was getting about the Cover Oregon project was being filtered in ways that kept him mostly in the dark about the scope of the problems. Kitzhaber can’t avoid accountability, but now the governor needs to press for more information — and, possibly, legal action.
Cover Oregon was supposed to begin online enrollment in insurance plans on Oct. 1. More than that, it was intended to connect Oregonians with other state services, providing a comprehensive portal to programs supporting public health and well-being. But nearly six months later no one-stop online insurance enrollments have been completed, and the links to other services may fall by the wayside. The state has registered nearly 50,000 people for private insurance under the Affordable Care Act, but that’s despite Cover Oregon, not because of it.
It will be hard for anyone who’s not an expert in information technology to figure out exactly what went so wrong with Cover Oregon. Maybe that’s the problem right there: Cover Oregon’s development was overseen by people who know all about health care, insurance and government — everything but software. The picture that emerges from the review, prepared by the First Data consulting group, is of a program run by people who put far too much trust in their software contractor, Oracle Corp., ignored or didn’t recognize signs of trouble and couldn’t fix things as Cover Oregon slid toward disaster.
The day he released First Data’s report, Kitzhaber also accepted the resignation of Dr. Bruce Goldberg as director of the Oregon Health Authority. Goldberg will remain as acting director of Cover Oregon until someone new is hired. His departure means that the top three state officials in charge of Cover Oregon have quit or been fired.
Goldberg is a capable and energetic health administrator. It was he, as much as anyone, who secured $1.9 billion in federal grants to set up coordinated care organizations under Oregon’s Medicaid program. But Goldberg was the wrong person to put in charge of a big information technology project.
The First Data report faulted Cover Oregon for lacking a “system integrator,” for poor communications, and for weak contracting processes. Those are all different aspects of the same problem: poor management. Kitzhaber said that Oracle initially indicated that 95 percent of Cover Oregon’s software could be off-the-shelf products. As the project progressed, it became clear that at least 40 percent of the software would need to be custom-made. Cover Oregon’s management was unprepared to make the shift from buying software to building it.
There may be deeper problems, Kitzhaber said. Risk status reports from Oracle differed from those provided by Cover Oregon — the governor has asked Sens. Ron Wyden and Jeff Merkley to ensure that the Government Accountability Office probe now under way investigates those discrepancies. State purchase orders from Oracle were broken into smaller parts, apparently to avoid the review to which larger orders would have been subjected. These matters could indicate something worse than managerial incompetence.
In addition, Kitzhaber has asked Attorney General Ellen Rosenblum to review the First Data report and assess the possibility of legal action against Oracle and other vendors. The GAO probe should also examine Oracle’s performance, the governor said.
The Legislature approved bills last month strengthening the oversight of state investments in technology, and the governor has signed them. Kitzhaber has consulted with Health and Human Services Secretary Kathleen Sebelius about alternate strategies for achieving Oregon’s insurance enrollment goals. These are necessary actions to prevent a recurrence of the problems plaguing Cover Oregon, and to deal with their aftermath.
Kitzhaber noted that First Data had pointed to Cover Oregon’s fractured management structure, with no single person having full authority and oversight.
But there is such a person, or there ought to be — he’s called the governor.