More than 30% of the "back end" infrastructure still remains to be built in the federally-run health insurance exchange marketplace, Henry Chao, the top IT official at the Centers for Medicare and Medicaid Services, testified on Capitol Hill on Nov. 19.

The consumer-facing portions of the site were fully functional on launch but what remains incomplete are back office systems, Chao said.

These systems yet to be built are not needed until 2014, added CMS Spokeswoman Julie Bataille in a daily CMS telephone media briefing, who explained the tools include “financial management, something we call monthly enrollment reconciliation and risk adjustment. … Things we need in order to process payments to issuers. But they are not something that consumers use in their own payment, which works directly to issuers.”

“As we've said before, we've prioritized that essential consumer-facing functionality that needed to be live Oct. 1,” she added. “The other functionality, that financial management functionality, will come online over time.” CMS said they are on track to complete these applications by mid-January which is when they understand it needs to be live.

Oversight hearing

Separately, at the hearing of the House Energy and Commerce Subcommittee on Oversight and Investigations, Chao made it clear that he had no decision-making power in the decision to launch the site on Oct. 1 and all he did was make sure to deliver a product by that launch deadline, as set by CMS Administrator Marilyn Tavenner and others.

In the buildup to what turned out to be a rocky launch, Chao said he never thought the administration wouldn't be ready. Even so, when asked by members of the committee if he wished he had more time before launching the site, Chao said, “That is true of every project I've ever worked on.”

He said that he never requested more time, and “did everything we could to make priorities set to deliver the system on Oct. 1.”


At the hearing, Chao revealed there has been one successful hacking incident into the federal exchange, but citing security concerns, refused to provide details about when this took place or what was accessed. He further said in response to questions there have been attempts to breach the security of the site, but they have been unsuccessful.

Brian M. Kalish and Gillian Roberts are reporters for SourceMedia, the parent company of Health Data Management.

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