We did have a lot of major media that came into this event and this room has been bursting through the seams. When you go back to the newsroom please insist your editors like you do their job. [applause] thank you for coming we have a special treat for you. Those red tickets, those are for a complimentary beverage that are served over at the bar. Appear they should have been here, seek them out and talk to them. The important part of the conference is about to begin and we want to remind you the audio of all of these presentations will be available on that website. Thank you so much for coming. [applause] one more thing i would like to thank the washington report publisher whos been sitting here and his whole generation of leaders, ralph nader who is here come the Harriet Fulbright and others in this room and the many students that came to. Audience members, exhibitors and advertisers we couldnt have had this without your help. Thank you. Enjoy your drinks. [inaudible conversations] [inaudible conversations] [inaudible conversations] republican president ial candidate ed ed cruise is set to speak with the media ahead of an event later this evening in arizona. We will have his News Conference at 5 45 on cspan. And a look at what you will see tonight at 8 00 eastern across the cspan networks the secretary Ashton Carter sitting down with politico mike allen for a conversation on the military and National Security on cspan. Meanwhile on cspan to be naacp president talks about Voting Rights in the upcoming election to benefit employees and employers. The next 10 p. M. , after words mac with Professor John yoo that examines the growth of the federal government and president ial power during the obama administration. Hes interviewed by victoria the former Deputy Assistant attorney general. It seems obvious the government cant regulate the money that you would use to participate in a constitutional life. So since it simply says since you have the right to free speech particularly as you said during politics when the framers want to protect the right of speech but you cant spend money on the speech using your constitutional right. It chronicles the lives of afghan women in the book with me are afghan women mrs. Bush wrote the introduction which was put out by the george w. Bush institute. Go to booktv. Org for the schedule. Now a look at implementation including recommendations for improving fraud protection, the Senate FinanceCommittee Hearing included testimony from an inspector an Inspector General with the health and Human Service department and an official from the Government Accountability office. This is just over an hour we have a lot on our plate. Its a pleasure to welcome everyone here this morning. Today we will be talking with representatives from the Office Office in the department of Health Office and the department of health and Human Services and from the Government Accountability office about the work with respect to health care. Gov and enrollment in the federal Health Insurance marketplace. We acknowledge the contribution to help the committee perform more accurate and timely oversight. It is no secret ive never been a fan of the socalled Affordable Care act. And as we approach the sixth anniversary and look closely looks closely at how it is working and being implemented, the evidence overwhelmingly shows that i and many others that opposed the law from the beginning have been right all along the facts speak for themselves. Since the hhs and the gao have raised six dozen reports detailing various automation implementation issues demonstrating the areas where the law is falling short they are specific and focused on key operational areas like enrollment controls in the systems issues some of which we hear more about today so lets keep in mind they are not enemies. They are independent watchdogs tasked with the responsibility of objectively assessing what is and what is not working in the federal programs. There is no better record of showing how this has happened and the reports that weve received from these offices. Today we are going to discuss the operation issues related to health care. Gov and problems in the federal insurance marketplace otherwise known as the federal exchange. Lets start with the health care. Gov launch taken within the deployment of of care. Gov and when trying to create accounts and enroll in health plans after numerous inquiries and reports we all know what ultimately caused these performance issues. For example an adequate capacity planning. The centers for medicare and Medicaid Services cut corners and didnt plan for adequate capacity to maintain health care healthcare. Gov and there were problems in the software that were entirely avoidable. The contractors identified the coding in the website but didnt adequately correct them prior to the launch. We saw that they didnt adequately prepare the necessary systems and functions on the website and the supporting systems prior to the initial launch. They also failed to ply and recognize best practices for the System Development which contributed to the problems admittedly since the launch of a taken steps to address the problems including requiring Additional Software quality and awarding a new contract to complete the development to improve the functionality of the key systems. However, many of the problems couldnt have been entirely resolved and continue to cause frustration especially for consumers trying to obtain Health Insurance. I wish we could play all of this down in the problems to the functions of the website. Indeed if this was just an it problem, all of our jobs would be a lot easier. However, the problem with obamacare and federal insurance marketplace in particular the go much deeper. Many of them remain unaddressed. We know that the enrollment controls in the federal marketplace have been an adequate during undercover testing by the gao the federal marketplace approved Insurance Coverage with taxpayerfunded subsidies for 11 out of 12 fictitious phone or online applicants. In 2,014th of the gao applicants, which once again were fake, makeup made up of people with a total of 30,000 of annual advanced premium tax credits plus eligibility for the were insurance costs at the time of the service. These fictitious enrollees maintain subsidized coverage throughout the year even though the gao said very clearly the fabricated documents were no documents at all to resolve the document in the consistencies. One of the subsidies including those in vicious applicants that have paid to the healthcare insurers they nevertheless represent the benefit to consumers for the cost of the government. They did find a cms relies on a contractor charged with document processing to basically uncover and report possible instances of fraud, get gao also found the agency does not require that the contractor has any fraud Detection Capabilities and according to the gao, they havent performed a single comprehensive Risk Assessment in the recommended best practice of the obamacare and enrollment eligibility process. Until such assessment is completed, cms is unlikely to deliver the existing control activities are designed and implemented to reduce the inherent risk to an acceptable level in other words, cms isnt even sure that the Fraud Prevention systems are designed correctly or if they are effective. While it isnt the focus that will be covered by the testimony today, another batter that we have been tracking closely is the oversight of the healthcare. We had a hearing on this topic where we examined a number of financial and oversight explanations for the carrier of the program. Todays report describes the efforts to deal with financial or operations issues including the use of the plan for the coops with problems that may require corrective actions on the oversight. As of november, 2015, they had enough problems that they had to submit to the escalation plan including nine that have discontinued operations. Just last week we heard that yet another one was on the verge of the financial insolvency despite the fact that it had been on a mandated escalation plan. In other words they appear to have failed like every other element of the program. To adequately implement the program is well documented here on the committee and elsewhere and house with so many other parts of obamacare, the highlight of highlighted rhetoric is falling short of reality with nearly half now closed, the failed experiment has wasted dollars and forced them to pay for new insurance with so many now in financial jeopardy i believe cms should work with and not against the states to safeguard the taxpayer dollars. So as always we have a lot to discuss and i look forward from hearing from the officials today so with that, i will turn to the senator for his opening remarks. It is old news that the initial rollout of healthcare. Gov three years ago was botched. It is news that the Inspector General of the health and Human Services department recently said, and i want to quote here. They cover the website for the High Consumer youth within two months and adopted more effective organizational practices. Thats what the Inspector General said that the department recovered the website for High Consumer use within two months. They are looking back at 2013 and 2014 the finance committee will be presented with today. After the launch went badly, some of the best minds in technology were brought in and scrambled to overhaul the system and the exchange was soon up and running at the center for the service is now following up on each of the Inspector Generals recommendations. In the most recent enrollment. For the nearly 10 million americans used healthcare. Gov to sign up for a plan or enroll on dramatically. In my home state which had its own problems close to 150,000 used the website to signup for the plan as of january 302001. That is up by more than 30 compared to last year. The committee will hear an update from the Government Accountability office on what has been called the secret shopper investigation. The general Accountability Office about the study brought the study before the committee in july of last year. On this side of the aisle we dont take a backseat to anybody in fighting fraud and protecting taxpayer dollars. It remains true today. This investigation has not uncovered one single shred of real world of fraud in the market place was built on fictitious characters and with specially created identities, not real consumers or fraudsters. Its true the Government Accountability office found there are sometimes differences between the information on some of these insurance applications and tax forms in the citizenship records, but when it comes to these inconsistencies in peoples data it cant differentiate between fraud and a typo. They do not look the other way when it fights the red flags. The year of the investigation the center of medicaid and medicare services] 100,000 insurance policies because documents didnt match or the mortgage provide. They were nearly 100,000 households. In 2013 the health and Human Services closed more of these and adjusted tax credits. They might take a different view but there is no basis whatsoever for them to ignore problems in their records or leave the door open to fraud. Rather than rehashing old news we ought to be looking at the facts and talking in a bipartisan way about how to move forward together. Insurance is at or near its point in half a century. They get their insurance from their employer, colleagues, premiums climbed. Let me repeat that, for 160 Million People get their insurance declined only 4 . Working age americans and organizations with the existing conditions, 80 Million People or more can no longer be denied insurance. We ought to be pulling on the rope and solving some problems. We look at ways that we can provide even more competition and bring costs down for consumers and a lot in the room look with me at that issue for some time. The real question is whether the Healthcare System is going to be able to afford them. Heres senator grassley has worked very closely with me to put together a bipartisan case study which looked at one blockbuster drug involving hepatitis solving the cost of the blockbuster growth is going to take a lot of hard work. I want to express my appreciation both sides of the aisle to be able to make Real Progress on a huge opportunity for older people in the country and that is protecting the medicare guarantee. While updating the program to look at the great new challenge which is chronic illness i want to thank senator bennett who was out in front of this issue for some time. Is something we didnt know until about an hour ago is the matter of the coop. What we have said is that we want to work in a bipartisan way to improve a variety of sections in the Affordable Care act. The new material which either i or no one on the side do anything about whats available from an hour ago we intend to look at it on a bipartisan basis Going Forward but my work ought to come back to this idea of making Health Care Policy more healthcare policy more accessible and more affordable and for now, and i certainly havent seen this report. Im not going to be participating in any celebration of people suffering because they were tight ebony Congress Congress generally induced economic straitjacket. Thank you mr. Chairman. We are going to introduce todays witnesses, the assistant inspector Inspector General for the evaluation and inspections for the Inspector General. Your career began in the year 2000. She started as an analyst for the evaluation and inspections and later went on to serve as a Senior Adviser where she provided management advice and analysis to the Inspector General and other Senior Executives on the priorities and internal policies and operations afterwards she worked from the 2009 to 2014 as the director of external affairs ended the relationship and in the Relationship Management with the administration. She received her bachelors degree from the university of notre dame and from the university of chicago. The second witness is the director for the Audit Services from the forensics audits and investigations of this team. Turning the gao he served in a variety of positions including the relations and assistant director for Homeland Security and justice. He also served on the congressional details. We are going to see you back here again. Hes also had a number of positions in the private sector including more recently focusing on the Political Risk in the Homeland Security. He received his bachelors degree in International Relations and economics from claremont and in nba from pepperdine university. We want to thank you for coming. We will hear the witness testimony in the order that they were produced. Please proceed with your fiveminute statement. Good morning chairman and other distinguished members of the committee. Thank you for the opportunity to testify today about the office of Inspector Generals case study which examines the management of healthcare. Gov. This is the website consumers use to apply for Health Insurance in the federal marketplace. As it is well known on october 1, 2013, the healthcare. Gov website failed almost immediately upon the launch yet within two months cms have substantially improved the safe performance. How to do such did such a high priority project to start so poorly and held how did the cms turned the website around . The study provides insights into these questions and Lessons Learned to help healthcare. Gov and other federal projects work better. We believe the assessment of the intersection of technology, policy and management can benefit a broad range of federal projects and programs. Our report chronicles the breakdown and turnaround over a fiveyear period. This morning i will summarize the highlights. From the outset, the healthcare. Gov project faced a higher risk of failure. Hi risk of failure. It was technically complex with a fixed deadline and many uncertainties. So hhs and cms made many missteps in its implementation. Most critical was the absence of leadership and overall product responsibility that had a ripple effect. Policy decisions were delayed effecting the decisions and policy and technical staff were in silos and not well coordinated and contract management was destroying type. The changes were not well documented and progress not adequately monitored. This coleman aided and not fully communicating or acting upon m