Tech measures in healthcare law come under GOP scrutiny

House Republicans pilloried a senior Health and Human Services official over the progress of implementing the Affordable Care Act in an April 24 hearing of an Energy and Commerce subcommittee. Republicans in Congress have been looking to overturn the health care law since it passed, so another bruising hearing is nothing new.

However, Republicans are now beginning to cast their attention to the provision of the law that requires the establishment of online health insurance marketplaces known as exchanges by October 1, the date set for open enrollment under the law.

"Buying health insurance is not like buying a book on Amazon or shoes on Zappos," testified Gary Cohen, director of the Center for Consumer Information and Insurance Oversight, which has a prominent role in establishing the exchanges.

One of the biggest information technology pieces is a Data Services Hub to connect exchanges to a verification service that taps information from the Social Security Administration, the Department of Homeland Security and the Internal Revenue Service. The hub is designed to give insurance applicants quick answers on their eligibility. Cohen said during the hearing that recent successful tests of state systems in the hub constituted, "a major milestone achieved on schedule." Cohen also indicated that the personal data from IRS, SSA, DHS and other systems won't be stored by the exchanges, but will simply pass through for verification purposes.

The security issue was explained in more detail in written responses from Marilyn Tavenner, President Obama's nominee to head the Centers for Medicare and Medicaid Services, to recent questions from senators on the panel overseeing her confirmation. The system uses, "a layered security approach to protect personal information which includes presentation of a secure web interface, use of secure transmission protocols, and validation of identity," Tavenner wrote. The approach is similar to that used in SSA's MyAccount.

The system is designed to be accessed online, although paper enrollment forms are available. One of the biggest challenges facing HHS is reaching out to populations of uninsured Americans to alert them to their eligibility, and to guide them through the application process. The situation is complicated because this population is less likely to have a home computer and a home Internet connection to support the application process. More than two-thirds of uninsured Americans under the age of 65 and the same proportion of Americans with household incomes under $40,000 say they don't have enough information about the how the ACA will affect them, according to a March poll by the Kaiser Family Foundation.

Some Republicans on the Oversight and Investigations subcommittee are concerned that the use of "navigators" -- essentially helpers who try to raise awareness about new insurance offerings under Obamacare, and assist potentially eligible people apply for coverage online -- could itself be a security risk. Subcommittee chairman Rep. Tim Murphy (R-Pa.) wondered if there were special penalties in place to punish navigators who used information from insurance applicants they were assisting for their own purposes. The concern addressed by Murphy and others is that the community groups who apply to work as navigators could use their access, "to pad their membership rolls or [conduct] funding drives."

So far, the federal government spent $393 million building the exchanges and establishing the Data Services Hub since the passage of the Affordable Care Act. The system is scheduled to be online in September of this year, just ahead of open enrollment. Expect government progress on this front to be a topic of increasing concern to Republicans in Congress as the October 1 deadline approaches. Indeed, Murphy concluded the hearing by thanking Cohen for appearing and said he expected to have him back in the witness chair soon.