Congress hears Tuesday from the senior administration official closest to the implementation of the malfunctioning "Obamacare" enrollment website, with lawmakers set to demand explanations about what she knew about the shaky internet portal's problems and whom she warned before it opened for business nearly a month ago.
President Barack Obama's White House legacy depends heavily on the success of his massive overhaul of the U.S. health care system, which has so far been a deep embarrassment. On Tuesday, members of a powerful panel in Congress will question Marilyn Tavenner, head of the agency tasked with launching the enrollment website that was crippled with technical problems after its Oct. 1 debut.
Lawmakers on the House of Representatives Ways and Means Committee plan to ask not only what went wrong with HealthCare.gov, but also whether lawmakers can trust administration promises to that it will be running efficiently by the end of November.
The administration's bungled rollout of system that promises to provide coverage for millions of uninsured Americans has given an opening to embattled Republicans ahead of next year's congressional elections. The Republican strategy to shut down the government on the day the Obamacare website launched failed to force the president to delay or defund the overhaul and led to record low approval ratings for the party.
With sign-up problems so widespread and persistent, even some Democrats have joined Republicans in calling for a one-year postponement of the law's new mandate that everyone must obtain health insurance or pay a tax penalty. The insurance industry warns that such a delay would saddle the new system with too many high-cost, older patients and too few healthy young people, whose participation is needed to fund the program.
The website was supposed to serve people who don't have a health insurance plan through their employer. Its target audience is not only uninsured Americans but the self-employed who already purchase coverage individually. A companion site for small businesses has also run into problems.
The U.S. has been the only major developed country without a national health care system, and the overhaul was supposed to change that. The system is not the centralized, government-run setup seen in places like Britain. Instead it uses various ways to require or encourage Americans to get private insurance or, for the poor or elderly, government-provided insurance.
Under the law, middle-class people can qualify for tax credits to make private health insurance more affordable, while low-income people will be steered to the established Medicaid program in states agreeing to accept federal money to expand it.
Tavenner's agency, the Centers for Medicare and Medicaid Services, oversees the government programs that provide health care coverage for the elderly and poor, and critics question why it was given the task of launching the website instead of private contractors who have now taken the lead.
Tavenner is less well known than Health and Human Services Secretary Kathleen Sebelius, whose resignation has been demanded by Republicans. Sebelius is likely to face some of the same questions Wednesday when she appears before another powerful House panel, the Energy and Commerce Committee.
Like other administration officials, Tavenner previously had assured Congress that everything was on track for a reasonably smooth launch in all 50 states.
"If people can't navigate such a dysfunctional and overly complex system, is it fair for the IRS to impose tax penalties?" said Ways and Means Chairman Dave Camp. In a concession, the White House has said it will waive Internal Revenue Service-imposed penalties for anyone who signs up by March 31, in effect granting a limited grace period.
Some lawmakers also want assurances about the security of the HealthCare.gov site and unintended consequences from the feverish, hasty work to repair the site.
Momentum to fix the problems has grown since Obama personally acknowledged the problems last week. He sent in management consultant Jeff Zients to assess the situation. By the end of the week, Zients reported that he had two big lists with dozens of needed fixes, and said he was optimistic they could be completed by Nov. 30.
The government also announced that an outside company would assume the role of general contractor shepherding the fixes, in effect taking over the coordination job that Tavenner's agency had been doing.
Although the administration has released a blizzard of statistics on the numbers of people visiting the website, opening accounts and having their income verified by the Internal Revenue Service, it has yet to say how many have successfully enrolled for health insurance.