The Obama administration brought in a private consulting team to independently assesshow the federal online health insurance enrollment system was developing, according to a newly disclosed document, and in late March received a clear warning that its Oct. 1 launchwas fraught with risks.

The analysis by McKinsey & Co. foreshadowed many of the problems that have dogged HealthCare.gov since its rollout, including the facts that the call-in centers would not work properly if the online system was malfunctioning and that insufficient testing would make it difficult to fix problems after the launch.

The report was provided to The Washington Post by the House Energy and Commerce Committee.

This risk assessment, which was encapsulated in a 14-slide presentation, was delivered to senior White House and Department of Health and Human Services officials in four briefings between March 28 and April 8, the committee said.

HHS Secretary Kathleen Sebelius; Marilyn Tavenner, then acting administrator of the Centers for Medicare & Medicaid Services (CMS); and White House Chief Technology Officer Todd Park attended a session about the report on April 4 at HHS headquarters. Obama health policy adviser Jeanne Lambrew and then-White House Deputy Chief of Staff Mark Childress received a briefing April 8 at the White House.

Rep. Tim Murphy (R-Pa.), who chairs the panel’s subcommittee on oversight and investigations, said the presentation suggests that, in the run-up to its fall debut, the enrollment system was more troubled than administration officials have let on.
“Despite assurances from Secretary Sebelius, Marilyn Tavenner and [CMS official] Gary Cohen that all was well and on track with the launch of the Affordable Care Act, we now have documents dating back to April that call into question the assertions made to this committee,” Murphy said.

The CMS said in a statement that the McKinsey assessment was “part of a standard process to identify potential risks and develop mitigating strategies.” It added that “the review was completed six months before the beginning of open enrollment, was in line with industry best practices and was followed by concrete action to address potential risks — as was intended.”

White House spokesman Eric Schultz said “flags were definitely raised throughout the development of the Web site, as would be the case for any IT project this complex. . . . But nobody anticipated the size and scope of the problems we experienced once the site launched.”

Administration officials noted that the assessment was not a technical review of the Web site’s functionality. They said a number of the recommendations were acted upon, including stepping up communication with states and funneling more resources to in-person helpers and the call center.

The document did not predict whether the project’s problematic design stage would hamper its rollout but instead made it clear that programs of this scale are ideally pursued in a more orderly process, with “significant testing and revision” before they launch.