HealthCare.gov launched untested in 2013 — six Americans enrolled the first day

On 1 October 2013, HealthCare.gov — the portal where Americans in states without their own marketplace were meant to shop for insurance under the Affordable Care Act — opened at 8am Eastern. It buckled within hours under traffic far beyond what its testing had covered; the White House later conceded the faults involved software and system design, not just volume. By the morning of 2 October, internal meeting notes released by Congress show, exactly six enrollments had been completed, across five issuers.

GAO's investigation traced the failure to how the work was bought and managed. CMS issued task orders while core requirements — how many states would participate, how many people would enrol — were still unknown, used cost-reimbursement contracts that paid contractor costs regardless of completion, never produced a required acquisition strategy, and spread the job across dozens of contractors with no single systems integrator in charge.

Warning signs were visible and ignored. In April and November 2013 CMS sent CGI Federal written concerns about product quality; in September officials moved into the contractor's offices to supervise directly. The readiness assessment was pushed from March to September 2013, just weeks before launch, and CMS started the site without verifying it met performance requirements — withholding only about 2% of CGI's fees.

CGI Federal, Serco and Equifax were hauled before Congress within the month. A 'tech surge' of outside engineers, with QSSI (a UnitedHealth Group subsidiary) installed as integrator, got the site working for most users by the end of November, and CMS paid Accenture $91M in January 2014 to continue the build — a figure past $175M by June 2014.

FFM contract obligations grew from $56M to over $209M; the Accenture rescue contract cost $91M rising past $175M; only 6 enrollments on day one.

Task orders were issued while the number of states and expected enrollees were unknown, so requirements churned throughout development.

No end-to-end integration test preceded launch, and the readiness review was rescheduled to just weeks before the deadline.

Dozens of contractors had no single integrator, leaving nobody accountable for performance of the whole system.

Cost-reimbursement terms paid contractor costs regardless of completion, and CMS chose not to withhold fees while launch was at risk.

A legal deadline is not an integration test. When nobody owns the whole system, every contractor can be on schedule while the system is not — and oversight that withholds 2% of fees is not oversight.

The White House's tech surge stabilised the site by the end of November 2013, and first-year enrolment eventually reached the Congressional Budget Office's 7 million projection. GAO's July 2014 report called CMS's planning and oversight ineffective and recommended immediate corrective action; HHS concurred, and the recommendations were closed out between 2015 and 2016 after new contract-monitoring rules. CGI Federal did not keep the work — CMS awarded continued development to Accenture in January 2014 — and the launch became the standard case study in federal IT procurement failure.