Audit: CMS Did Not Always Manage and Oversee Contractor Performance for the Federal Marketplace as Required

The Affordable Care Act (ACA) established health insurance exchanges (commonly referred to as “marketplaces”) to allow individuals and small businesses to shop for health insurance in all 50 States and the District of Columbia (States). For each State that elected not to establish and operate its own marketplace (State marketplace), the ACA required the U.S. Department of Health and Human Services (the Department) to operate a marketplace (the Federal marketplace) within the State. Beginning on October 1, 2013, the Federal marketplace offered private insurance plans, known as qualified health plans, and enrolled individuals in those plans through its HealthCare.gov Web site (Web site) or through other means. However, consumers experienced significant problems accessing the Web site, including slow response times, errors that dropped consumers out of the enrollment process, and unplanned outages that made enrollment difficult or impossible.