(Bloomberg) -- The federal government’s Patient Protectionand Affordable Care Act enrollment system has cost about $2.1billion so far, according to a Bloomberg Government analysis ofcontracts related to the project.

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Spending for HealthCare.gov and related programs, including atthe Internal Revenue Service and other federal agencies, exceedscost estimates provided by the Obama administration, the analysisfound. The government’s most recent estimate, limited to spendingon computer systems by the agency that runs the site, throughFebruary, is $834 million.

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See also: PPACAcosts fall as premiums beat forecast

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HealthCare.gov and its associated programs are the main portalfor millions of Americans to sign up for coverage under the PPACA.Spending for the system has been a matter of dispute between theadministration and Republican opponents in Congress, who have triedto block funding for the law.

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“The way in which Obamacare has been rolled out hasbeen very messy,” with spending scattered across dozens ofcontracts, many of them predating the law and amended afterward,said Peter Gosselin, a senior health-care analyst at BGov and leadauthor of study. “One of the reasons it has been implemented in theway it has been, financially, is precisely to deny opponents of thelaw a clear target.”

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The construction of HealthCare.gov involved 60 companies,supervised by employees of the Centers for Medicare and MedicaidServices instead of a lead contractor, according to the inspectorgeneral at the Health and Human Services Department. The projectwas marked by infighting among the contractors, CMS officials andtop officials at HHS, the Cabinet-level department that overseesCMS, according to e-mails released Sept. 17 by the House Oversightand Government Reform Committee.

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Consumer savings

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“Expenditures related to the Affordable Care Act are publiclyavailable and widely known,” Aaron Albright, a spokesman for CMS,said in an email, adding that the law had saved consumers about $9billion in health-care costs so far.

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“CMS takes its responsibility for spending taxpayer dollarsseriously,” he said in an e-mail. “That’s why we’ve movedaggressively to implement extensive contracting reforms, bringingin new leadership to oversee marketplace operations, hiring asystems integrator, and ending our largest contract with CGI andmoving to a new type of contract with Accenture that rewardsperformance.”

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Earlier this year, CMS fired the original contractor for HealthCare.gov, CGIGroup Inc. of Montreal, and hired Accenture Plc for the project. AUnitedHealth Group Inc. executive, Andy Slavitt, who had managedrepairs of the site, was hired as the principal deputyadministrator at CMS. Kevin Counihan, the former chief executiveofficer of Connecticut’s successful state-run insurance exchange,was hired Aug. 26 to manage healthcare.gov.

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Watching costs

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The Medicare agency and independent auditors have had troubletracking the costs of Affordable Care Act programs. The GovernmentAccountability Office, a congressional agency, said in a Sept. 22report that it was “difficult and time consuming” to obtainfinancial information for the Center for Consumer Information andInsurance Oversight, the CMS office that manages many ACA programs,and that it “could not determine the reliability of most of theamounts” CMS provided.

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Albright said CMS has created a task force to track costs of theinsurance exchange and “strategically manage” its futureacquisitions.

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Healthcare.gov opened on Oct. 1 last year and promptlycollapsed, preventing millions of Americans from enrolling incoverage until December, after a frantic repair effort. By April,about 8 million people had initially signed up for privatehealth plans using healthcare.gov or state-runsystems, according to the federal government.

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Plan enrollment

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About 7.3 million people were enrolled in privatecoverage obtained under the Affordable Care Act as ofAug. 15, the CMS administrator, Marilyn Tavenner, said lastweek.

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The BGov analysis is based on contract data compiled by theWashington-based organization, which is a division of Bloomberg LPseparate from Bloomberg News. BGov’s price tag includes severallarge costs left out of the Obama administration’s estimate: $387million in spending for healthcare.gov by the IRS and otheragencies outside the health department; a $300 million contract toprocess paper applications; and spending by CMS after Feb. 28.

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Senator Lamar Alexander, a Tennessee Republican who hasscrutinized the Obama administration’s construction ofhealthcare.gov as the senior Republican on the Health, Education,Labor and Pensions Committee, said the cost of the site exceededthe combined value of his state’s three professional sportsteams.

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Website’s flaws

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Despite the spending, the site “still isn’t secure, doesn’t letpeople easily compare doctors and medications covered by each plan,and has not processed all of the applications from last year’s openenrollment,” he said in an e-mail from a spokeswoman.

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While spending for HealthCare.gov has exceeded officialestimates, the Affordable Care Act is coming under budget in atleast one area: subsidies to help Americans buy insurance.

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The BGov analysis estimates the government will spend $14.9billion through the end of September to reduce premiums for peoplepurchasing Obamacare plans. The administration predictedit would spend more than twice as much: $36.7 billion.

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The discrepancy may be an indication of problems healthcare.govhas experienced communicating with computer systems at healthinsurance companies, Gosselin said. The subsidies are paid directlyto insurers, and there may be a lag for the transfers becausehealthcare.gov’s back-end connections to insurers aren’tcomplete.

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“Round one, the crisis was in the front-end of the system,”Gosselin said. “Round two, it’s going to be in the backoffice.”

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To contact the reporter on this story: Alex Wayne in Washingtonat [email protected]

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Copyright 2018 Bloomberg. All rightsreserved. This material may not be published, broadcast, rewritten,or redistributed.

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