Case study

HealthCare.gov

No clear leader, warnings ignored

What happened

The US federal marketplace launched badly in October 2013. The inspector general’s case study named the lack of clear leadership as the most critical problem. Too much effort went to policy and too little to the website, and warnings went unheeded. Recovery came through one team and “ruthless prioritization”.

Why it matters

Divided leadership slowed decisions and left tasks poorly defined.

Lessons

• Name one accountable leader.
• Act on warning signs.
• Prioritize ruthlessly in recovery.

Tools for this

• RACI Matrix
• Leading and Lagging Indicators
• Steering Committee

Sources

• HHS OIG, HealthCare.gov: Case Study of CMS Management of the Federal Marketplace (2016)

Last reviewed 2026-11-02. “Why it matters” is our reading of the sources.

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