| What: | The rollout of HealthCare.gov |
| When: | The website was launched as part of the Affordable Care Act in 2013. |
| Why it matters: | HealthCare.gov was meant to help users sign up for health insurance plans created under the legislation. The failed launch catalyzed a movement that would redefine how government implements technology and give rise to the creation of the U.S. Digital Service. |
Politics
How Healthcare.gov’s botched rollout led to a digital services revolution in government
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The crash of HealthCare.gov in October 2013 sparked a nationwide conversation about how the federal government designs and launches online services to the public.
The website was launched as part of the Affordable Care Act, and was meant to help users sign up for health insurance plans created under the legislation. But the site was unable to handle the large volume of web traffic on the first day of its launch.
But the failure of Healthcare.gov didn’t just spark public outrage — it catalyzed a movement that would redefine how government implements technology, and give rise to the creation of the U.S. Digital Service.
Former USDS Administrator Mina Hsiang served on an ad hoc “tech surge” team in the immediate aftermath of the HealthCare.gov crash.
“What we discovered was there were many people working across different parts of healthcare.gov who knew there was a big problem; who were not really surprised at the outcome. They would tell us ‘We knew that this was going to happen.’ So then the question is- how do you ensure that people with detailed understanding of what is going on have an appropriate voice and are empowered? How do we make sure that leaders are asking the right questions and hearing from the right people? Because that’s clearly not what was happening. It became clear that incentives are not correctly set up for it, and also there weren’t the people with the right expertise in key leadership positions. So our team was a key part of the near-term solution for that.” Hsiang said.
Code for America CEO Amanda Renteria, who was working in the Senate at the time, said the rocky rollout underscored a disconnect between policy and implementation.
The Affordable Care Act, she said, “was this major win for this administration, and then it was hit by this implementation problem that made it very clear that implementation matters.”
“So much of implementation is reliant on how we deliver services, and that is reliant on our infrastructure and technology,” Renteria said.
About a year after the HealthCare.gov crash, the White House launched the U.S. Digital Service, a tech team within the Executive Office of the President.
“In the beginning, the USDS work was a lot like being an EMT. We arrived when something was in crisis and could diagnose and stabilize the situation and take things that were struggling and make them dramatically more successful,” Hsiang said.
But over time, USDS became less reactive and took a more proactive approach to digital services.
“I, during my tenure, worked to continue to evolve the function of USDS, because ideally, you stop having so many emergency situations. You start saying, ‘OK, what would good look like?’” Hsiang said. “Not just rescue, but how can we actually help agencies and the federal government, writ large, understand what true technology-enabled, user-focused, human-focused execution looks like? And that requires expertise in all of these fields – product management, engineering, design, but also contracting.”
USDS started out as a crisis response team to address service delivery challenges. But over time, USDS helped more than 30 agencies deliver a better digitally-enabled experience to the public.
At the height of the COVID-19 pandemic, USDS launched a vaccine finder tool.USDS recently helped the IRS develop Direct File, a free online tax preparation that was piloted in a dozen states in 2024 and expanded to 25 states in 2025.
“When you’re testing things out in government, the scale is so big, the scrutiny is really high, and so the need to be thoughtful is incredibly important, and it’s lasted. When we were rolling out Direct File, people were like, how can this not be like HealthCare.gov?” Renteria said.
‘You can’t do agile in a waterfall world’
Healthcare.gov’s failure exposed the dangers of waterfall-style development, a method of long planning cycles followed by a single, large-scale release. The recovery process for Healthcare.gov underscored how agile software development could work in government.
USDS and the General Services Administration’s 18F tech office began institutionalizing modern development practices — iterative testing, user research and accessibility by design.
“It really challenged traditional wisdom at the time,” said Lindsay Young, a former 18F administrator and founding member of the tech office. “It helped redefine what was safe to do. It turned into a success. I think that really gave wind in the sails for the way forward.”
Jen Pahlka, former U.S. chief technology officer and founder of Code for America, who helped found USDS, said the botched HealthCare.gov rollout also revealed deeper structural problems.
“You can’t do agile in a waterfall world,” Pahlka said. “You could spend a lot of political capital passing a huge, important bill, and that might not matter, if you hadn’t thought about and protected the space for implementing that bill. It’s not just the software that has to be agile. Everything around it — funding, management, contracting — needs to change, too.”
Pahlka said USDS succeeded in planting the seeds of a better way of working, even if it wasn’t always visible.
“What used to be something that USDS did for agencies is now just something agencies do,” she said. “It’s happening behind the scenes, in the dogs that don’t bark — the things that work, that don’t make headlines.”
Pahlka said the government’s ability to deliver benefits and services also has a direct impact on public trust in government.
“People are starting to have delightful experiences, doing things like renewing their passports,” she said. “They assume they’re going to stand in line, and then they don’t have to. That changes how people think about government.”
Rise of DOGE
The work of USDS has changed substantially under the Trump administration. President Donald Trump, soon after taking office in January, signed an executive order creating the Department of Government Efficiency (DOGE), and renamed USDS as the “U.S. DOGE Service.” USDS lost many of its previous employees with the rise of DOGE.
USDS leaders have always championed a culture of cutting through bureaucracy. But the pace of DOGE’s changes gives some pause.
“When people move fast and things break in government, it doesn’t just have real harm to people, but it has a lasting impact on trust in public institutions,” Renteria said.
Young stressed that those working on digital tools within the federal government “have a responsibility to the security and privacy of the public.”
“It’s just so unnecessary to rush things out the door without testing or basic security,” she said.
Amid all these changes, the ideas seeded by USDS endure.
“A lot of the best work is going to be done at the state and local government level,” said Amy Paris, a former USDS team lead. “Where USDS is going to live on is in organizations that are out there actively trying to provide services for the American people.”
Young said the tools and playbooks developed at 18F and USDS continue to guide digital modernization efforts.
“People that we’ve never even met are able to use templates, are able to use best practices playbooks, and USDS put together a lot of good playbooks as well. That kind of knowledge we have just been working on preserving,” she said.
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