It's not about what needs to be done, it's about finding reliable people to do it, especially when there's all sorts of opportunities for people to funnel it to a "preferred bidder".
If half of them would work outside of the US, people would already be happy. DO’s usability goes down a lot if you don’t have a credit card (you literally pay to be able to pay), and Twilio is quite similar.
The government was immensely paranoid about it, insisting it had to run on site, and be completely configurable by their tech staff, who were not themselves engineers.