"It's very seductive when you hear what fancy technology can do," said Kevin Counihan, CEO of the Connecticut exchange. "We didn't think the contractors could get done everything they said they could get done. The time frame was so tight. We though we were better off doing fewer things well."
Like Maryland, Connecticut had a quasi-governmental agency with an appointed board and executive director structure to create and run its exchange. It used some software code written by IBM — the same company that provided key software for Maryland's system.
Connecticut officials said they decided what features were essential to have in place from the start and what could wait. They also quickly addressed problems, such as adding agents when consumers complained about long waits at the call center.
Sharfstein, O'Malley and others have heavily criticized the technology used by Maryland's prime contractor, Noridian Healthcare Solutions, which included software to determine eligibility that was written by IBM. Sharfstein said the "off-the-shelf" technology did not perform as promised and was not easily altered.
In testimony before Congress last week, Sharfstein said Maryland plans to sue contractors and would reimburse the federal government for some of the money spent to build the first exchange if the state recoups.
In turn, IBM and Noridian have blamed state managers and government regulators for many of the problems.
IBM has said that it has worked above its contractual obligations to "overcome the state's failure to properly manage the implementation of the exchange." The Deloitte technology includes IBM software that was customized for the exchanges.
Noridian said in a lengthy statement released Friday that many of its problems stemmed from requirements dictated by state and federal regulations. For instance, federal regulations required users to be locked out of the system after three unsuccessful log-in attempts. Account lockouts were one of the biggest problems with the site.
"With the adoption of the Connecticut exchange platform, Maryland is now pursuing a simpler, streamlined system that does not contain the enhanced capabilities and features that the State demanded of Noridian after contract award, and that led to many of the system problems," Noridian's statement said.
Despite assurances from the O'Malley administration that the Connecticut fix would work, several lawmakers remain concerned that they were not included in the decision-making.
"We've been completely cut out of the loop," said Del. Kathy Szeliga, a Republican from Baltimore County.
She said the O'Malley administration will have "to own this decision. They haven't asked for any input or advice. Clearly, it's not an issue of partisanship. They've cut everybody out of the exchange."
Del. Susan W. Krebs, a Republican from Carroll County, said she doesn't have full confidence the state will succeed in light of how the first exchange crashed.
"They tried to do too much too fast," she said. "They keep talking about the contractors, but there's a lot of blame to go around."
Some legislative leaders and administration officials were briefed about potential problems with Maryland's exchange months before it launched, through a consultant's reports. But major changes in the exchange did not come until after the disastrous launch.
Howard said buying into Connecticut's "exchange-in-a-box" proposal would be the fastest way to get a new website up and running in Maryland. But Maryland declined the offer to have that state develop and run its exchange from Connecticut's servers.
"Technology is just one differentiator among the states that had a greater relative success in implementing their marketplaces versus those that did not," he said. "The clock is ticking. Nov. 15 is fast approaching, and Maryland has no margin for error."
Others agreed that Maryland has to do more than adopt new software to make the exchange work properly.
The keys are good products, good vendors and the less "intangible issue of leadership and oversight," said Sabrina Corlette, senior research fellow and project director at the Georgetown University Health Policy Institute's Center on Health Insurance Reforms.
She added, "I don't want to minimize the value of just plain dumb luck."