Maryland consumers will get an additional eight days to buy health insurance on the state's online exchange after officials announced Friday they would extend enrollment.
The state joined the federal government in giving people more time to make a decision on a health plan as marylandhealthconnection.gov continues to face technical difficulties that include slowness and error messages.
The state exchange is where uninsured Marylanders — estimated to number 800,000 — can buy health plans under the Affordable Care Act. The new deadline for enrollment to receive coverage starting in the new year is Dec. 23. Consumers must buy a plan by March to avoid a penalty.
"I think we are continuing to fix issues with the site," said Health Secretary Dr. Joshua M. Sharfstein. "But more time in general is good for consumers."
The state also announced that once they've enrolled through the exchange, consumers will make their first premium payment directly to insurers, rather than on the site. This will also give technicians more time to improve the website.
"We need to focus on the core issues for the users," Sharfstein said.
Improvements to the site continue and state officials believe people are finding it easier to enroll. Enrollment saw its biggest jump since the exchange opened in October with more than 500 people buying plans in the week ending Nov. 16. A total of 2,253 people have signed up for insurance.
More than 87,000 additional people are expected to get coverage under a Medicaid expansion when they are moved from a state program for low-income people to Medicaid or enroll for coverage on their own.
The enrollment extension is the latest way the state and community groups have tried to deal with problems the website has faced since its launch Oct. 1 when it almost immediately crashed.
Opening of the small-business marketplace was delayed for a second time because of the issues. Initially, it was to launch in October and then January, but now will open April 1.
The Maryland Citizens Health Initiative Education Fund is spending about $400,000 on advertising and staffing of a phone line to help people enroll by patching them to a state call center. Other groups have been trying to sign up people using paper applications.
CareFirst BlueCross BlueShield said this week that it would offer more than 55,500 customers the chance to extend their health care plans for another year, even though the policies don't comply with the federal Affordable Care Act. About 73,000 Marylanders had received non-renewal notices
Advocacy group Health Care Access Maryland welcomed the extended enrollment date.
"With the slow start we had, any extra time is greatly appreciated," said Kathy Westcoat, the group's executive director. "I think people need all the time they can get because it's a lot of information. There are a lot of different plans to select from."
The extra time also will help the group process a backlog of about 1,500 paper applications collected from those seeking insurance while the state's website was slow or down, Westcoat said. Volunteers and staff still need to enter the information into the state's website and follow up with the applicants once the site determines what plans they might be eligible for.
Columbia-based Healthy Howard is planning to extend evening and weekend hours to give people more opportunity to learn about their health care options before the deadline.
"This extra time they've been allowed gives them more time to review the plan options and make a really informed decision," said Christine Hall, Healthy Howard's executive director.
Dr. Peter C. Beilenson, who has started insurance co-op Evergreen Health Cooperative Inc., said the site has gotten better, but his agents remain unable to enroll about 450 people. They still run into frozen screens and verification problems. The site also crashes when people try to sign electronically.
Beilenson said the extension is good and will enable more people to sign up. But it will only help so much if the site doesn't improve, he said.
"A week will be nice if the site is running smoothly, but not highly helpful if it is not," he said.
Sharfstein said technicians have been better able to pinpoint the problems with the website.
"For the user experience we are down to very specific error codes and challenges that users have and the team is moving down the list," Sharfstein said.
Other upgrades allow consumers to email information on health plans to themselves from the electronic application. Enrollees now can save information in the middle of enrollment and come back at a later time. Applications completed over the phone can be linked to an external account for shopping and enrollment.
Westcoat said she has noticed improvements.
"We got off to a slow start, but we are seeing more and more improvements on a daily basis," Westcoat said. "I still don't think we're quite where we need to be, but are definitely in a better spot than we were Oct. 1."
Baltimore Sun reporter Scott Dance contributed to this article.