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Health exchange officials face deadline for repairs

Consumers say website still doesn't work; state officials step up oversight

By Meredith Cohn and Andrea K. Walker, The Baltimore Sun

6:49 PM EST, December 10, 2013

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Even as state officials are racing to meet a self-imposed deadline to fix major glitches with the state's online insurance marketplace, some consumers continued to have problems buying health coverage through the exchange.

Gov. Martin O'Malley pledged to correct the problems by mid-December, and two new state officials have been tapped to lead the exchange after weeks of technical problems and the resignation of its executive director.

But none of that matters to Dan Sauter, who still can't buy a health plan.

The Frederick cashier needs to enroll in a plan by Dec. 23 to have insurance by January, but the online Maryland Health Connection doesn't seem to recognize him despite repeated attempts to provide personal information. He was finally told by exchange representatives to come in person and show his driver's license.

Given his experience, Sauter isn't convinced and said he figures: "My odds of signing up in time are 99.9 percent against."

State officials have stepped up their oversight of the exchange, created under the federal Affordable Care Act, in recent days. The exchange has been plagued for months by infighting among contractors and management problems in addition to the technical issues, according to emails and documents obtained by The Baltimore Sun.

State officials had acknowledged glitches but had given few details of the behind-the-scenes turmoil. On Friday, hours before the resignation of Rebecca Pearce as executive director of Maryland Health Connection, Lt. Gov. Anthony G. Brown took responsibility for the failings but said he'd been kept in the dark about the level of discord.

Brown pledged to more regularly be available to answer questions, and plans a news conference Tuesday with the new leadership of the exchange.

"The Governor and I have been receiving multiple daily reports about the progress of this project," Brown said in a statement Monday. "And with a staff surge and project leadership reorganization in full effect, we are optimistic that we'll continue to improve the website experience for more Marylanders and help all Marylanders access quality affordable health care."

Brown had been tapped by O'Malley to head the health care reform effort in the state, and he has faced criticism from political opponents for the exchange's botched rollout. On Monday, he came under fire for failing to disclose more about his role.

Attorney General Douglas F. Gansler, one of Brown's gubernatorial rivals in next year's Democratic primary, called on the lieutenant governor to make public emails associated with the creation of the exchange website or provide a more specific defense for withholding them.

Brown's office cited executive privilege for not releasing emails sought in a public information request by The Sun. The newspaper asked for emails between Brown and the Maryland Department of Health and Mental Hygiene and Maryland Health Benefit Exchange, the agency in charge of the exchange.

It is unclear how many emails Brown is withholding.

"Lt. Governor Brown failed and now is trying to hide behind executive privilege to avoid responsibility," Bob Wheelock, communications director for the Gansler campaign, said in a statement. Wheelock added that Brown should at least explain why he is claiming executive privilege.

Brown's campaign replied that the attorney general's office "provided the legal direction and advice on this matter to the Health Exchange, just as it does on all public information requests to state agencies."

"It's time for Mr. Gansler to decide if his run for higher office is more important than his oath of office, and its fundamental requirement that he provide honest, impartial and competent legal services to all state agencies," Brown campaign manager Justin Schall said.

Just over 3,700 people have signed up for private plans on the exchange and more than 97,000 are expected to be added to the Medicaid rolls through the exchange by Jan. 1, according to the latest figures. About 800,000 residents are uninsured in the state, and they are supposed to be able to buy coverage on the exchange.

But the exchange crashed on Oct. 1, the day it launched, and has not provided consistent help for users since.

O'Malley said in late November that glitches affecting most people, such as unexplained screen freezes, error messages that don't provide instructions and problems logging in, should be worked out by the mid-December deadline. In the meantime, he said, other work-arounds are in place, such as paper applications.

He said users would likely still experience trouble after mid-December. He likened the expected improvement to clearing Interstate 95 during a snowstorm but not residential side streets.

A spokeswoman for O'Malley noted that progress is being made and enrollment numbers are ticking up at a faster pace each week. Updated totals won't be available until Friday.

An exchange official said that of the nine major fixes targeted by O'Malley, three have been resolved and work continues on the remaining six. Four are expected to be resolved this week.

"Our IT and operations teams have made progress on the key tasks that need to be addressed to help more Marylanders get health coverage, including getting our website working for people to smoothly create accounts, have eligibility determined, and shop for and select plans," said Dori Henry, a spokeswoman for the exchange.

That still may not be good enough, say some providers who have been struggling to sign people up for coverage. Dr. Peter C. Beilenson, director of Evergreen Health Cooperative, said his company has a backlog of almost 1,000 people who want to buy its plans sold on the exchange.

Beilenson said he has tried to access the site 184 times and has seen little improvement from two or three weeks ago.

"It's going to be a huge effort to improve it enough," he said.

"The site is still crashing, and it's happening from when they are creating accounts to when they are verifying IDs to when they are literally hitting the submit button," Beilenson said. "My concern is real people aren't going to be covered Jan. 1 because the exchange isn't operating."

Americans will be fined if they do not obtain coverage by March 31. In Maryland, residents must enroll in a plan by Dec. 23 for coverage to begin the first of the year.

Beilenson did praise state officials for bringing in a tech expert to oversee website fixes.

Isabel Fitzgerald, the state's chief technology officer, was brought in last week by O'Malley administration officials. That shifted major responsibilities from Pearce even before she resigned. Carolyn Quattrocki, a top adviser to O'Malley, also was brought on to replace Pearce on an interim basis.

Officials said Monday they have not worked out an exit package for Pearce, who was hired in 2011 at an annual salary of $175,000.

Exchange officials including Pearce knew about some problems before the launch, according to a recent investigation by The Sun. Critics of the exchange rollout have since called for an investigation into the botched efforts. State officials, including Brown, say they are choosing to focus first on correcting technical problems.

"I will be one of the loudest voices calling for a thorough review," Brown said Tuesday. "Marylanders deserve accountability."

meredith.cohn@baltsun.com

andrea.walker@baltsun.com