Maryland has resolved many of the problems with its new health insurance exchange and more people are signing up, officials said Tuesday, though they acknowledged that a number of glitches remain.
On the same day that a top Obama administration official apologized for the troubled federal health care website, the head of Maryland's system said some state residents are still unable to complete their enrollments online.
Rebecca Pearce, the executive director of the agency responsible for the exchange, had said earlier that changes last week "fixed" Marylandhealthconnection.gov. Users of the site, much like the exchanges run by the federal government for other states, encountered difficulties in buying coverage.
She clarified late Tuesday that technical issues might still prevent some people from enrolling, and said that the state will be looking for ways to improve its site.
"While we have been pleased with the interest in Maryland Health Connection, we have not been satisfied with the performance of Maryland's health insurance website, or with the pace of improvements to the site," Pearce said.
Former Baltimore Health Commissioner Peter Beilenson, who now heads the health co-op Evergreen Health Cooperative Inc., said the technical issues led the co-op to switch its focus from using the exchange to sell its plans to individuals to selling directly to small businesses. Evergreen's insurance plans disappeared from the exchange temporarily last week.
Beilenson said that five people the co-op attempted to sign up Tuesday got through the entire process, but the site crashed when they hit the "enroll" tab.
"It is frustrating," Beilenson said. "We depend on this for our livelihood. Our members can't sign up."
Pearce spoke about the state website as criticism continued of the federal rollout.
Marilyn Tavenner, administrator of the Centers for Medicare and Medicaid Services in Woodlawn, told a congressional committee Tuesday that the website faces "complex technical issues" four weeks after it opened for enrollment.
"We know that consumers are eager to purchase this coverage," she told the House Ways and Means Committee. "And to the millions of Americans who have attempted to use Healthcare.gov to shop and enroll in health care coverage, I want to apologize to you that the website has not worked as well as it should."
The problems persist.
Hundreds of thousands of people who buy insurance on the individual market have received notices that their policies will be canceled or amended — and their premiums on new policies could rise.
The notices follow provisions in the Affordable Care Act that set minimum coverage requirements for plans sold to individuals.
Under the law, policies sold or renewed after Jan. 1 must cover maternity care and mental health. They cannot deny coverage because of preexisting conditions, or charge higher premiums based on gender.
Plans that don't meet such standards are grandfathered in, if they were purchased before the law was signed in March 2010 and not changed since. Plans sold or changed after that date must be upgraded, and could cost more.
These adjustments were a long-expected outcome of the law's attempt to regulate a market that some argue offered shoddy coverage and kept premiums low by discriminating against sick people and other groups. Roughly 15 million people, or 5 percent of the U.S. population, are covered on the individual market.
"It was always expected that once the clock struck midnight on December 31st, that the rules of the game in the individual insurance market would change," said Larry Levitt, a senior vice president and health policy expert at the Kaiser Family Foundation. "And that meant that policies sold under the old rules could no longer be offered."
President Barack Obama had said the insured would not lose their coverage.
"If you're one of the more than 250 million Americans who already have health insurance, you will keep your health insurance," he said last year after the Supreme Court upheld his signature legislation. "This law will only make it more secure and more affordable."
Critics pounced on those comments on Tuesday, accusing the White House and administration officials of deceiving the public.
"The whitehouse.gov website says, if you want to keep the health insurance that you've got, you can keep it, and now they're being told they can't," Republican Rep. Aaron Schock of Illinois said at the hearing Tuesday. "That's a lie."
The White House said the vast majority of insured Americans, who get insurance through their employer or through Medicare or Medicaid, will not see any changes to their plans.
Officials also argued that insurers have some leeway in how and when they alter the plans to meet the new standards. Many are offering new policies and informing consumers that they could be eligible for subsidies through the healthcare.gov site.
In Maryland, the contractor that developed the state exchange is increasing staff and other resources devoted to improving the website.
State health officials said those moves by Noridian Healthcare Solutions will give the exchange website more technology and project management support.
Pearce said Noridian is still working out how much extra staff to devote to the website. The Maryland Health Benefit Exchange agreed to a $67 million contract with Noridian last year.
Pearce said that the "base system" is "steady" and said the state would continue to use Noridian to run the site.
Noridian declined to comment.
State officials received complaints from consumers who wanted to buy coverage on the exchange but said they could not register, browse plans or complete applications.
Pearce has said a high level of interest on the first day caught officials off guard. She said the system had been tested as if 5,000 people were using the site at the same time.
At some points, far more than that have tried to use the site.
Statewide, just more than 3,100 households have signed up for health coverage on the exchange, according to the latest numbers released by the Maryland Health Connection. There are about 800,000 uninsured Marylanders.
Pearce said enrollment at this point. is about what she expected. State officials believe many people will research and browse plans before making a final decision.
Open enrollment under the Affordable Care Act has been extended through March 31, 2014. People who enroll by mid-December can get coverage beginning Jan. 1.
Reuters and the Tribune Washington Bureau contributed to this article.
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