The train wreck of Maryland's Affordable Care Act insurance exchange should have been no surprise to Gov. Martin O'Malley, Lt. Gov. Anthony G. Brown or anyone else responsible for its creation. That's the unmistakable conclusion from a Washington Post article on Sunday based on not-previously disclosed documents and interviews with key participants. The Post's report fleshes out the story of dysfunction revealed in records obtained last month by The Sun through a public information request and leaves no doubt that state officials were warned repeatedly and in detail that the website was, in one former official's words, "a disaster waiting to happen." The more of the picture we see the clearer it becomes that political considerations trumped prudence — and that Marylanders in need of quality health insurance paid the price.
Much of the Post report by Aaron C. Davis and Mary Pat Flaherty relies on audits, letters, emails and other documents to or from the Portland, Maine-based firm BerryDunn, which was paid $9 million to provide oversight for the development of Maryland's exchange. Among the highlights:
•State Senate President Thomas V. Mike Miller and House Speaker Michael E. Busch were warned in writing as early as Nov. 1, 2012, that key work to coordinate records access by the health exchange had not been completed by the necessary deadlines and that state officials weren't even aware that the deadlines had not been met. What they did to follow up or provide additional oversight of the administration's efforts is unclear.
•In December 2012, BerryDunn warned state officials that the staffing for the project appeared inadequate, that there was no detailed plan for how to complete all the remaining tasks, and that there would be insufficient time to test all the systems before the site was to go live.
•An information technology project manager was hired in February and quit in May out of frustration.
•Amid increasing infighting between contractors, the state flunked a key test in late August when the website crashed in front of federal overseers. On Sept. 13, internal testing revealed the system to be "extremely unstable." Two weeks later, Governor O'Malley and key aides were told about the likely problems of the website. In what turned out to be an overly optimistic assessment, he was told that while people would be able to log onto the system, some would not be able to check their eligibility for subsidies or select plans. He decided to go ahead anyway.
It's hard to imagine that there could have been more warning signs, from the lawsuit between IT contractors to the nearly empty room where programmers should have been working around the clock 12 days before the launch to the fact that it took then-exchange director Rebecca Pearce four tries to log onto the system hours before it went live. Why, then, did Governor O'Malley decide to go forward with the Oct. 1 launch?
We may never get a straight answer to that; on CNN's "State of the Union" on Sunday, the governor called the website a "complex IT challenge [with] ups and downs every step of the way." "There were lots of cautionary lights, lots of red lights, but there were also green lights," he said. Based on what The Post and The Sun have found, it's clear that anyone seeing green lights in this mess was engaged in some serious wishful thinking.
And why might that have been? The most convincing explanation is politics. Governor O'Malley could not have been farther out in front in the effort to implement Obamacare — he held a press conference to announce the first phase of the effort the day after President Barack Obama signed the Affordable Care Act into law. Maryland was the second state to enact legislation setting up an exchange, Lieutenant Governor Brown became a national face of the effort to implement the law, and just two days after Mr. O'Malley gave the final go-ahead to launch, he appeared alongside President Obama to lap up praise for Maryland's efforts.
The documents obtained by The Post and those previously disclosed by The Sun offer myriad explanations for what went wrong, but one email from state Health Secretary Joshua Sharfstein to Ms. Pearce from Sept. 23 provides as succinct an explanation as possible for why the state didn't choose a different course as disaster loomed. Dr. Sharfstein's email, with the subject line "from today's Sun," consisted of nothing more than a single quote from Sen. Barbara Mikulski from a story about her endorsement of Mr. Brown for governor: "On Oct. 1, while we're fighting to save Obamacare, we know that in Maryland we have a health exchange that's ready to go because of Anthony Brown."
Just as much as Republicans have been blinded by their sense that they have much to gain from Obamacare's failure, Democrats, at least in Maryland, appear to have been blinded by their sense that they have much to gain from its success. In both cases, it has been the public that has suffered.
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