Some Marylanders will get nearly two more weeks to enroll in health insurance after a rush of last-minute interest clogged phone lines and overwhelmed staff Sunday, which was to have been the last day to buy plans.

It made for a rough end to what has been an otherwise smooth three months of open enrollment for the exchange, which was a technical debacle the year before. People who don't get insurance through their employers are required to secure insurance through the exchange under the Affordable Care Act.


Enough people got stuck in the system over the weekend to prompt state officials to offer the extension until Feb. 28 for people who began the application process before midnight Sunday.

Most people could easily access the state exchange, but many had questions about enrollment and turned to the call center for help, said Carolyn Quattrocki, executive director of the state exchange. That resulted in a backlog of calls that could not be answered in time for everyone to enroll.

"We realize that some folks may have been unable to complete their enrollment on the last day due to a great increase in call center volume," Quattrocki said.

More than 15,750 people tried to fill out applications Sunday on the state health exchange — nearly triple the daily average during the open enrollment period. The average wait time for people calling for help during the last week of enrollment ballooned to 20 to 25 minutes, compared to waits of six minutes the week before and about two minutes from January to early February.

The decision to extend also was influenced by the fact that other states that run their own health exchanges, as well as those run by the federal government, also decided to give people more time to enroll. People might have gotten confused if Maryland didn't also extend, Quattrocki said.

The call for an extension for an extension gave more fodder to critics who said it highlights the system's weaknesses yet again.

"Unlike websites such as Amazon, where you can buy goods and have them at your house the next day, after more than four years and hundreds of millions of taxpayer dollars, Maryland still has not created a fully functional and efficient exchange," Rep. Andy Harris said in a statement.

Maryland's first enrollment season last year was a public relations and technology disaster. The exchange crashed on its first day and staggered through an extended open enrollment to sign up about 300,000 people in private and public plans, including close to 100,000 who were automatically moved from a bare-bones state health plan into Medicaid, the federal-state program for low-income people.

After enrollment ended, the state scrapped its technology and acquired software used by Connecticut to build a new system in Maryland.

Those who have worked to enroll people have described this year's process as much smoother and essentially glitch-free compared to last year.

Dr. Peter Beilenson, CEO of Evergreen Health Co-op, attempted hundreds of times to enroll last year and got frozen in the system every time. Only 440 small businesses and individuals were able to enroll in plans offered by his company last year. This year about 15,000 individuals and small businesses were able to get insurance with Evergreen as of Feb. 1.

"I went on five or six times, and every time it went smoothly," Beilenson said. "We have not had a single complaint from anybody in our call center."

Through Feb. 14, 253,232 Marylanders signed up for health plans on the exchange, including 113,463 in private plans and 139,769 in Medicaid. People can apply for Medicaid at any time, but private insurance plans are offered only during the enrollment period. Numbers through the end of enrollment will be released Tuesday.

Quattrocki said the extension does not signal problems with the exchange.


"We have been really pleased with the way it has gone," Quattrocki said. "We enrolled a quarter of a million people in three months."

Exchange officials anticipated a surge in applicants in the final week, but Quattrocki said it was larger than expected. Despite 300 call center workers on the clock, it was not enough to handle the more than 8,600 people who called Sunday

Under the Affordable Care Act, every American must get insurance through their employer, a government program like Medicare or through the exchange, or pay a tax penalty.

In 2015, the penalty for not having coverage is 2 percent of gross household income over the federal income tax filing threshold, or $325 per individual, whichever is greater. Those who received subsidies also may have to pay them back if they discover their incomes were higher than they thought.

Beilenson said people should be allowed to switch plans if this is the case. Federal officials would have to decide to allow this to happen.

"We need to allow them to change to plans with a lower subsidy so they wouldn't be hit for the same thing next year," Beilenson said. "They will owe the extra subsidy this year, but it would keep them from facing double jeopardy."