O'Malley says major health exchange problems are fixed

Gov. Martin O'Malley speaks during a news conference about Maryland's health care exchange Thursday, Dec. 12, 2013, in Annapolis.
Gov. Martin O'Malley speaks during a news conference about Maryland's health care exchange Thursday, Dec. 12, 2013, in Annapolis. (Steve Ruark / For The Baltimore Sun)

The state has resolved the nine "major issues" preventing its glitch-ridden health exchange from working, officials said Saturday, a milestone Gov. Martin O'Malley has framed as key to boosting the low enrollment in insurance plans offered under the Affordable Care Act.

While officials cautioned that more repairs are necessary beyond those nine problems, O'Malley said through a spokeswoman that the site "is now functional for most citizens." Praised as a national model during its development, the $107 million online marketplace has been troubled by screen freezes and crashes in the two months since its launch.


The Saturday announcement comes at a critical time for O'Malley, who has been facing increasing criticism over the rollout of Obamacare in Maryland — recently from some in his own party. And though the site has been declared functional, it remains to be seen whether users will feel the same way.

"Color me skeptical," said Del. Justin Ready, a Republican from Carroll County, said. "I've been getting lots of complaints from people."


O'Malley's office did not go into detail about the technical obstacles that remain for the site, but said that the state would step up its marketing efforts to get more users on board before the end of March, when Americans without health insurance face a tax penalty.

The state exchange, with its feuding contractors and prolonged technical problems, could become a political liability if still does not work, political observers said. For most top Maryland Democrats, widespread praise of the effort shifted into silence and quiet disappointment as the exchange struggled after its launch.

"If this continues, at some point for their own political survival, they will have to speak out against it," said Todd Eberly, a political science professor at St. Mary's College.

Some in the party have begun sharpening criticism of the troubled online marketplace. On Friday, two Maryland congressmen urged the state to consider any means necessary to speed progress, including using the federal exchange to reach an estimated 800,000 uninsured residents.


O'Malley and Lt. Gov. Anthony G. Brown, who have staked their reputations on the ability to make the exchange work, might have the most to lose, Eberly said.

Brown has promised a state assessment of what went wrong, but said his focus now is on continued improvement.

"Experts have been working around the clock to address the technical problems and, while we still have a lot of work left to do, more Marylanders are getting quality and affordable care through the exchange," Brown said in a statement Saturday night.

For the first time last week, some Democrats began publicly offering suggestions on how the state should address the problem.

Rep. John Delaney of Montgomery County suggested Friday that the state scrap its system and use the federal government's website, which also had problems for months but is now running smoothly for most people.

"We can have the best policy ideas in the world, but if no one thinks we can execute, no one will trust us to do them," Delaney said, adding that he's not sure state exchange officials are making tangible progress. "I think the Maryland exchange is an example of Democrats not managing well."

Asked about Delaney's comments, Rep. Elijah E. Cummings, a Baltimore Democrat, said that using the federal exchange should be considered if it is a more viable option.

He is among the congressmen on regular phone briefings from O'Malley about the exchange. Minutes after concluding a Thursday call with Maryland's health secretary, Dr. Joshua M. Sharfstein, Cummings said the state needs to show more progress.

"We need to resolve this by any means necessary, as fast as possible, period," Cummings said. "I think they've been doing everything that they can, but I think it's now an appropriate time to even think outside the box — whatever that means."

The federal government has started a probe into what went wrong with its exchange, and Republican Rep. Andy Harris of Baltimore County suggested the inquiry could expand into the failure of state systems built with federal grants.

"Taxpayers in Maryland deserve an answer as to how you could spend that much money and not have a product that solves the problem," he said.

Leaders in the Maryland State House and the governor expect hearings when the General Assembly convenes next month.

House Speaker Michael E. Busch predicted there would be plenty of inquires into the problems with the Maryland exchange because it's "incumbent on us to make sure it works for everybody."

Maryland was among 16 states and the District of Columbia that created their own exchanges rather than use the federal version.

Emails and other documents obtained by The Baltimore Sun show that even before it launched, Maryland's exchange was beset by technical problems — as well as a dispute between prime contractor Noridian Healthcare Solutions and a key subcontractor, EngagePoint Inc. Weeks after the launch, EngagePoint was fired, and the director of the exchange later resigned.

Despite the revelations about widespread problems, most Democratic lawmakers in Annapolis and Washington have not publicly criticized the O'Malley administration and its mission to repair the site.

O'Malley, who appointed Brown as Maryland's point man for implementing the reforms known as Obamacare, said criticism of the state site's failure has been loud and persistent from people frustrated about signing up.

The governor said last week that the state has made enough progress that "we're almost at a point where we can unleash our marketing plan," which was suspended when the system crashed.

The state has kept its goal of signing up 150,000 people in private plans by the tax deadline, March 31. As of Dec. 7, about 5,200 people in Maryland had enrolled in plans through the exchange.

Officials expect close to 100,000 low-income adults to move into the expanded Medicaid program in the new year, and about 17,000 have successfully signed up for that plan through the Maryland exchange.

Like many Democrats in Annapolis last week, Busch continued to express optimism that the exchange could be repaired.

"Everyone, of any political affiliation, has been disappointed with the rollout we've had in the state of Maryland, but we have faith in the administration and the secretary of health to work out all of the kinks," he said.

Even when legislators held hearings this fall, some Democrats said they deliberately held back.

"We understand the kind of pressure and monumental challenge this represents," said Del. Kirill Reznik, a Montgomery County Democrat and member of the House Health and Government Operations Committee. "We're trying to be as productive participants as possible rather than sitting on a panel and grilling people. I'd rather they be fixing the problem rather than sitting before us telling us what they are trying to do."

Sen. President Thomas V. Mike Miller, a Democrat, said public rebukes may have been tempered both because Democrats want the exchange to work and because with so many state agencies, contractors and subcontractors involved, "it gets real confusing who the finger should be pointed at."


A large share of the political blowback has hit Brown, who made leadership on implementing health care reform a central pillar in his campaign for governor.


Brown has been endorsed by much of the Maryland Democratic establishment, but his chief rival for the party nomination has pounced on the rocky rollout of President Barack Obama's signature health care law as a point of attack.

"There are Democrats across the country dancing and dodging what went wrong," Maryland Attorney General Douglas F. Gansler said last week. "No one is living in a fantasy land here. Maryland should have been a leader in this."

Gansler said that highlighting the botched rollout is not criticism of the federal law, which he supports, or of Obama. But he called the problems "embarrassing for our state. ... Places like Kentucky are blowing our doors off."

Senate Minority Leader David Brinkley, a Frederick County Republican, said last week that the public show of support — or the lack of public criticism — belies the private anger he's heard from Democrats.

"I know that behind the scenes, they're furious," Brinkley said. "They have so much at stake because they blindly supported this. ... It's a major, major embarrassment."

Baltimore Sun reporters Meredith Cohn and Luke Broadwater contributed to this article.