No timetable set to eliminate glitches in health exchange

Maryland Health Secretary Joshua Sharfstein told state lawmakers on Tuesday that he could not say when the state's troubled health exchange website would be free of technical glitches.

Sharfstein told the Senate Finance Committee that state workers hope to get the public marketplace for insurance plans problem-free "as soon as possible," but that the pace of enrollments is still sluggish and "I wouldn't say I'm happy."


Sharfstein, who chairs the Maryland Health Benefit Exchange, declined to speculate on when marylandhealthconnection.gov would be running properly.

"I've learned I have to see it to believe it," he said.


Nearly two months after the exchange went live, enrollment in the private insurance plans at the heart of the Affordable Care Act remains far behind expectations.

As the state and its contractors work to repair the site, lawmakers in Annapolis asked why Maryland's effort, which officials had held up as a model for other states, has not been as successful as those elsewhere.

"We heard we're on an upward trajectory," Senate Minority Leader David Brinkely, a Republican, said after the hearing. "Well, they had no where to go but up."

Of the 90,000 people expected to gain new coverage by January, 84,000 are to be automatically transferred from a state health program to Medicaid.

The state's original goal was to sign up 150,000 people, less than a fifth of the state's uninsured, for private coverage by early March. So far, fewer than 2,500 people have enrolled in private health plans sold through the exchange.

"Obviously, if you look at that, we're not happy," Sharfstein said. He said the state won't undertake marketing efforts to increase enrollment until the website problems are resolved. "We're going to do everything we can to get as many people as we can covered."

Committee Chairman Thomas "Mac" Middleton expressed disappointment.

The Charles County Democrat reminded Sharfstein that when they served together on the Health Care Reform Coordinating Council, they had "homed in on that issue: Is it going to be ready? Is our IT system going to be ready come Oct. 1?

"We were given every assurance that it was going to be."

When the exchange launched at the beginning of October, visitors had trouble logging on and shopping for insurance plans. Some of the same problems that plagued the federal system — overloaded servers and software hiccups — also tripped up Maryland's system.

Sharfstein said more people sign up for coverage each week than did so in the previous week. But he could not predict when the website would be repaired.

"We just need some reasonable assurance that everything's going to be put in place and working," Middleton told him.


Sen. Delores G. Kelley asked if the state could let people browse for insurance plans without forcing them to create an online account, a process that not only bogged down the shopping process but shut some people out of the system.

"I've had a lot of people calling my office because they've been stuck," the Baltimore County Democrat said. "Some are still complaining that they're being asked to register when they want to see what the options are. Some have given up."

Tuesday's hearing was the first convened by state legislators on the rollout of the health exchange.

Maryland invested millions of dollars, much of it in grants from the federal government, in an exchange that state leaders hoped would be at the forefront of efforts nationwide to implement President Obama's signature health care law.

Republicans on Capitol Hill have grilled federal officials on the failure of the national rollout.

On Tuesday, lawmakers relayed concerns that Maryland workers had not responded to complaints quickly.

Carolyn A. Quattrocki, who oversees the Office of Health Care Reform for Gov. Martin O'Malley, apologized for phone calls from lawmakers' offices that had not been returned. She said the office has deployed a worker to deal full-time with complaints from the public, and created a new system to log complaints and make sure each is addressed.

Sen. Katherine A. Klausmeier read what she said was a letter from a constituent whose employer had decided to eliminate health care benefits and cut her part-time hours below the threshold at which the law would require him to provide coverage in the future.

Klausmeier said it was a story she heard repeatedly.

"We as a state can't do anything about it, right?" she asked Sharfstein.

Sharfstein told her the state could not.

Sen. Victor Ramirez asked why exchanges in other states were performing better than Maryland's.

"I wish I knew the answer to that," Sharfstein said.

Sharfstein said some states designed simpler, less ambitious websites, and others built new software from scratch. Maryland attempted to modify existing software.

"We're not spending a lot of time going through the past," Sharfstein said. "We're trying to get everything lined up to get this continually improving."

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