A Maryland congressman, frustrated with the state's troubled health insurance exchange, said Friday that officials should consider abandoning the state website and using the federal government's.
Officials in Gov. Martin O'Malley's administration have been struggling to address problems with the state website that was designed to help uninsured Marylanders obtain coverage. More than two months after its launch, technical problems have kept thousands from applying.
Several Washington lawmakers said they're disappointed in the state's exchange, which now appears to be lagging behind the federal government's effort to repair its own site. And Rep. John Delaney, a Montgomery County Democrat, suggested using the federal site instead.
"Maryland should abandon its exchange and simply use the federal website and exchange that are now working to a high standard," said Delaney, who added that he's not pleased with the pace of the state's repairs.
"I'm confident they can get it fixed," he said, "but I haven't seen evidence like what we saw on the federal side that they're making tangible progress."
Asked about Delaney's comments, Rep. Elijah E. Cummings said health coverage is extremely important to his constituents and noted that many of them are facing a deadline to enroll. The deadline to sign up for coverage that would kick in next year is Dec. 23.
"If going to the federal exchange would get people the access to quality and affordable health insurance -- if that's one of the ideas that might allow people to do that -- then I think we should consider that and any other option," the Baltimore Democrat said.
"By any means necessary, we have got to get this done," Cummings said.
When Congress passed the Affordable Care Act -- better known as Obamacare -- it gave states the option to create their own websites to help people buy private insurance. The provision was a concession to Republican lawmakers who were skittish about a federal takeover of health care.
In all, 16 states and Washington, D.C., decided to create their own exchanges. Maryland, because it embraced the idea of an exchange early, was seen as a national leader in the effort. It has spent more than $70 million of the $107 million planned for setting up the online exchange.
O'Malley has acknowledged the problems with the site and has said he intends to have the bulk of them fixed by mid-December. The state is making progress -- as evidenced by higher enrollment numbers -- but so far only about 5,200 people have obtained private coverage through marylandhealthconnection.gov.
Through a spokesman, O'Malley referred questions about a federal takeover of the site to his state health commissioner, Joshua Sharfstein.
Sharfstein did not directly address questions about that idea.
"Looking forward, of course we are considering all options," he said. "We'll do what we think works best to enroll as many Marylanders as quickly as possible."
It's not clear that turning over the state exchange to the federal government would solve the problem.
Switching systems midstream could potentially open up a new issues, such as how to integrate databases maintained by the private insurers selling policies in Maryland with an entirely different website.
"I don't know why Maryland would make that change unless their site can't be fixed," said Ron Pollack, executive director of Families USA, a health care advocacy group. "It's kind of late for it to be happening."
Delaney stressed that he is simply throwing out a possible solution.
But the comment underscored mounting frustration among Maryland Democrats -- all of whom ardently support Obamacare -- with the pace of enrollment in the state.
Rep. C.A. Dutch Ruppersberger, a Baltimore County Democrat, described the state's effort as "frustrating" and "disappointing" but said that now is not the time to cast blame.
"I'm disappointed in the rollout here in Maryland," he said. "We can start pointing the fingers later and find out exactly what happened."
Under increasing pressure from the public and members of Congress, the Obama administration announced in late October that it would have the federal website mostly operational in a month -- a target it appears to have met, despite some lingering glitches.
Several other state-based exchanges -- notably those in Kentucky, California and New York -- have outperformed the federal website.
Some third-party groups say they are starting to see incremental signs of progress in Maryland's site. Sheila Mackertich, vice president of health reform initiatives at Health Care Access Maryland, said improvements have been made.
But she also warned people against waiting until the last minute to enroll because, she said, the site is unpredictable.
"I certainly wouldn't make an assumption that if I come in on the 21st that I will definitely be able to get through," she said.
The group has signed up nearly 700 people since the site launched Oct. 1, but had expected to help thousands if the system had worked from the first day.
The organization Healthy Howard is also "focused on working with consumers to resolve any outstanding issues that we can in order to meet enrollment deadlines for coverage on Jan. 1," said spokesman Eric Masten.
The group has seen a significant increase in interest and has adjusted staffing and increased office hours in response.
Baltimore Sun reporter Erin Cox contributed to this article.
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